Bedside Shift Report to Address Handoff Communication Errors Communication is a vital component of safe, quality health care that takes place between doctors, nurses, patients, and families. The sharing of patient information is especially important during times of patient transfer, patient discharge, and health care provider shift change. Handoff can be defined as the transfer of information, primary responsibility, and authority from one exiting caregiver to another oncoming caregiver (Friesen et al.). The purpose of handoff is to relay essential patient information, promote continuity of care, assure the safe transfer of care of the patient to a qualified and competent nurse, provide patient education, debrief the oncoming staff, plan and …show more content…
Handoffs lacking critical patient information have been directly linked to errors, sentinel events, and near misses by nurses (Taylor, 2015). It is imperative for nurses to receive correct and complete information at the change-of-shift interchange to assess patient needs, plan care, establish goals, and prioritize care in order to provide safe, quality patient care (Dufault et al., 2010). The detrimental effects produced by unsuccessful handoffs can include ineffective or wrong treatment, delay in medical diagnoses, medication errors, wrong-site surgeries, life threatening adverse events, increased length of hospital stay, and even patient death (Foster-Hunt et al., 2015). Additionally, poor communication leads to a lack of trust by patients and their families, frustration from all parties, conflict, wasted time, and a breakdown in interprofessional communication, leading to potential safety violations (Mannix et al., 2017). Therefore, handoff should occur verbally at the patient’s bedside and include the patient and family. Bedside shift report (BSR) is among the most efficient methods for handoff and can be implemented by nursing staff in various hospital
This method uses a correct transfer of medical vital information of the patients during shift change that needs immediate attention, SBAR is achievable for nurses and identification of any error in information transfer process can be possible easily. This technique enhances the communication between health professionals and increase patient
The adoption of clinical information systems is one way that healthcare organizations are making an effort to improve patient safety, provide a means to exemplify regulatory compliance, and facilitate exchange of patient information between care providers (Kirkley & Stein, 2004; Nadzam, 2009). To achieve this goal, Barnes-Jewish Hospital (BJH) recently implemented a new CPOE/clinical documentation system. One of the objectives of the new system was to give bedside clinicians a standardized electronic tool, known as the Clinical Summary, for bedside shift hand-off reporting. Soon after go-live, it was identified that the standard nursing Clinical Summary did not meet specialized the reporting needs of the nurses on the Women and Infants divisions. Consequently, an application enhancement request was submitted. The goal of this project is to synthesize the knowledge gained throughout this Masters Degree program to initiate, plan, and execute changes to the current clinical documentation system to provide a standardized Clinical Summary review screen to meet the specialized hand-off reporting needs of the nurses on the Women and Infants divisions at BJH. This paper includes project objectives, a supporting evidence-based literature review, project methodology, formative and summative evaluation criteria, and a graphical timeline with a narrative description for the Women and Infants Clinical Summary project.
nurses who frequently enhance the communication problems in discharge planning, and who strive to improve the working relationship, collaboration and who use the teamwork approach to patient and family centered discharge planning will greatly reduce patient readmission (Lo, Stuenkel, and Rodriguez, 2009, p. 160). Lo, Stuenkel and Rodriguez (2009) emphasize that an organized and well prepared discharge planning, education of patients with multi-lingual services and use of different methods of teaching greatly improves the patients’ outcome (p.157). These include an experienced and well-taught phone call follow-up sessions after discharge along with ensuring the extension of adequate postoperative care. Another way nurses can deliver a planned discharged teaching is by providing direct checklist for patient and family to follow. One must understand that these approaches will enforce the staff nurses and other health care providers to develop the safe patient transition to home.
7). In an article by Rosalina Butao, RN, MSN, “Hitting Two Birds With One Bullet: Bedside Shift Reporting; “bedside reporting solidifies compliance to the Joint Commission’s 2009 National Patient Safety Goals: improve the accuracy of patient identification, improve communication among caregivers and encourage patient’s active involvement in their own care” all of which improves patient safety (Butao, 2010 p. S50). In a synthesis of literature by Sherman, et al., (2013), patient benefits include the patient being more knowledgeable and involved in their health care, improved the relationship between the nurse and patient, also improving patient satisfaction, as well as patient safety thus decreasing the number of falls, and increasing discharge times (p. 310). Bedside reporting allows the patient and family the opportunity to intervene during
Furthermore, there should be enough trust between the nurses and physicians where they can easily put aside their egos and ask for a second opinion when they have any doubts concerning a patient's safety. This was clearly exemplified when the nursing staff attending to Lewis Blackman failed to contact the physician when various side effects arose; instead they tailored the signs to fit the expected side effects. Even after Blackman’s health was deteriorating, the nurses remained in their “tribes” and never once broke out of it to ask for help. The entire hospital was built on strong culture of remaining in their tribes instead of having goals oriented towards patients care and safety.
The nursing profession is a profession where people put their trust in you to provide care that is not only effective, ethical, and moral, but safe. Not all health situations are simple or by the book. Not all hospitals have the same nurse-patient ratios, equipment, supplies, or support available, but all nurses have “the professional obligation to raise concerns regarding any patient assignment that puts patients or themselves at risk for harm” (ANA, 2009). When arriving at work for a shift, nurses must ensure that the assignment is safe for not only the patients, but also for themselves. There are times when this is not the situation. In these cases, the nurse has the right to invoke Safe Harbor, because according the ANA, nurses also “have the professional right to accept, reject or object in writing to any patient assignment that puts patient or themselves at serious risk for harm” (ANA, 2009).
The end of shift handover nursing report is the time when the off going nurse hands over patient care to the oncoming nurse. During this process critical information about patient’s status and plan of care must be communicated properly. Conducting the shift-to-shift report at the bedside allows patients and families to become involved in their care. It also lets them participate in the sharing of information, which ensures that patient, family and team goals are identified and aligned. Bedside shift-to-shift nursing reports increases patients’ satisfaction, improves the nurse-patient relationship, decreases patient falls, discharge time occurs faster, strengthens teamwork, and leads to better nurse
Nursing staff from an array of specialized backgrounds have identified underperformances and barriers within the handover process which resulted in staff reporting problems and decreased confidence from poor handover practices. The PACT Project, a study conducted in a large-sized Victorian private hospital evaluating handover, identified a clear scope for improvement in the way handovers occurred within the nursing cohort. Key results from the study entailed that only 32% stated that they always received information needed at handover, 94% identified that different nurses give handover in different ways, 85% felt a clear room for improvement in the way nurses communicate, and 60% stated that they would like to deliver handover more effectively. The core underperformances and barriers identified specific to Mater consisted of poor patient identification and lack of discussion within handover, time constraints which placed significant stress, and a more formal and assertive approach in handover training. While, the Mater’s handover process ‘SHARED Framework for Clinical Handover’ is a comprehensive, appropriate and safe clinical communication tool irrespective of clinical setting, several concepts can be integrated to expand on the tool to meet NSQHS Standards and improve patient
Professor Cantu and Class, The first article is, Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Chapter 34 “Handoffs: Implications for Nurses”, this article is applicable not only to my unit, but to every nurse in the profession. It is imperative that the translation of patient information from one person to the next during shift change, patient transfer, or transfer to another facility is clear, accurate, understandable, and complete, conveying all pertinent information about that patient. The article discusses why we have problems with handoffs, and different methods for handoff styles.
Firstly, Nurses must develop the right communication tools when dealing with their patients. For example most nurses do bedside reporting, before they change their shift in the morning, therefore they would be relaying information to the other nurse about the patient they dealt with during the night. The nurse that is going off shift would give a report to the incoming nurse in the presence of the patient. He or she has to discuss the condition of the patient, medications and the procedures so the next nurse would be on the same level. Most nurses in the General Hospital do their reporting by the bedside of their patients.
It helps to improve the communication channel between the staffs and the patients and to increase the nurse accountability (Baker, 2010; Kent, Stevens, Patterson, & Plunkett, 2010). However, I realised that bedside handover may significantly increase the handover duration. Therefore, I started my research in this aspect and I found out that bedside handover did not increase handover duration (Bradley & Mott,
Two main staffing methods that are currently used in most nursing facilities are staffing by patient acuity using patient classification systems and staffing by mandated nurse-to-patient rations. Each method has an impact on patient outcomes, safety and overall satisfaction determined from different articles and studies done on each staffing method. There are pros and cons to each staffing methods. Nursing facilities look at many of these pros and cons when determining staffing methods that are used, cost, patient outcomes, and nursing
In addition, the charge nurse needs to reinforce the safety check among nurses in regular basis. On the other hand, nurses are spending a great amount of time on charting their assessments outside the patients’ rooms. Knowing that every patient room is equipped with a computer, nurses can complete all their nursing risk assessment at the patient’s bedside in order to provide some supervision to the patients especially clients at high risk for falls and injuries. Furthermore, nurses are great educators. Teaching patients how to use their call bell during admission and have the patient demonstrate back is a big intervention to encourage patients to press the call button when help is needed instead of getting out of bed on their
Patients expect instant response to call lights due to today’s technological advancements. This can negatively impact nurse stress and cause contempt toward the patient. However, the expectation to respond promptly improves safety and encourages frequent rounding. Also, aiming for high patient satisfaction scores on the HCAHPS/Press Ganey by fulfilling patient requests can overshadow safe, efficient, and necessary healthcare. Although patient satisfaction is important, ultimately, the patient’s health takes precedence over satisfying patient and family requests, especially when those requests are unnecessary, harmful, or take away from the plan of care (Junewicz & Youngner, 2015). The HCAHPS/Press Ganey survey focuses on the patient’s perception of care. The problem with this aspect of the survey is that the first and foremost goal of nurses should not be to increase a patient’s score based on perception. According to an article in Health Facilities Management, the nurse’s top priority is to provide the safest, most quality care possible for patients with the resources they are given (Hurst, 2013). Once this has been accomplished, the nurse can then help the patient realize that the most
Doctors and other health professionals such as nurses have issues within their offices that trickle down to patients which causes distrust. Most doctors and nurses have so many patients, where the time they have with each patient is limited. Patients come to doctor offices and hospitals to get the equal amount of time and care from these professionals. A study published in the journal BMJ Quality & Safety in May 2013, researcher Heather L. Tubbs-Cooley and colleagues observed that higher patient loads were associated with higher hospital readmission rates. The study found that when more than four patients were assigned to an RN in pediatric hospitals, the likelihood of hospital readmissions increased significantly [3].