Lehigh Valley Health Network LVHN Scholarly Works Patient Care Services / Nursing Bedside Shift Handoff Amelia Bard BSN, RN Lehigh Valley Health Network Tyler McLean BSN, RN Lehigh Valley Health Network Mollie Rohrbach BSN, RN Lehigh Valley Health Network Follow this and additional works at: http://scholarlyworks.lvhn.org/patient-care-services-nursing Part of the Nursing Commons Published In/Presented At Bard, A., McLean, T., Rohrbach, M. (2014, June 5). Bedside Shift Handoff. Poster presented at LVHN UHC/AACN Nurse Residency Program Graduation, Lehigh Valley Health Network, Allentown, PA. This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org.
Bedside Shift Handoff Amelia Bard, BSN, RN Mollie Rohrbach, BSN, RN Tyler McLean, BSN, RN
Background/Significance To implement a change in practice in shift report at ED-CC that will result in improved patient outcomes and nurse satisfaction, while decreasing adverse patient safety incidents.
PICO QUESTION PICO Question written as a question and show the elements (PICO) (P) In adult emergency department patients, (I) will standardizing bedside shift handover (C) as compared to report at the nursing station (O) be effective in decreasing negative patient outomes (i.e. IV infiltrations, medication rate errors, biohazard exposures) and increasing nurse accountability?
TRIGGER? Knowledge v. Problem Trigger: Knowledge deficit at change of shift At change of shift there was an informal handoff that took place only at the nurses station For example: orders not being completed, medications not being given, disorderly rooms, and infiltrated IVs
EVIDENCE Negative Patient Outcomes Nurses able to visual patient at very beginning of shift and end (Reinbeck & Fitzsimons, 2013) Sentinel events occur from communication breakdowns during shift reports (Weigand, 2013) Allows for glance at patient status, IV patency, fall precautions, etc) (Baker, 2010) Nurse Accountability/Satisfaction Bedside reporting promotes accountability and teamwork (Weigand, 2013) More accurate hand off (Evans, D., Grunawalt, J., McClish, D., Wood, W., & Friese, C. R., 2012) Bedside reporting encourages a successful transition to practice environment for nurses (Joshi, Currier, & O Brien, 2011) It is a way to transfer trust between nurses (Baker, 2010)
EVIDENCE Resistance to Change Staff reported bedside handoff took little to no additional time from completing tasks (Cairns, Dujak, Hoffman, & Lorenz, 2013) HIPAA concerns addressed by specifying appropriate in-room comments between nurses (Reinbeck & Fitzsimons, 2013) Initially, staff members were concerned with an increase in length (Reinbeck & Fitzsimons, 2013) Nurses oppose due to report taking too long (Weigand, 2013) Bedside shift report is meant to be fast (Baker, 2010) Patient Satisfaction HCAHPS scores increased (Reinbeck & Fitzsimons, 2013) Patients were more involved in their care and able to identify with their caregivers (Evans et al. 2012) Bedside report integrates patient into healthcare team (Joshi et al., 2011) Patients are more comfortable about the direction of their care and satisfied with the healthcare team (Baker, 2010)
Current Practice at LVHN At LVHN the current standard of practice is to complete bedside shift handoff at every shift change, however it was not always implemented in the past on specific units
IMPLEMENTATION Implementation and staff compliance of Bedside Shift Handoff will: Increase nurse-to-nurse accountability Integrate patients into their own healthcare team Recognize change in patient status Increase nurse satisfaction Catch and/or prevent medical errors
Practice Change Nurses completed pre-survey to include their concerns Staff was educated with a TLC learning module to demonstrate the conduction of a bedside shift handoff, as well as its importance Bedside shift handoff was also demonstrated to the staff by the nurse residents prior to the to Go Live date Nurses will be validated during Go Live time on bedside shift handoff by the residents
RESULTS Nurse residents are currently awaiting the Go Live date in June of 2014 to validate staff and await results of the post-surveys
Implications for LVHN Implications for LVHN include: Increased patient satisfaction RN to RN reliance, respect, and satisfaction Safe practices Improved patient outcomes and care
Strategic Dissemination of Results Poster presentation at nurse residency graduation Staff made aware of progress of the EBP project through frequent e-mails from Deb Greenwood, group facilitator
Lessons Learned Nurse residences learned the process of applying the research of evidence-based practice project to a unit Hopefully, post- Go Live results will show that: RNs of floor learned the importance of bedside shift handoff in their care and how to effectively and efficiently perform bedside shift handoff
References Baker, S. J. (2010). Bedside shift report improves patient safety and nurse accountability. Journal of Emergency Nursing, 36(4), 355-358. Cairns, L., Dujak, L., Hoffman, R., & Lorenz, H. (2013). Utilizing bedside shift report to improve the effectiveness of shift handoff. Journal of Nursing Administration, 43(3), 160-165. Evans, D., Grunawalt, J., McClish, D., Wood, W., & Friese, C. R. (2012). Bedside shift-to-shift nursing report: Implementation and outcomes. Medsurg Nursing, 21(5), 281-292. Joshi, M. S., Currier, A., & O Brien, K. (2011). Bedside change-of-shift reporting: A strategy to increase patient safety. National Patient Foundation. Safety Reinbeck, D. M., & Fitzsimons, V. (2013). Improving the patient experience through bedside shift report. Nursing Management, 44(2), 16-17. Wakefield, D., Ragan, R., Brandt, J., & Tregnago, M. (2012). Making the transition to nursing bedside shift reports. The Joint Commission Journal on Quality and Patient Safety, 38(6), 243-253. Weigand, L. (2013). Customer service: The nursing bundle. Journal of Emergency Nursing, 39(5), 454-455.
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