Overcoming Barriers to Nurse Bedside Shift Report

Improving patient safety is critical for healthcare systems, professionals, and also consumers of healthcare services. In 2012, The Joint Commission (TJC) stated that miscommunication between health care professionals during patient hand-offs is a root cause of patient safety incidents. One approach that can be utilized to improve nurse handoff is Nurse Bedside Shift Report (NBSR). Per the Agency for Healthcare Research and Quality (AHRQ) in 2013, NBSR helps to ensure the safe handoff of care between nurses by engaging the patient and family at the bedside and utilizing a structured approach for giving and receiving report. Evidence has shown that NBSR can improve patient outcomes including communication, patient safety, and patient experiences of care. Despite the evidence, NBSR is still not implemented consistently within organizations. This project involved a change in practice regarding NBSR that was previously piloted and disseminated to in-patient care units to standardize and improve patient handoff during RN shift report in an acute care facility. The purpose of the project was to continue to explore NBSR acceptability and sustainability strategies and to evaluate the impact of NBSR on improving quality care indicators of patient satisfaction and fall occurrence data on and between a multi-service medical-surgical unit (MSO) and a medical-oncology unit (MONC). This project embedded strategies noted in the NBSR literature to assist with gaining acceptance and sustainment of the NBSR process. Although patient satisfaction scores and fall occurrence data did not result in statistical significance, valuable narrative feedback was obtained from open-ended questions from a RN survey on the NBSR process. This feedback will help to guide and tailor specific strategies for gaining acceptance and also sustaining NBSR in this acute care facility.