Publication Title
Presented at Providence Holy Family Hospital
Document Type
Presentation
Publication Date
11-2024
Keywords
washington; spokane; phfh
Abstract
Implementation of the AHRQ Nurse Bedside Shift Report on a Progressive Care Unit
Objectives:
1. After reviewing this presentation participants will be able to understand how purposeful bedside report was implemented on a progressive care unit (PCU).
2. After reviewing this content participants will understand how bedside report impacted safety events and falls on the PCU.
Purpose/Aims:
Background: Advancing evidence-based practice at our hospital is one of the top priorities of our nursing strategic plan to achieve excellent patient outcomes. The PCU wanted to understand if implementing a nurse bedside shift report would impact safety events and fall rates on their unit, so they conducted a literature review to look for best practices.
The PCU identified the Agency for Healthcare Research and Quality (AHRQ) Nurse Bedside Shift Report tools as a best practice they could implement to improve communication, accountability, and safety, as well as reduce serious safety events such as falls.
Methods/Approach:
Acute care nurses on the PCU worked with their leadership team to set a professional development goal of self-reporting at least 90% compliance with the use of the Nurse Bedside Shift Report. All nurses were provided evidence -based AHRQ education via PowerPoint and tools were shared with the PCU unit-based council and charge nurses. A timeline of expectations was established, and progress was shared via weekly unit newsletters. A preintervention paper survey was administered to nurses (n=40) to gather a baseline percentage of self-reported participation as well as perceived safety events identified during the report process. A midpoint survey was administered to nurses on the PCU (n=30) to understand progress and to address barriers to using the tools. Post implementation surveys will be gathered for final results in December 2024.
Results/Outcomes:
Nurses self-reported a significant increase in participation of bedside shift report collected by midpoint survey data. They further reported reduced frequency of perceived safety events.
Barriers identified: HIPPA concerns for patients who occupied double rooms, patient behaviors, time, family in the room, patients who are sleeping, patient needs during report, and other category for nurse resistance to bedside report.
Self-reported compliance: At midpoint survey collection self-reported bedside report compliance had increased from a mean score of 36.15% to 63.3%, an increase of 27.15%.
Self-reporting concerns for patient safety had decreased from a mean score of 31.52% to 15.3%, a 16.22% reduction. The YTD fall rate has reduced from 2.55 in 2023 to 1.83 in 2024 (awaiting final data).
Conclusions/Implications:
Nurses reported increased compliance and reduced safety concerns during shift change after the implementation of an evidence-based AHRQ Nurse Bedside Shift Report tool. Fall rates were also reduced. The creation of a timeline and overall unit goal was key to success and accountability for this change in nursing practice. Addressing barriers throughout the process allowed leadership to support the team. Consider patient assignments to ease process and mitigate patient behaviors to reduce barriers to compliance. Highlight the importance of Nurse Bedside Shift Report as a partnership to improve patient safety.
Contact Information
Dawn.doud@providence.org
References
Agency for Healthcare Research and Quality [AHRQ] (2024). Preventing falls in hospitals: A toolkit for improving quality of acre. Retrieved November 7, 2024, from, https://www.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/index.html
Guttman, O. T., Lazzara, E. H., Keebler, J. R., Webster, K. L. W., Gisick, L. M., & Baker, A. L. (2021). Dissecting Communication Barriers in Healthcare: A Path to Enhancing Communication Resiliency, Reliability, and Patient Safety. Journal of patient safety, 17(8), e1465–e1471. https://doi.org/10.1097/PTS.0000000000000541
Specialty/Research Institute
Nursing
Specialty/Research Institute
Hospital Medicine
