Sample Size and Reliability
According to Sand-Jecklin and Sherman (2014), the patient sample size consisted of a baseline of 233, a three-month sample of 157, and a thirteen-month sample of 154 surveys. The valid and reliable survey tool used was adapted from Larrabee Patient Judgements of Nursing Care with a Cronbach’s alpha scoring of 0.96 (Sand-Jecklin & Sherman, 2014). The nursing sample size consisted of a baseline of 148, a three-month sample of 98, and a thirteen-month sample of 54 surveys (Sand-Jecklin & Sherman, 2014). The valid and reliable survey for nurses was conducted from a review of literature focusing on bedside reporting and reviewed by medical experts such as medical surgical managers and consisted of a Cronbach’s alpha scoring of 0.90 (Sand-Jecklin & Sherman, 2014). Sand-Jecklin and Sherman (2014) state the following:
The 17-item nursing survey contained items such as perceived efficiency and effectiveness of report; perceptions of report helping to identify recent changes in patient status and promote patient safety; whether they felt that report promoted patient involvement in care; the influence of report on nurse mentoring, teamwork and accountability; and perceptions of whether report provided all information needed for patient care. (p. 2857)
This study did a conduction from data analysis of variance between groups using the Dunnett T-3 post hoc comparisons for both pre and post implementation of patient and nurse responses (Sand-Jecklin & Sherman, 2014). Sand-Jecklin and Sherman (2014) found the following:
Responses to ‘report helps prevent patient safety problems’ were significantly more positive at 13 months postimplementation than both baseline and three months postimplementation. The number of...
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...line process and will improve over time, will help with gaining acceptance. For example, Evans et al. (2012) report that in 2007, the average report time is 45 minutes and in 2008, it decreased to 29 minutes.
Conclusion
Bedside reporting has essential benefits for those that reside in private rooms in a long-term care geriatric community. Research data reveals a decrease in falls with adapting to the new practice guideline of bedside reporting. In addition, literature discovered the improvements with communication and satisfaction with patients and healthcare staff over plans of care. In conclusion, if staff will adhere to the new practice guideline of bedside reporting, the staff and patient will notice an improvement in communication and a decrease of falls leading to an overall improvement in safety and quality of care that the geriatric patient will receive.
Hinkle, Janice L, Cheever, Kerry H. (2014). Brunner &Suddarth’s textbook of Medical-Surgical Nursing. Philadelphia: Wolters Kuwer/Lippincott Williams &Wilkins.
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.
Falls in nursing homes residents are associated with morbidity, mortality, and healthcare costs. The centers for Medicare and Medicaid indicate falls as the quality indicator. (Leland, Gozalo, Teno, Mor, 2012). Factors such as new environment, medication, cognition, and non-compliance contribute to falls. A significant number of falls occur from wheelchairs. (Willy, 2013). Newly admitted residents to long-term care facilities are confused with the change. The new environment and the new unfamiliar faces increase the level of anxiety. Pain may also contribute to falls. In order to take tailor made preventative measures, fall risk factors for each resident should be evaluated periodically. Tools scoring risk factors can be utilized.
According to an article in Health Services Research, safety is one of the main reasons that HCAHPS/Press Ganey surveys patients after their hospital stays (Isaac, Zaslavsky, Cleary & Landon, 2010). This positive aspect brought about by HCAHPS/Press Ganey surveys is the re-focus of patient safety, something that should be a top priority and nursing responsibility of all patient care. A direct example of this focus is that if a patient experiences a serious safety event or is harmed by a medical error, his or her overall experience will be negatively impacted. (Isaac et.al., 2010). Cohen (2015) predicts that if the focus of healthcare shifts to the delivery of safe, compassionate, high-quality care, the patient experience and satisfaction with their overall care is likely to rise. There is also evidence that increased patient satisfaction is important for improving patient adherence. How patients perceive the receptiveness of the unit’s hospital staff likely reflects the hospital 's safety culture thus promoting adherence to treatment guidelines (Isaac, Zaslavsky, Cleary & Landon, 2010). Patients are more likely to continue suggested healthy habits and be compliant with their medication if they are satisfied with their healthcare practitioners. Spence & Fida (2015) correlated in their article the relationship between a nurse 's job satisfaction, job retention, and perceived
Implications for nursing practice are as follows. First, the study indicated that additional medical intervention is not always supportive of positive patient outcomes. Instead, it
Beaumont, K., & Russell, J. (2012). Standardising for reliability: the contribution of tools and checklists. Nursing Standard, 26(34), 35-39.
For this practice guideline, the original development panel of six members included; a Chief Nursing Officer, Charge Nurse, Clinical Nurse Specialist, Clinical Practice Facilitator, a Professor from a School of Nursing, and an Education Coordinator. The revision panel members included; a Chief of Nursing & Professional Practice, an Assistant Lecturer from York University, a Clinical Nurse Specialist, Clinical Practice Facilitator, a Nursing Professional Development Educator, an Internist/Geriatrici...
Today health care systems are expected to meet set standards and core measures to earn everything from accreditation and recognition to payment. Reports need to filled to accomplish this, as well as what is being done to improve areas that may not be meeting standards. One way this is done is by utilizing dashboards. The purpose of this paper is to analyze the data from a dashboard and develop a nursing plan for improvement of a low scoring area.
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
Still today, nurse staffing is a crucial health policy issue. Since the 1980s, the nursing profession has taken on more prominence in America with a large focus on research studies. In fact, U.S. Public Law 99-158, Health Research Extension Act of 1985, authorized the National Center for Nursing Research (NCNR) at National Institutes of Health (NIH) (Health Research Extension Act of 1985, 1985). With U.S. Public Law 103-43, NIH Revitalization Act of 1993, the NCNR was formally changed to the National Institute of Nursing Research (NINR) (NIH Revitalization Act of 1993, 1993). The NINR started constructing purposeful research projects, which produced a positive correlation between the number of staff and quality of care. However, the 1996 Institute of Medicine (IOM) report expressed, at that time, no significance between nurse staffing and clients’ outcomes in acute-care hospitals (Institute of Medicine Staff, Davis, Sloan, & Wunderlich, 1996, p. 9).
Wu, A. W. (2011). The value of close calls in improving patient safety: Learning how to avoid
This systems limits patient involvement creates a delay in patient and nurse visualization. Prior to implementation of bedside shift reporting an evidenced based practice educational sessions will be provided and mandatory for nursing staff to attend (Trossman, 2009, p. 7). Utilizing unit managers and facility educators education stations will be set up in each participating unit. A standardized script for each nurse to utilize during the bedside shift report will be implemented to aid in prioritization, organization and timeliness of report decreasing the amount of information the nurse needs to scribe and allowing the nurse more time to visualize the patient, environment and equipment (Evans 2012, p. 283-284). Verbal and written bedside shift reporting is crucial for patient safety. “Ineffective communication is the most frequently cited cause for sentinel events in the United States and in Australian hospitals 50% of adverse events occur as a result of communication failures between health care professionals.” Utilizing written report information creates accountability and minimizes the loss in important information during the bedside shift report process (Street, 2011 p. 133). To minimize the barriers associated with the change of shift reporting process unit managers need to create a positive environment and reinforce the benefits for the procedural change (Tobiano, et al.,
O’Daniel, M., & A.H., R. (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville: Agency for Healthcare Research and Quality. Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK2637/
Davenport, Joan M., Stacy Estridge, and Dolores M. Zygmont. Medical-surgical nursing. 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall, 2008, 66-88.
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia