Reimplementation of a Bedside Shift Report Essay.
Change Proposal Topic: Re-implementation of Bedside Shift Report
Submit Section I – VII of your change proposal, Your rough draft should be in APA format for instructor review and feedback.
Parts I – IV is completed in the paper attached below called rough draft. Please now include parts V – VII to the paper. For instructions of parts V – VII please look at the Capstone guidelines and rubric attached below for what is needed to be done. We made an outline for parts VI – VII which is attached below that can be edited and added to the rest of the rough draft. Part V hasn’t been done yet and also needs to be added. Please be thorough and provide evidence based facts.Reimplementation of a Bedside Shift Report Essay.
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Change Proposal: Reimplementation of a Bedside Shift Report
The identified clinical problem that is relevant to nurses in the workplace is the bedside shift report (BSR). The bedside shift report may be used to help the development of teamwork, ownership, and accountability thus increasing the satisfaction of the nurses. The reason for selecting the reimplementation of a bedside shift report is because; at a targeted facility the implementation of the bedside shift report is becoming poor. This has led to the poor compliance with the standards of practice, and increase costs in the facility. Also, reimplementation of BSR will reduce operational costs by eliminating overtime pay and unnecessary legal fees that arise from preventable compliance errors.
The reimplementation of a bedside shift report is important for the nurses practicing in the organization. Bedside shift report assists in improvingthe experience of the client and improving the handoff care between the nurses through including the family and client in the delivery of care. Bedside shift report is leading to the introduction of a change in the nursing culture i.e. introduction of various methods of communicating patient-specific care at a shift transformation. Shift reports given atthe bedside is helping in changing the manner in which nurses are communicating and practicing (Clark et al., 2020).
At the targeted facility, the execution of the bedside shift report is poor and this is associated to the lack of knowledge concerning the role of bedside shift reporting on the patient outcome. The healthcare providers at the facility are not directly engaged in the provision of healthcare. There is poor communication of the goals of the bedside shift reporting and their importance about the positive outcomes and benefits that are involved in the change (Clark et al., 2020).Reimplementation of a Bedside Shift Report Essay.
According to the study by Gregory et al., (2014), the process of assessing the transformation in practice that involves transitioning of the bedside nurse shift handoffs is important. The evaluation process is helpful in the re-implementation plan to help in improving the areas of weaknesses. The evaluation process of the success in the implementation in the practice is assessing the perception of the nurses about the proposed changes i.e. the re-implementation plans. There is evidence showing the positive impacts of the bedside shift report in the safety of the patient, the control of the pain, the satisfaction of the patients, and improvement in the nurse to patient or nurse to nurse communication (Gregory et al., 2014).Reimplementation of a Bedside Shift Report Essay.
A study by Dempsey et.al. (2014) highlights the necessity of looking at nurse-sensitive indicators such as the impact of nurses’ communication on patient satisfaction, in the process of improving bedside shift reporting. The success of the reimplementation of the bedside shift reporting also depends on the education that is being provided to the nurses. Most of the cases of poor bedside shift reporting in the facility were associated with lack of understanding on its benefits and reasons for its implementation. Since there is no clear understanding of the need for the implementation, most of the nurses are not prepared to fully implement the procedure.Reimplementation of a Bedside Shift Report Essay.
The poor process of implementing bedside shift reporting is associated with a lack of understanding of the importance of such practices. This leads to poor compliance with the necessary set of standards of practice and increases in the cost of healthcare. Therefore, the reimplementation of the bedside shift reporting is necessary to ensure that nurses are informed about the importance of such practices. It also helps in equipping nurses with the knowledge needed towards the implementation of the bedside shift reporting.Reimplementation of a Bedside Shift Report Essay.
My present work environment complies with The Joint Commission principles concerning patient-focused care yet the facility is struggling to improve patient fulfillment scores based on Press Ganey overviews.Several patients treated at the facility indicate that they are not satisfied with the services offered to them. For this reason, my proposal is meant to alleviate the situation through implementation of bedside shift reporting. The proposed change will facilitate effective interaction and coordination between nurses, patients and relatives. By so doing, patients’ experiences and satisfaction scores will improve in the long run. The reason for implementing the bedside shift report is basically to meet patients’ satisfaction by monitoring their wellbeing conditions since they listen to their wellbeing report as medical caretakers change shifts; reduced expenses by removing additional time pay and scrubbing off legal errors which bring about lawful charges, and improving quality of health care by allowing patients and relatives to contribute their emotions on their wellbeing and that of their friends and family (Meyers, 2020).Reimplementation of a Bedside Shift Report Essay.
Justification of Need
During the change of shift report, lack of proper communication has resulted in about 65% of sentinel events (Joint Commission, 2016). With healthcare’s focus shifted to patient-centered care, many concepts and proposals have come about to improve the patient experience. With my facility needing to improve upon patient experience and satisfaction, the goal for my clinical practice project was to implement a change that would positively affect all involved, including the patient and their families, nurses, and the organization.Reimplementation of a Bedside Shift Report Essay.
In this proposal, I decided to use Lewin’s theory of planned change to ensure that my project implementation will be successful and achieve its primary purpose. Lewin’s Theory of Change is straightforward and execute as it centers on changing people’s behaviors. Also, this theory is excellent to influence a change of mentality among employees at the facility. Lewin’s theory of planned change creates awareness about the advantages of accepting change thus it will be effective to promote the reimplementation of BSR. Support from the organization group and key leaders to the nursing staff during the moving and refreezing stages is fundamental for the viability and consistency of the change. As per Lewin’s theory, the first step of implementing the proposed change will be unfreezing. This phase involves creating awareness about the negative implication of the current procedures at the facility. Implementing the proposed change, in this case a reimplementation of BSR, will be the next step. Finally, the last step involves reinforcing the implemented change. This will be done by formulating relevant policy to support the BSR and prevent reverting change. It is an excellent method to bring about a mentality change among employees and creating awareness of the advantages of change.
Our facility’s mission is to care, serve, and heal with a mission to provide world-class care to our patients and community. Right now, there is no standard in nurse handoffs or changes in inpatient care. Every unit unexpectedly performs shift change handoffs. During transitions in care, research shows that patients are being ignored and left unattended (Grimshaw et al., 2016).Patients are avoided from accessing their plan of care, frequently not realizing what prescriptions they are on, what they are going after, where their treatment plan is going. My proposed solution to improve patient perception, experience, and fulfillment was to execute mandatory bedside shift reporting for medical attendants. The objective of the bedside shift is to promote a more patient-centered approach to care (Meyers, 2020).Reimplementation of a Bedside Shift Report Essay.
To implement the plan, education and tip sheets will be provided to every nurse and then each nurse will participate in bedside shift reporting for both day and night shifts.The nursing staff will observe, and assess the impact of implementing bedside shift reporting in both night and daytime shifts.Direct feedback on how the patients felt about the new adjusting process, their preferences of the procedure, and what should be possible contrastingly to improve their experience during a move change has to be recorded. Lastly, I must assess the staff’s thoughts and emotions on bedside reporting and evaluate criticism from the patients with the team and make changes accordingly.
My proposal will engage different healthcare professionals such as case managers, social workers, physical therapists, physicians’ assistants, nurse practitioners, and physicians. My central organizational resource will be the Agency for Healthcare Research & Quality (AHRQ). The agency will align with my hospital’s mission of providing quality care, safer healthcare, affordable, accessible, and equitable care. Also, my plan should comply with standards highlighted by other stakeholders such as the U.S department of health and human services to ensure evidence-based care is the ultimate aim of the program (Grimshaw et al., 2016).Reimplementation of a Bedside Shift Report Essay.
Factors likely to affect the implementation of my recommended activities
Several factors need to be considered when reimplementation of bedside shift report is taking place. One primary thing considered here is the quality of healthcare provided in the facility where the project will roll out. To minimize the number of medical errors, educating, and training all stakeholders within the facility is essential as it will improve hospital operations’ effectiveness. Technology integration and raising funds are other necessary factors need considerations.
Evidence-based rationales to propose how I will address them, incorporating my identified change theory.
With the facility needing to improve upon patient experience and satisfaction, the goal for my clinical practice project is to implement a change that would positively affect all involved, including the patient and their families, nurses, and the organization. Compliance and rounding monitoring will be conducted following evidence-based protocols alongside side Lewin’s change three-stage model. This will sustain the new practice of standardized nurse bedside shift report (Gregory et al., 2014).Reimplementation of a Bedside Shift Report Essay.
My target floor for my project implementation is within the acute care rehabilitation centers. Patients in acute care rehabilitation centers require adequate follow-up care with their health provider team. Technological devices such as telehealth will be used to facilitate care by enhancing follow-up appoints and communication across departments. Telehealth devices are very important to the implementation of the BSR because they facilitate effective communication between patients, nurses, and relatives. Patients in the acute care rehabilitation centers will utilize the devices to present their concerns to their care givers. On the other hand, nurses will utilize the devices to relay crucial information to other attending nurses as well as relatives. Therefore, nurses receiving this project must learn and remain competent with telehealth technological services. Finding a group of health care providers that are willing to start treating patients this way is the first step.Reimplementation of a Bedside Shift Report Essay.
I do understand that implementing BSR changes is not an easy thing, and sometimes changes to take effect takes longer. However, the BSR program will ensure that nurses and other stakeholders are educated on how the new program will operate and how it will benefit patients and their families in reducing BSR medical errors. However, for changes to take effect, approval must be granted by different agencies. Once certification is given, all involved medical staff must receive a copy of the project plan document. Some of the concerned committees are audit and compliance committee, strategic planning, safety and quality, and finance department (Dempsey et al., 2014).
Strategies for building buy-in-among different stakeholders, including nursing
During the change process, case managers, social workers, physical therapists, physician assistants, nurse practitioners, as well as doctors, must be on board. Historically, nurses are stakeholders involved with resistance to change mostly (Gregory et al., 2014).
Financial trends & anticipation of the availability of human resources& project funding.
There will be a financial constraint in implementing telehealth and electronic health record systems during BSR implementation. Mostly, training and educating both nurses and patients will cost money, which the organization will have to be prepared to put into their budget. It would be a financial benefit when the institution strives to remove the cost of readmissions in their plan (Joint Commission, 2016).
Hospital or governmental policy constraints
It would be difficult for patients to work on their insurance policies while still under Medicare or Medicaid programs. It takes a long time while in the hospital to get a policy set into place.Reimplementation of a Bedside Shift Report Essay.
Regulatory acts that need some attention in this project would be the Medicare Access and CHIP Reauthorization Act of 2015 and The Health Information Technology for Economic and Clinical Health Act (HITECH) (Joint Commission, 2016). These two acts will be beneficial in balancing patient’s quality of care with the payment model as they will minimize readmissions rate that will automatically help with reimbursement (Meyers, 2020).
Some factors have to be considered when educating patients about their well-being. Quality of care, according to Meyers (2020), is improved when nurses reduce the readmission rates for a specific population. It means, considering the technology used, family support, language spoken, and reading levels will determine how training and education will be conducted.Reimplementation of a Bedside Shift Report Essay.
Bedside shift-to-shift reportimpliesthepractice of involvingthepatient in the handing over process between nurses, as they are exchangingshifts. Itprovides a chance to careforpatients to takecare of themselves. As a result, thepatient is consideredthecenter of all his or her healthcareactivities. Studies by manyscholarsindicatethatit is thebestsolution to theproblemsassociated with thetraditionalmethods of reporting. Itallowsthepatients to participate in updating their healthcarestatus, medicalstatusandprovision of informationregarding their healthcarerecovery. Thepositiveoutcomes from theadoption bedside shift-to-shift reportincludefinancialsavings, fasterrecovery of thepatientswhilenurses are moreprepared to helpphysiciansattend to thepatients. The bedside reportingprogram can be adopted through three mainsteps in a healthcaresector, which includebuilding a team, identification of thegoals of theprocessandfinally prioritizing its implementation.
Bedside shiftreportrefers to theprocess in which nursesinvolved in attending to thepatientsprovide a shift-to-shift report, which is placed at the bedside of the concerned patient. Thereport is mainlyplacedparticularlyforthepatient to know his or her medicalstatus, andprobablytakecare of his or her healthcare. Itrepresents a shift from thetraditionaltapedmethod, which wasinvolved between thehealthcare providers, to a morepatientinvolvedbed sided shift-to-shift reporting. In thismodel, patients are moreinvolved in their care, status, andotheractivities. In addition, thepatient is alsoinvolved in updating their healthstatus, their medicalplan as well as theinformationregarding their progress in healthrecovery.
In otherwords, thepatient is consideredthecentral to all theinformationregarding his or her healthcareactivitiesandstatus. Theprocessspeeds up thepatient’s recoveryandgives him or her thepeace of mindconcerningthehealthstatus. Besides increasingthepatientinvolvement, bedside shift-to-shift reportingmakesiteasyforthosenursingstarting their shift, to gettherelevantinformation from theoutgoingpatient. Therefore, they can quicklydevelop a priorityforthepatientcare, as well as managingtheload of thepatientattendanceeffectively. In relation to this, thepresentpaper will addresstheimportanceand effectiveness of bedside shift-to-shift report. In relation to this, thepresentpapercarries out a comprehensiveanalysis of the of the bedside shift-to-shift reportingprogram. Theanalysis will be done on thebackground of four articles, relating to bedside shift-to-shift reporting. Thepaper will discusswhetherit should be implementedor not, andthoroughlyexplainthereason behind thedecision. In theanalysis, thepaperprovidesthebackground of theprofessionalissue, literaturereviewand a statement of theprofessionalpoint.
Background of Bedside Shift Report
Thesociety, particularlythoseaffected by healthcareissuesdemand to enjoyandhaveunparalleledaccess to all theinformationtheyneed. Theuse of Healthcare currently has a greatdesire to seek actively forinformation of thevariousdiseaseconditionsandtreatmentprocedures. There is believe in thesociety that access to healthcareinformationhelps to improvethehealthcareoutcomes. Thereason behind it is thatthosepatientswhoare informed about thestatus of their healthcare are likely to be involved in their healthcarerecovery. However, thetraditionalmethod of maintaining andprovision of healthrecordshave not capturedtheaspects of givingthepatientsfullinformationconcerning their healthstatus.
Themedical practitioners involved in differentinformationexchangethe data concerningthepatientprivately. Some of the data transferredincludediagnosis of thepatient, procuresalreadyperformed, theplan of healthcare, the hemodynamic stability of thepatientandanyotherrelevantinformationregardingthepatient. In thiscase, bothpatientand his or her familyare not actively involved in this handing over of theinformation. Thereason is thatmost of thesenursing handing overoccureither at thenursingstationor in a conference, wherenopatients of their familymembers are participants of theinformationbeingexchanged. As a result, moreadvantagesassociated with access to information by thepatientorthefamilymembers are foregone.
However, therecentstudiesproposethattheinvolvement of patientsand their families in theexchange of medicalinformationrelating to thepatient is morebeneficial to thenurses as well as thepatients. It, therefore, raisestheimportance of shifting to thecurrentmethod of sharinginformation with thepatient, under the bedside shift-to-shift records.
Theadoption of the bedside records would, therefore, improvetheinefficientconditions of thetraditionmethod of recordkeeping. It will allowthe incoming nurse to visualizetheprogress of thepreviousnurse in attending to thepatient. It will alsoencouragethepatient to participate in thehealthcareplans, leading to a standardizedcommunication with nurses between theshifts.
Critique of the Literature on Bedside Shift
Asindicated by Grunawalt, McClish, Wood & Friese (2011), theprocess of thepatient handoffs between nurseswhenchanging their shifts is an important clinical nursingpractice. Theprocessensures continued careforthepatient, exchange of thepatient’s information, as well as thepromotingthesafety of thepatients. Asindicated by the 2010 nationalsafetygoals, it is significant to involvethepatients in their healthcare, and implementation of a standardized handoff process of communication, when there is a change of care providers. According to Maxson, Derby, Wrobleski & Foss (2011), the implementation of the bedside shift-to-shift handoff is themostefficientway of facilitatingthepatients’ safetystandards.
Thepatientswhohavebeenintroduced to the bedside reportfeelssaferregarding their healthcarestatus, andtheyappreciatetheintroduction of the incoming newnurse, as well as their plansforhealthcare. In addition, thesepatients can providesubstantialinputs towards their healthcareimprovementsifthey are allowed to participate in the bedside nurse-to-nurse handover.Reimplementation of a Bedside Shift Report Essay.
Grunawalt, McClish, Wood & Friese (2011) found out thatpatientsparticipate in the bedside handoffs iftheyare given a chance to commentandaskquestions during the handoff process.Sherman, Sand-Jecklin, & Johnson (2013) assessedthepatients’ families’ perception towards the bedside handover andtherolethey can play to makeitmoreuseful. Itcreates an approach, which is congruent with thetheory of family-centered care (FCC). FCC implies an innovative process, which involvesplanning, deliveryand evaluation of healthcare services, which is governed by thepatient, a healthcare professional, andthepatients’ familymembers. Tobiano, Chaboyer & McMurray (2013) purportedthatfamilymembersvaluethischance, andthey are ready to participate in improvingthehealth of thepatientand handover communicationaccuracy. Italsohelpsthefamilymembers to understandthesituationandthepatient’s condition as well as his or her treatmentprogress. FCC alsooffers a chanceforthe three parties to shareandclarifyinformation, as well as combining their efforts towards improvingthehealthconditions of thepatient.
However, according Maxson, Derby, Wrobleski & Foss (2011), there are severalbarriers, which are associated with thenursing shift-to-shift report. Forpractical implementation of thenursing shift-to-shift report, severalconditions are required. Among them is thatnursesneedadequatetimeforpreparation of thereports to hand over.Theyalsoneedadequatespaceandresourcesfortheexecution of their reports. Maxson, Derby, Wrobleski & Foss (2011) indicatedthatthemajorchallenge in this implementation is theinterruptions of thepartiesinvolved. In addition, there is nostandardizedprocess, which thesereports should be prepared. In mosthealthcarecenters, there is theunderdevelopedmechanism of communicationand technology.
Therefore, to improvetheoutcomes of the shift-to-shift nursingreport, Evans, Grunawalt, McClish, Wood & Friese (2011) suggestedthattheappropriatemechanism is thepatient bedside report. Itresults to improvedsatisfactions of thehealthcareprofessionalsandincrease of directcare to thepatients. From theanalysis of theaboveliterature, it is evidentthat bedside shiftreporting has morebenefits as compared to thetraditionalmode of reporting. Mostauthorsindicateitthebestmethod that can be used to offsettheproblemsexperienced with thetraditionalmethod of reporting.
Evaluation of Outcomes and Formulation of the Statement regarding bedsideshift-to-shift reports
There are severalpositiveoutcomes, which can be gained from theadoptionand implementation of the bedside shift-to-shift report. Thesebenefitsincludethefinancialsavings of thepatientsandfamilymembersinvolved, as well as thehealthcareinstitutions. It could alsoresult in thephysicianandstaffsatisfactionandthefasterandeffectiveimprovement of healthcareservicesforthe concerned patients. Thefinancialgainwasbecause of thedecrease in theincidentaltime. Incidentaltime in thiscaseimpliedtime over theshift, which wasconsumed by thetraditionalmethod of reporting. Thesaving in incidentaltimetranslates to financialsavings (Tobiano, Chaboyer & McMurray, 2013).
The bedside shift to shiftgives an assurance to thepatientthatthehealthcareprofessionalswork as a team, and everybody includingthepatient’s familymembers are aware of thecareplan. Patientshave a chance of asking a questionandcontributevaluableinformationregarding his or her healthcareconditions. Researchrecommendsthatpatientswho are moreinformed are likely to adhere to themedicaladvice, and are lessanxious. In addition, they opt to start their treatmentearlier, henceselectinglowerriskinterventions. There is alsosolidevidencethatpatientswhoare involved in their healthcareservices, are lesslitigateandhave a high level of satisfaction. Because of increasedsatisfaction of thepatients, theytranslate to be loyalcustomers, who are likely to returnin casetheyexperiencehealthproblems. Further, thecost of healthcare decreases through efficient utilization of resourcesand self-management by thepatients.Reimplementation of a Bedside Shift Report Essay.
Thestaffnursealsobenefits from theadoption of the bedside reporting. They can visualize their patientsimmediatelyanddevelop a medical prioritization forthecare. Italsoenablesthenurseconcerned to be moreprepared in answeringquestions to thephysicians, andofferbetterassistanceand is activities (Sherman, Sand-Jecklin, & Johnson, 2013). Further, bedside can provideexperimentallearningwhentheydemonstratetheworking of theequipmenttheyhaveused are share individualized informationrelated to thepatient’s needs. In addition, there is an increase of accountability between thenurses’ shifts, because of theimmediate visualization of theneeds of thepatients in bothshifts. Therelation between thestaffis improvedthecommunication from one shift to theother is face-to-face, leading to a teamworkenvironmentandreducingchances of blames.
Implementation of Bedside Report
From thisanalysis, it is evidentthat bedside shift-to-shift reporting is morebeneficialand should be incorporated in healthinstitutions. For effectiveness, a well-definedmethodicalprocess should be utilized to implementit. Theprocess should involvestaffeducationandtraining through an extensiveprocess of feedback and evaluation. Theprocess would includeseveralactivities as illustratedbelow.
Thefirststep towards building an effective bedside report is building a team, which is made up of formalandinformalleaders. Theofficialleaders should managetheteamwhiletheinformalleaders should who should supportthechange. There should also be unitcompanionswhoare identified as thestaff, and should remainactive in theface of theupcomingchallenges. It could also be morehelpfuliftheorganizationsobtainedworkerswhohaveexperience in theworking bedside report.
Identification of Goals and Outcomes
Sharingthesamevision by all the stakeholders involved, is thekey to thesuccess of theprogram. Therefore, thisstage would include all themembersinvolved in theteam to understandandarticulatethegoalsandoutcomes that are going to be achieved by implementingthe bedside shiftreporting. Thesegoals may includeimprovinghealthcare, makefinancialsavingandimprovethecustomer’s satisfaction.
Makingthe implementation thepriority
After thelaunch of theinitiative, the managing team should ensurethatnootherchanges are beingimplementedforthefirstfewmonths. As a result, the concerned staff would consider bedside shift as a priority, henceincreasingthechances of success of theprogram. Post implementation meetings should be arranged, to allowtheteam to resolveanyissues that may haverisen as well as identifytheareas of concern. At thesametime, there should be education to thestaffregardingthenewshiftprocessandtheexpectedoutcomes.
From thefindings of thepublishedstudies, it is evidentthat bedside nursingreport has positiveoutcomes. Theylead to theimprovement of theoutcome of thepatient as well as nursesandpatient. However, thepresentrisk is thatthepercentage of change to thismodel is verylow. Most of thenursesprefer a hybridsystem. Therefore, full implementation should be encouraged towards bedside reporting. At thesametime, theleaders in an organizationimplementing bedside report should ensure data collection, before and after bedside report implementation. The data should be collected from both thepatientsandnurses. It would help in theanalysis of the effectiveness of theprogram, as well as predictingtheareas that could needimprovement.
From thisanalysis, it is clearthatcommunication between thephysiciansandnurses is an importantcomponent in thehealthcaresectors. Themostimportant is the nurse-to-nurse report, whenthey are exchanging their shifts. However, thecurrenttraditional has not beeneffective, andseveralproblemshavebeenassociated with it, suchwaste of time, highcost, andineffectiveprovision of healthservices. To counter theseproblems, thebestapproach that should be adopted by healthcare institutions is the bedside shift-to-shift report. Thereportallowsthepatientsand his or her familymembers to participate in healthcare. As a result, theprogramresources in terms of timeandmoney. Italsoincreasesthesatisfaction of thepatientand effectiveness of healthservicedelivery by nurses.Reimplementation of a Bedside Shift Report Essay.
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