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Implementation of Bedside Reporting in the OB Department at CRAH
Background
• Shift to shift bedside handoff is considered best practice and can improve patient safety and
quality, patient experience, staff satisfaction and accountability. However, there are many
perceived barriers to implementation that include timing, perceptions of privacy violations, how
to discuss sensitive information and fear of change. Current results from Press Ganey patient
experience found gaps in information and handoff practices from shift to shift. Nurses also
found that they often found discrepancies from report after the las shift had already gone home.
Purpose:• The purpose of this project was to implement bedside report in a structured fashion.
Introduction
Design
Discussion and ConclusionsMethods
Literature Cited
Contact Information
10th Annual Centura Health EBP Research and Innovation Conference
November 10, 2017
Castle Rock Adventist Hospital; Centura Health, Castle Rock, CO
Kathryn Podorsek, RN, MSN
Discussion• 8 months post-implementation the overall percentage of patients reporting that nurses
usually or always do bedside report increased from 29% to 60%.
• Staff and ANM’s needed regular, on-going surveillance to assure that they are consistently
going to the bedside. Without this monitoring they tended to go back to reporting at the
nurse’s station.
• ANM buy in is crucial to the success
• On-going discussions to resolve barriers was crucial to this change
• Elimination of negative Press Ganey comments and addition of positive comments
regarding shift change reinforce the increased perception of higher patient satisfaction
Implications for Practice• Bedside report is a best practice for clinical coordination, communication, patient safety
and quality. However, there are perceived barriers and some resistance to this practice.
This project demonstrated how a structured method of change can ease implementation
and led to higher responses on HCAPS scores. Further work is needed in order to
determine how report lends to better quality and patient outcomes.
Kathryn Podorsek
720-455-0367
Results
Agency for Healthcare Research and Quality (nd). Nurse Bedside Shift Report Implementation Handbook.
Retrieved from
https://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy3/index.html
Setting: 13 bed LDRP unit and 4 bed neonatal intensive care unit in a small community
hospital.
Procedures: Pre and post intervention data was collected from the Press Ganey surveys
returned by patients after discharge. The question: At change of shift my off-going nurse and
oncoming nurse discussed my care at my bedside was used as the indicator for change.
Interventions : The Lean process method was used to search the literature for best practice,
perform a gap analysis that compared the initial state with the target state, create standard
work for bedside report, perform rapid experiments and finally evaluate results.
The target was defined as:
• Increasing bedside report question on PG survey to 90% always or usually
• Eliminating negative Press Ganey comments regarding shift-shift issues by end of
FY2017
Evaluation was conducted on a monthly basis that included reviewing the Press Ganey
surveys and tracking the answer to the question using “never,” “sometimes,” “usually,” or
“always” as well as monitoring comments
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Never
Sometimes
Usually
Always
Initial StateResponse to PG question “At change of shift my off-going nurse
and oncoming nurse discussed my care at my bedside.”
Patient feedback on PG comments:
“there seemed to be no communication between
shifts”
“some difference between shifts & information/care
plan between night & day shift”
“would have like to see a nurse sooner than a few
hours into the next shift”
“…was upset that nurse staff change and initial
nurse did not say goodbye or tell me about new
staff”
• Bedside report takes too long
• Violating HIPAA
• Sensitive information being shared
• Patient sleeping
• Fear of change
Gap Analysis
No comments noted on any survey following implementation