Bedside Hand-off : Enhancing the Patient Experience

Purpose for the program:

Ineffective communication has been cited by The Joint Commission as the root cause of the majority of reported sentinel events. Patient handoff has been identified as a time when the risk of ineffective communication contributes to errors. When report is given at the bedside, there is an opportunity to visualize the patient and include the patient and family in an exchange of information and planning of their care.  Bedside report has been shown to decrease lapses in reported information thus increasing patient safety and satisfaction. Improved nurse efficiency at shift change has been demonstrated while putting the woman, her infant and support system at the center of communication. 

Proposed change:

Shift report has traditionally taken place at the nurses' station with little consistency in content or quality of the information exchanged.  The proposed change moved the shift report to the bedside, utilizing the electronic medical record and incorporating the patient and her support system into the planning of her care.

Implementation, outcomes and evaluation:

The first step was to research best practice regarding shift to shift report and various methods for implementation of such a change.  From this research, a timeline was developed, which included staff and patient education, process development, utilization of tools in the electronic medical record and staff competencies prior to implementation.  "Nurse Champions" volunteered from each shift to act as leaders in bringing this change forward. This was key.  A task force of nursing staff came together to identify challenges and potential solutions during each step of the development and implementation of this process.  All staff received a weekly email prior to implementation which enhanced their understanding of the positive impact of shift report at the patient bedside and kept staff informed of where we were in the process of changing report from nurses' station to bedside.  Staff acceptance and therefore participation in this process was greatly enhanced by education and buy-in prior to implementing bedside report. 

The Nurse Manager on our unit rounds on our patients daily and discusses bedside report as a part of their experience.  To date, no negative issues regarding bedside report have been verbalized by patients.

Implications for nursing practice:

Bedside reporting improves the patient experience by forming a partnership between the patient/family and their caregivers.  In this poster presentation we will share our experience in planning and changing an integral part of our daily routing by moving report to the patient bedside.

Keywords:

bedside report, hand-off, shift, patient safety