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Let's Talk Bedside



Credits: None available.

Description

The purpose of this project was to implement a standardized method of beside shift report (BSSR) to improve communication between nurses, patients, and family members, increase patient satisfaction, and decrease the occurrence of reportable nurse key practice indicator (KPI) events. No hospital policy existed for bedside shift reports despite evidence regarding benefits of standardization. Literature highlights bedside handoffs as the only method that involves patients, family members, and nurses (Bradley & Mott, 2013). Roughly 80% of serious medical errors involve miscommunication between caregivers during patient transfer (Mitchell et al., 2017). A standard BSSR tool was needed to perform safety checks during shift change and improve health care team communication. Bedside nurses and managers from 2 medical-surgical units completed a literature review exploring current evidence to create a standard bedside tool to replace previous inconsistent practices. With the tool, nurses included the patient, discussed care plan and fall risk status, and educated on hourly rounding. Nurses verified orders, indication, and removal criteria for central lines or indwelling catheters to prevent infection. Using electronic records, Braden and Hester Davis scores auto-populated for high-risk patients. Nurses completed skin assessments on patients at high-risk for skin breakdown. Nurses trained with the new BSSR tool and pilot units started BSSR on August 1, 2021. Pre-intervention data was collected from July 2020 through July 2021 and post-intervention data from August 2021 through October 2021. Patients were asked “After you pressed the call button, how often did you get help as soon as you wanted?" through the Hospital Consumer Assessment of Healthcare Providers and Systems surveys, measuring staff responsiveness. Staff responsiveness scores increased from the 59th to the 92nd percentile post-intervention, an increase of 56%. Central line-associated bloodstream infection rates decreased from 1.62 to 1.0 events and falls with injuries from 0.35 to 0 per 1,000 patient days. Health care-associated pressure ulcers decreased from 0.33 to 0.19. Standardizing BSSR increased patient safety, improved communication, and decreased the amount of miscommunication-related medical errors. Next steps include hospital-wide standardization to improve patient outcomes and satisfaction and to eliminate inconsistent nursing handoff practices.

Evidence-based references
1. Bradley, S., & Mott, S. (2013). Adopting a patient-centred approach: an investigation into the introduction of bedside handover to three rural hospitals. Journal of Clinical Nursing, 23(13–14), 1927–1936. https://doi.org/10.1111/jocn.12403
2. Mitchell, A., Gudeczauskas, K., Therrien, A., & Zauher, A. (2017). Bedside Reporting is a Key to Communication. Journal of Healthcare Communications, 03(01). https://doi.org/10.4172/2472-1654.100124

Speaker(s):

Credits

Credits: None available.

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Allegra Halyard
9/29/22 10:23 am

I appreciate and enjoyed your poster. I found your poster and research very engaging. At my facility, we instituted a standard bedside reporting process using Illness severity (I), patient summary (P), action List (A), situational awareness and contingency plans (S), and synthesis by the receiver (S) I-PASS, for patient handoff. Along with the handoff standard application, we started an annual competency to ensure it is used properly and effectively, coupled with quarterly audits for competency and compliance. This process is still fairly new, and compliance has been challenging, but we hope to eventually get better. I appreciate your poster because it gives me the opportunity to share your success with my team and hopefully improve compliance. Thnk you

Elizabeth Braam
10/5/22 2:56 am

This was so helpful. I was fortunate to see this in person. You answered all my questions and provided me with so much support, as this is an initiative we are currently trying (and struggling) to implement.