2.50
Hdl Handle:
http://hdl.handle.net/10755/211554
Type:
Research Study
Title:
NURSING HANDOFF AT THE BEDSIDE: DOES IT IMPROVE OUTCOMES?
Author(s):
Merrill, Katreena; Brown, Kelleen
Abstract:
Purpose:  The purpose of this study was to describe nurses and patients experience with implementation of a standardized bedside handoff and to measure its effects on patient satisfaction, falls and adverse events. Background: The specific processes of nursing handoff communication are based upon tradition rather than research.  Lack of consistent and thorough communication results in errors and compromises patient safety. Several regulatory agencies recommend a standardized shift report and involvement of patients in their care.  However, the effect of nursing handoff communication on outcomes has not been well studied. Methods:  A mixed methods study was conducted in six adult inpatient departments across three hospitals.  Perceptions of handoff communication were solicited from 376 staff nurses using a structured interview approach at baseline and interview plus focus groups at follow up (nine months after implementation).  Structured interviews were conducted at follow up from a convenience sample of 30 patients.  Patient satisfaction with nursing communication was measured using the Hospital Consumer Assessment of Healthcare Providers and Systems instrument commissioned by the hospital.  Patient falls and adverse events related to communication were obtained from the hospital event reporting system. Results:  The staff survey was completed by 119 staff (31.6% response rate) at baseline, 100 staff at the follow up (26%). Focus groups were attended by 11 staff nurses, educators and managers.   Baseline staff respondents indicated that their current shift report (at the nurses’ station) was effective and changing to bedside report was unnecessary.  Three themes were identified at follow up; nurses were ‘warming up’ to bedside report, bedside report was not perceived as efficient and there was a continued concern with waking up patients for report.  Interviews were conducted with 30 patients.  Most patients gave the nurses a grade ‘A’ on the effectiveness of their report (86%). Patient themes indicated that nurses communicate pain, medications, history and what is happening with care during report; patient involvement consisted of nurses asking patients “is that right?” and “do you have any questions?”.  Patients reported that if they ‘butted in’ they were allowed to contribute to the handoff report.  Only one patient complained about being woken up for report. Patient falls, adverse events and satisfaction were analyzed for the previous 12 months. No significant difference was identified with these rates. However, patient satisfaction with nurse communication increased in each department which was considered to be a clinically significant finding. Implications: Nursing handoff communication and involvement of patients in their care are important safety initiatives. However, nurses in this study considered bedside report as extra work and their perceptions of patient preferences (such as being woken up for report) did not accurately reflect the opinion of their patients. Nurses need to fully comprehend that involving patients in their care is a key quality measure that contributes to the work of nursing rather than hindering it.  This study identified that implementation of bedside report may contribute to patient satisfaction, however, more research is needed to determine the effect of specific aspects of nursing handoff communication on patient outcomes.
Keywords:
Nursing handoff communication; Patient satisfaction
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5465
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleNURSING HANDOFF AT THE BEDSIDE: DOES IT IMPROVE OUTCOMES?en_GB
dc.contributor.authorMerrill, Katreenaen_US
dc.contributor.authorBrown, Kelleenen-US
dc.identifier.urihttp://hdl.handle.net/10755/211554en
dc.description.abstractPurpose:  The purpose of this study was to describe nurses and patients experience with implementation of a standardized bedside handoff and to measure its effects on patient satisfaction, falls and adverse events. Background: The specific processes of nursing handoff communication are based upon tradition rather than research.  Lack of consistent and thorough communication results in errors and compromises patient safety. Several regulatory agencies recommend a standardized shift report and involvement of patients in their care.  However, the effect of nursing handoff communication on outcomes has not been well studied. Methods:  A mixed methods study was conducted in six adult inpatient departments across three hospitals.  Perceptions of handoff communication were solicited from 376 staff nurses using a structured interview approach at baseline and interview plus focus groups at follow up (nine months after implementation).  Structured interviews were conducted at follow up from a convenience sample of 30 patients.  Patient satisfaction with nursing communication was measured using the Hospital Consumer Assessment of Healthcare Providers and Systems instrument commissioned by the hospital.  Patient falls and adverse events related to communication were obtained from the hospital event reporting system. Results:  The staff survey was completed by 119 staff (31.6% response rate) at baseline, 100 staff at the follow up (26%). Focus groups were attended by 11 staff nurses, educators and managers.   Baseline staff respondents indicated that their current shift report (at the nurses’ station) was effective and changing to bedside report was unnecessary.  Three themes were identified at follow up; nurses were ‘warming up’ to bedside report, bedside report was not perceived as efficient and there was a continued concern with waking up patients for report.  Interviews were conducted with 30 patients.  Most patients gave the nurses a grade ‘A’ on the effectiveness of their report (86%). Patient themes indicated that nurses communicate pain, medications, history and what is happening with care during report; patient involvement consisted of nurses asking patients “is that right?” and “do you have any questions?”.  Patients reported that if they ‘butted in’ they were allowed to contribute to the handoff report.  Only one patient complained about being woken up for report. Patient falls, adverse events and satisfaction were analyzed for the previous 12 months. No significant difference was identified with these rates. However, patient satisfaction with nurse communication increased in each department which was considered to be a clinically significant finding. Implications: Nursing handoff communication and involvement of patients in their care are important safety initiatives. However, nurses in this study considered bedside report as extra work and their perceptions of patient preferences (such as being woken up for report) did not accurately reflect the opinion of their patients. Nurses need to fully comprehend that involving patients in their care is a key quality measure that contributes to the work of nursing rather than hindering it.  This study identified that implementation of bedside report may contribute to patient satisfaction, however, more research is needed to determine the effect of specific aspects of nursing handoff communication on patient outcomes.en_GB
dc.subjectNursing handoff communicationen_GB
dc.subjectPatient satisfactionen_GB
dc.date.available2012-02-20T12:02:00Zen
dc.date.issued2012-02-20T12:02:00Zen
dc.date.accessioned2012-02-20T12:02:00Zen
dc.description.sponsorshipWestern Institute of Nursingen_GB
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