Increasing Patient Satisfaction and Safety Through Bed Side Reporting

Jodie Gayton, RN Heather McLemore, RN Kateri Pletcher, RN

Statement of the Problem

Historically, nurses have provided change of shift reports to the
oncoming shift at nurses stations or secluded rooms away from the
patients. Little to no patient or family involvement in patient plan of
care during shift change allows for potential gaps in care. Specific
patient problems that are often overlooked include assessments such
as specific wound observation, IV sites, or fluids. Sentinel events such
as falls or rapid condition changes are more likely to occur during
change of shift. Standardization of information provided is not widely
used during reporting and as a result important information can be
overlooked.
The Joint Commissions 2009 and 2010 National Patient Safety Goals
included a requirement to encourage patients to be involved actively in
their care and to implement a standardized handoff communication
process when a change of care providers occurs.

Presentation and critical appraisal of the

evidence
Non bed side reports were noted to be around 35-40 minutes in
length on average, interrupted and disorganized.
Often reports on all patients were given to all nurses in a group
setting.
Surveys that were used in studies: retrospective and prospective.
Likert scales were implemented in surveys.
Surveys and studies were approved by institutional review boards.
Data was analyzed by statisticians and appropriate software.
SBART (Situation, Background, Assessment, Recommendations,
Thanks).

Clinical Question
Does implementing bedside shift reports lead to greater patient
satisfaction with care when compared to traditional shift change
reports at the nurses station?

Suggestions for Future Research

Additional randomized controlled trials.
Meta-analysis of literature.
Further research on pediatric floors.
Standardized report formats for all department types.
Research for optimal ways to wake up patient/family.
Post implementation studies to evaluate continued
effectiveness over several years.
Effective and success program modifications.
Training seminars on management of the implementation.
Appropriate training durations prior to implementation.

Search for Evidence

Studies and research on this topic were located through CINHAL.
The articles were searched for using these terms: bedside
reporting and shift reporting. Results were limited to the last 5 to 10
years. A combinations of 22 research articles, reports and pilot
studies were selected for review. References from articles were
also used to locate and select additional literature. Research
literature covered various nursing practices ranging from pediatrics,
medical/ surgical units, telemetry/cardiology units, mother/baby
units and birthing centers.

Clinical Practice Implications

Promotes patient safety by ensuring bed alarms, bed rails, call
lights, in place, patients are seen sooner.
Timely interventions during shift change especially for rapid
changes in condition, reducing potential sentinel events and
perception that no one is around during shift change.
Provides an opportunity for patients/family to meet oncoming staff,
to ask questions, receive clarification, collaborate and participate in
their plan of care, and correct inaccuracies.
Patients report higher satisfaction ratings that translates into loyal
customers who are more likely to return for follow-up care and
services and evidence shows they are less likely to litigate.
Decreases patient/family anxiety.
Sensitive issues can be handled outside the room prior to entering.
Avoids subjective discussions, chit chat/social time and promotes
staff accountability by visualizing the room and ensuring certain tasks
are completed rather than discovering issues after prior shift has left.
Decreased medication errors by reviewing prior shift medications
and allergies in room.
Nurses report higher satisfaction with reporting, ability to leave on
time resulting in financial savings in terms of overtime since time
spent in report decreases to 2-7 minutes per patient (acuity
dependent).
Provides oncoming nurses faster patient recognition and ability to
prioritize care earlier.
Doctors report satisfaction with nurses able to answer questions
sooner.
Uses a standardized form to communicate such as SBART.