Running head: WORKSHEET FOR SLP 1

Your name:

Anne Waskiewicz

Date:

October 11, 2017

Community or population of interest:

Nurses at the University of Maryland Baltimore Washington Medical Center

Review of literature and health outcomes data:

Patient safety and quality. The Agency for Healthcare Research and Quality (AHRQ)

defines a bedside shift report as a clinical expression of engaging patients and families as

essential partners in the health care team. (Strategy 3: Nurse Bedside Shift Report

(Implementation Guide), n.d.) Historically, hand-off reports took place at the nursing stations, in

the hallway, away from the patient.

According to a 2014 survey conducted by the Agency for Healthcare Research and

Quality(AHRQ), 51% of surveyed individuals agreed with the statement that important

information is lost during shift change. The Joint Commission estimated that 80 percent of

serious medical errors involve miscommunication between caregivers when patients are
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transferred or handed-off. (Mardis, et al., 2016). A study released in 2017 estimated that

communication failures in U.S. hospitals and medical practices were responsible at least in part

for 30 percent of all malpractice claims, resulting in 1,744 deaths and $1.7 billion in malpractice

costs over five years. (Sentinel Event Alert, 2017)

Patient experience of care.

A patients experience within the hospital setting can be terrifying or reassuring. If the

patient or family feel that their needs are falling on deaf ears, the impact on the patients

recovery can be slowed. The patient may experience increased anxiety that may increase the use

of the call lights. The family members may not recommend your hospital to friends or family

members. Research shows patients involvement in their healthcare is linked to improved health

outcomes and enhanced patient safety. (Coulter & Ellins, 2007) The patients experience can

positively or negatively impact the Hospital Consumer Assessment of Healthcare Providers and

Systems (HCAHPS) score and financially impact to the facility.

Effective communication between caregiver to include patient.

Inviting the patient and family to be involved in bedside shift report gives them the

opportunity to hear what has occurred throughout the shift and the next steps in their care.

(Strategy 3: Nurse Bedside Shift Report (Implementation Guide), n.d.)

The benefits of a bedside shift report are a consistent, concise report and a transfer of

accountability and responsibility to the oncoming nurse. It is important to establish a

relationship between caregiver and patient and family members. A bedside shift report helps to

establish a relationship from the start of your shift as well as allows the off-going nurse to close
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the relationship at the same time. The safety of the patient will be enhanced because during the

hand-off you will address questions, concerns, ensure the IV lines are infusing correctly, the bed

alarm is activated as necessary, and verify the patients ID.

Your selected health concern focus:

Consistency of care

An important component of the bedside shift report is the patient. The patient should

be the prime focus of the report. The relationship with my patient and family members begins

as soon as the nurse enter my patients room. The anxiety and fear or concerns are shown to

decrease when the patient feels someone has their best interest at heart. The family members

benefit because they feel reassured they can leave the hospital and their loved one will be safe

and in good hands.

Three possible nursing interventions:

Identify the change makers on the unit.

1. Discuss with colleagues on the unit the upcoming change and get their feedback.

Involve individuals who are passionate about the quality and safety of their patients

care. Encourage interested members to look up evidence based practice articles

regarding bedside shift report and present the results to other members of the team.
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Educate the staff.

Get the word out to the staff. Prior to implementation of the Bedside Shift Report, the

staff will be educated and informed about benefits to the change and details of

implementation.

Various methods include:

Providing announcements in the daily huddles,
Create a tri-fold poster board on the unit in the breakroom,
Post on the hospital intranet,
Email staff,
Present in the hospital education fair
Add some intrigue by posting throughout the hospital, Do you
know what is BSR?
Role play describing the old and new way of shift report, and
Present BSR at general orientation for the new employees
joining your facility

Standardize the process.

Educate the patients and family about what bedside shift report is, what to

expect and how they can participate. Present a tri-fold brochure in the welcome packet.

The staff nurse can give the verbal explanation.

Implement a standardized form. A standardized form will ensure the critical

information will not be missed. If the nurse floats to another unit she will know the

report form and hand-off report are the same throughout the organization.
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Your selected nursing intervention:

Effective communication with caregiver to include patient using a Bedside Shift Report
hand-off

The Service Learning Project was at an Education Fair at the University of Maryland

Baltimore Washington Medical Center on September 8, 2017. One goal of the Education fair

was to educate the staff about the benefits of Bedside Shift Reporting, while the overall theme

of the Education fair was Competency. The Education Fair was open to all employees and

visitors. A second goal was to educate both the night shift and day shift personnel. The event

took place from 5 a.m. to 4p.m, which allowed an opportunity for both shifts to participate.

The main topic presented was Bedside Shift Reporting and the evidence-based practice to

support the implementation and the benefits of performing shift report at the bedside. A third

goal was to reinforce the purpose and benefits of the Bedside Shift Report using a Jeopardy

game format. The game provided a hands-on educational tool which was fun and light-hearted.

The total participants during the education fair numbered over 200.
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Brief plan for conducting nursing intervention:

UM BWMC has a Bedside Shift Report and a Taskforce which facilitates the

monitoring, auditing and reporting of the monthly Bedside Shift Report audits. I will continue

to educate the new employees to our unit. I will hold the three BSR auditors accountable to

completing the audits. We will discuss barriers to the process and collaborate with other

taskforce members at the bi-monthly meeting to modify or change the audit questions.

I will track the quality and safety quarterly reports to see if our communication scores

are improving. I will also ensure the reported data is given to the Director so it can be posted

on the hospital dashboard. I will continue to promote the results and best evidence based

practice during our daily huddles.

I will continue to encourage the staff to go in the room during the shift report. I will let

all nurses know that bedside shift report is an expectation and NOT an option. The taskforce

has compiled a memo that will be completed by the auditor regarding the successes and areas

for improvement to be emailed to the participants and the nurse manager after audit is

complete. I am contemplating the possibility of a recruiting a couple people to be a secret

shopper and evaluate the success of BSR on other units.

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References

2009 National Patient Safety Goals for hospitals. (n.d.). Retrieved from Joint Commission
Resource: http://www.jcrinc.com

Mardis, T., Mardis, M., Davis, J., Justice, E. M., Riley Holdinsky, S., Donnelly, J., . . .
Riesenberg, L. A. (2016, January/March). Bedside Shift-to-Shift Handoffs: A
Systematic Review of the Literature. Journal of Nursing Care Quality, 31(1), 54-60.
doi:10.1097/NCQ0000000000000142

Sentinel Event Alert. (2017, September 12). Retrieved from Joint Commission:
www.jointcommission.org

Strategy 3: Nurse Bedside Shift Report (Implementation Guide). (n.d.). Retrieved from
AHRQ.gov: www.ahrq.gov

UM BWMC-Narrative-Report.pdf. (2014). Retrieved from

http://www.hscrc.maryland.gov/documents