This presentation discusses a quality improvement project aimed at implementing bedside shift reporting. Data was collected and findings showed that nurses were not performing bedside shift reporting or getting to see patients in a timely manner. This increases fall risk, medication errors, and decreases patient, nurse, and physician satisfaction. Root causes identified included a lack of interest and a culture of noncompliance. Evidence supports the benefits of bedside shift reporting for improved satisfaction and safety. A timeline is proposed to educate staff, implement the change, monitor outcomes, and celebrate results. Tools are available from AHRQ to assist with successful implementation.

1. Quality Improvement Presentation:
Bedside Shift Reporting
April 25, 2016
Alexandria El Mokdad
Tarynn Hampton
Taylor Honigford
Brandy Mason
Molly Porterfield
Shelby Weidanz

2. Data Collection
Findings
The majority of the nurses were found not
performing bedside shift reporting, not
getting in to see their patients in a timely
manner, and not filling out the patient
communication boards.
Client Implications:
-Patient fall risk increases
-Risk of medication error increases
-Patient, nurse, and physician
satisfaction are not what they could be!
Where was Report Given?
Nurses
Station
3
Hall
9
Door
10
Room
3
9

3. Were the Boards Filled?
NT
9
13
Who Filled Them?
RN
6
Both
2
Not Filled
4
Data Collection
Complete
9
Partial
11
Not Filled
4
10

4. 7:00-7:30
7
7:30-8:00 8:00-8:30
5
8:30-9:00
44
9:00-9:30
2
After 9:30
3
Data Collection
Time of First Encounter

5. Understanding the Issue
Motivation
One nurse from the unit
said she just doesn’t care
about bedside report.
Burnout
One nurse from the unit
said she just doesn’t have
time to perform bedside
report.
Noncompliance
One nurse from the unit
said, “That is what we are
supposed to do, but
nobody ever does it. I do
it sometimes.”

6. Root Cause Analysis
Lack of Interest
Culture
(Melnyk & Fineout-Overhold, 2010)

7. Our Base of Evidence
Nursing Bedside Clinical
Handover—An
Integrated Review of
Issues and Tools
Bedside Shift-to-Shift
Handoffs: A Systematic
Review of the Literature
A Literature Review of 45 Articles Explored the
Benefits of Implementation of Bedside Shift
Report and Issues Associated with this Practice
A Systematic Review that Demonstrated
Improved Satisfaction or Perceptions with
Patient Care, Quality, and Safety Associated
with Bedside Shift Report

8. Recommended
Changes
• Identify the Goal
• Find EBP Mentors and Change
Champions
• Incorporate Practice as a
Standard
• Monitor the Process and
Outcome Indicators
• Celebrate and Disseminate
Results
(Melnyk & Fineout-Overhold, 2010)

9. Implementing the Change
1. Assess Cost and Staffing
2. Build Multidisciplinary Teams to Find Areas of Improvement
3. Assess Family Presence/Visitation Policies
4. Assess Current Views on Nurse Shift Changes
5. Recognize Challenges in Changing Staff Behavior
6. Set Aims to Implement the Change
7. Identify the Logistics
8. Decide how to Use and Adapt the Tools
9. Implement and Evaluate
10. Implement on More Units!
(AHRQ, 2013)

10. AHRQ: Nurse Bedside Shift Report
Tools Available for Implementation
Checklist
Brochure
Training PowerPoint
Video Examples
Implementation Handbook
http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy3/index.h
tml
(AHRQ, 2013)

11. May Jun Jul Aug Sep Oct Nov Dec
Timeline for Change
Education Implementation of Change
Hospital go-live
Start on Next Unit
(AHRQ, 2013)

12. References
● Agency for Healthcare Research and Quality. (2013). Strategy 3: Nurse bedside shift report. Retrieved from:
http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy3/index.html
● Anderson, J., Malone, L., Shanahan, K., & Manning, J. (2015). Nursing bedside clinical handover—an integrated review of issues and tools.
Journal of Clinical Nursing, 24 (5/6), 662-671, doi:10.1111/jocn.12706
● Barker, S., & Cincinnati Children's Hospital Medical Center. (2013). Best evidence statement increasing -patient satisfaction by moving nursing
shift report to the bedside. Best Evidence Statement (BESt), 170, Retrieved from: http://www.cincinnatichildrens.org/svc/alpha/h/health-
policy/best.htm
● Jeffs, L. Acott, A., Simpson, E., Campbell, H., Irwin, T., Lo, J., Beswick, S., & Cardoso, R. (2013). The value of bedside shift reporting: Enhancing
nurse surveillance, accountability, and patient safety. Journal of Nursing Care Quality, 28 (3). doi: 10.1097/NCQ.0b013e3182852f46
● Mardis, T., Mardis, M., Davis, J., Justice, E. M., Riley Holdinsky, S., Donnelly, J., & ... Riesenberg, L. A. (2016). Bedside shift-to-shift handoffs: A
systematic review of the literature. Journal of Nursing Care Quality, 31(1). doi:10.1097/NCQ.0000000000000142
● Maxson, P.M., Derby, K.M., Wrobleski, D.M., & Foss, D.M. (2012). Bedside nurse-to-nurse handoff report promotes patient safety. Medsurg
Nursing, 21(3), 140-145. Retrieved from: CINAHL Plus Full Text.
● Melnyk, B., & Fineout-Overhold, E. (2010). Evidence-based practice in nursing and healthcare: A guide to best practice, 2nd ed. Baltimore, MD:
Lippincott Williams& Wilkins
● Sand-Jecklin, K., & Sherman, J. (2014). A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation.
Journal Of Clinical Nursing, 23(19/20), 2854-2863.
● Wakefield, Douglas S., Regan, Roland, Brandt, Julie, Tregnago, Megan. (2012). Making the transition to nursing bedside shift reports. The Joint
Commission Journal on Quality and Patient Safety, 38(6), 243-254. Retrieved from: http://www.jcrinc.com/assets/1/14/S1-JQPS-
0612_wakefield.pdf