Discussion: Identification & Application of Research in Nurse Practice Literature Review

Discussion: Identification & Application of Research in Nurse Practice Literature Review ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Identification & Application of Research in Nurse Practice Literature Review In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project. Discussion: Identification & Application of Research in Nurse Practice Literature Review Provide a synopsis of the review of the research literature articles provided. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project. While APA style is not required for the body of this assignment, must use solid academic writing, and in-text citations and references should be presented using APA guidelines PICOT Question: Among patients admitted to the hospital (P) how do nurses’ bedside shift reports (I), compared totraditional reports outside of patients’ rooms (C), affect the occurrence of adverse events (O) during hospital stay (T)? Population: Patients admitted to the hospital Intervention: Nurses’ bedside shift reports Comparison: Traditional reports outside of patients’ rooms Outcome: The occurrence of adverse events Discussion: Identification & Application of Research in Nurse Practice Literature Review Time: During hospital stay *See Literature Review attachment and Capstone Articles 1-8. (Articles 1,3,4,7,8 Web Link Provided). Capstone Articles 2,5,6 Attached Separate Document: Create a list of measurable outcomes for your capstone project intervention (Improving Patients’ Quality of Care through Bedside Shift Report). Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a one or two sentence rationale. While APA style is not required for the body of this assignment, must use solid academic writing, and in-text citations and references should be presented using APA guidelines nrs_493_literature_review.docx capstone_article_1.pdf capstone_article_2.pdf capstone_article_3.pdf capstone_article_4.pdf capstone_article_2.pdf capstone_article_5.pdf capstone_article_6.pdf Literature Evaluation Table Student Name: Change Topic (2-3 sentences): Topic: Improving Patients’ Quality of Care through Bedside Shift Report. Criteria Article 1 Article 2 Article 3 Article 4 Author, Journal (PeerReviewed), and Permalink or Working Link to Access Article Reference: McAllen, E.R., Stephens, K., SwansonBiearman, B., Kerr, K., Whiteman, K (April 9, 2018) “Moving Shift Report to the Bedside: An EvidenceBased Quality Improvement Project” OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 2. Reference: Bigani, D. K., & Correia, A. M. (2018). On the Same Page: Nurse, Patient, and Family Perceptions of Change-of-shift Bedside Report. Journal of Pediatric Nursing, 41, 84–89. Reference: Grimshaw, J., Hatch, D., Willard, M., & Abraham, S. (2016). A Qualitative Study of the Change-of-Shift Report at the Patients’ Bedside. The Health Care Manager, 35(4), 294–304. https://doi.org/10.1097/hcm. 0000000000000125 Reference: Ford, Y., Heyman, A., & Chapman, Y. L. (2015). Patients? Perceptions of Bedside Handoff. Journal of Nursing Care Quality, 29(4), 371–378. https://doi.org/10.1 097/ncq.000000000 0000056 Web Link: https://ojin.nur singworld.org/ MainMenuCat egories/ANA Marketplace/A NAPeriodicals/ OJIN/TableofC ontents/Vol23-2018/No2May2018/Articles- Web Link: Permalink: https://journals.lww.com/he https://lopes.idm.oclc althcaremanagerjournal/Abs .org/login?url=https:// tract/2016/10000/A_Qualita search.ebscohost.com tive_Study_of_the_Change_ /login.aspx?direct=tru of_Shift_Report.3.aspx e&db=edo&AN=130 462037&site=edslive&scope=site&cus tid=s8333196&group id=main&profile=eds 1 © 2015. Grand Canyon University. All Rights Reserved. Web Link: https://journals.lwwDiscussion: Identification & Application of Research in Nurse Practice Literature Review .com/jncqjournal/A bstract/2014/10000/ Patients__Perceptio ns_of_Bedside_Ha ndoff__The_Need.1 0.aspx PreviousTopics/Moving -Shift-Reportto-theBedside.html Article Title and Year Published Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project On the Same Page: Nurse, Patient, and Family Perceptions of Change-of-shift Bedside Report A Qualitative Study of the Change-of-Shift Report at the Patients’ Bedside Patients’ Perceptions of Bedside Handoff The Need for a Culture of Always Year Published: 2016 Year Published: 2015 Year Published: 2018 Year Published: 2018 Research Questions (Qualitative) /Hypothesis (Quantitativ e) Purposes/Ai m of Study Design (Type of Quantitative , or Type of Qualitative) Setting/Sam ple Methods: Intervention /Instruments Analysis Key Findings Recommend ations Explanation of How the Article Supports EBP/Capsto ne Project © 2017. Grand Canyon University. All Rights Reserved. Criteria Article 5 Author, Journal (PeerReviewed), and Permalink or Working Link to Access Article Reference: Schirm, V., Banz, G., Swartz, C., & Richmond, M. (2018). Evaluation of bedside shift report: A research and evidencebased practice initiative. Applied Nursing Research, 40, 20–25. https://doiorg.lopes.idm.oclc.org/10. 1016/j.apnr.2017.12.004 Article Title and Year Published Article 7 Article 8 Reference: Foster-Hunt, T., Parush, A., Ellis, J., Thomas, M., & Rashotte, J. (2015). Information structure and organization in change of shift reports: An observational study of nursing hand-offs in a Pediatric Intensive Care Unit. Intensive & Critical Care Nursing, Permalink: 31(3), 155–164. https://lopes.idm.oclc.org/ https://doilogin?url=https://search.eb org.lopes.idm.oclc.org/1 scohost.com/login.aspx?di 0.1016/j.iccn.2014.09.00 rect=true&db=edselp&A 4 N=S0897189717301118& site=edsPermalink: live&scope=site&custid=s https://lopes.idm.oclc.or 8333196&groupid=main g/login?url=https://searc &profile=eds1 h.ebscohost.com/login.a spx?direct=true&db=cc m&AN=103357319&sit e=ehost-live&scope=site Reference: Radtke K. (2015). Improving patient satisfaction with nursing communication using bedside shift report. Clinical nurse specialist CNS, 27(1), 19– 25. https://doi.org/10. 1097/NUR.0b013Discussion: Identification & Application of Research in Nurse Practice Literature Review e3182777011 Reference: Ofori-Atta, Judymae MSN, BSN, RN; Binienda, Maura BSN, RN; Chalupka, Stephanie MSN, EdD Bedside shift report, Nursing2019: August 2015 Volume 45 Issue 8 – p 1-4 doi: 10.1097/01.NU RSE.000046925 2.96846.1a Evaluation of bedside shift report: A research and evidence-based practice initiative Improving Patient Satisfaction With Nursing Communication Using Bedside Shift Report Year Published: 2018 Article 6 Information structure and organization in change of shift reports: An observational study of nursing hand-offs in a Pediatric Intensive Care Unit Year Published: 2015 Web Link: https://pubmed.n cbi.nlm.nih.gov/2 Web Link: 3222024/ https://journals.l ww.com/nursing /Fulltext/2015/0 8000/Bedside_s hift_report__Im plications_for_p atient.20.aspx Year Published: 2015 Research Questions (Qualitative) /Hypothesis © 2017. Grand Canyon University. All Rights Reserved. Bedside shift report Implications for patient safety and quality of care Year Published 2015 (Quantitativ e) Purposes/Ai m of Study Design (Type of Quantitative , or Type of Qualitative) Setting/Sam ple Methods: Intervention /Instruments Analysis Key Findings Recommend ations Explanation of How the Article Supports EBP/Capsto ne © 2017. Grand Canyon University. All Rights Reserved. ANA Home About OJIN FAQs Author Guidelines Featured Authors Editorial Staff Board Contact Us Site Map search WHAT’S NEW JOURNAL TOPICS LOGIN » OJIN is a peer-reviewed, online publication that addresses current topics affecting nursing practice, research, education, and the wider health care sector. COLUMNS TABLE OF CONTENTS Home ANA Periodicals PreviousDiscussion: Identification & Application of Research in Nurse Practice Literature Review Topics LETTERS TO THE EDITOR OJIN Table of Contents CONTINUING ED Vol 23 2018 ANA HOME No2 May 2018 Articles Moving Shift Report to the Bedside Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project ^md Edward R. McAllen, Jr., DNP, MBA, BSN, BA, RN Kimberly Stephens, DNP, MSN, RN, DNP Brenda Swanson-Biearman, DNP, MPH, RN Kimberly Kerr, MSN, RN Kimberly Whiteman, DNP, MSN, RN, CCRN-K Find Out More… Abstract Announcements New Column in OJIN! Permission to Reprint OJIN Articles Planning a conference or class? Call for OJIN Manuscripts on a previous topics… Benefit for Members Members have access to current topic More… Letter to the Editor The delivery of healthcare in the United States has been static for the past century with care delivered through problem-based visits in an office or hospital setting. This model has not adapted to changing demographics and makes healthcare inaccessible to many. In this model, disparities in healthcare access are multifactorial. Continue Reading… View all Letters… A Midwestern, 532-bed, acute care, tertiary, Magnet® designated teaching hospital identified concerns about fall rates and patient and nurse satisfaction scores. Research has shown that the implementation of bedside report has increased patient safety and patient and nurse satisfaction. An evidence-based practice change incorporating bedside report into standard nursing care was implemented and evaluated over a four-month time period on three nursing units. Fall rates, HCAHPS and Press Ganey® scores, and nurses’ response to a satisfaction survey were measured before and after the project implementation. This article begins with the background of the problem and literature review, and then presents the project methods, measures, and data analysis. Results demonstrated that patient fall rates decreased by 24%, and nurse satisfaction improved with four of six nurse survey questions (67%) having percentage gains in the strongly agree or agree responses following implementation of bedside report. HCAHPS and Press Ganey® results demonstrated improvement in Press Ganey® scores on two of the three nursing units. Discussion: Identification & Application of Research in Nurse Practice Literature Review In this project, implementation of bedside report had a positive impact on patient safety, patient satisfaction, and nurse satisfaction. The authors conclude with discussion of findings and implications for nursing management. Citation: McAllen, E.R., Stephens, K., Swanson-Biearman, B., Kerr, K., Whiteman, K (April 9, 2018) “Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project” OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 2. DOI: 10.3912/OJIN.Vol23No02PPT22 Key Words: bedside report, shift report, handoff, patient safety, patient satisfaction, nurse satisfaction, evidence-based nursing practice, patient centered care, quality improvement, teamwork, work redesign, leadership, and organizational culture. In April 2011, the Centers for Medicare and Medicaid (CMS) enacted a hospital Value Based Purchasing (VBP) program that began to measure and pay for hospital quality performance (Medicare.gov, n.d.). By 2015, CMS focused on four domains: clinical process of care, patient experience of care, outcome, and efficiency. Patient safety and patient and nurse satisfaction are scored within these domains. For a health system to be successful and maintain its viability and future growth, patient safety and patient and nurse satisfaction are key components (Medicare.gov, n.d.). Hospital leaders and healthcare organizations are making concentrated efforts to change their environments to assure patient safety and patient and nurse Bedside shift report (BSR) enables accurate and timely communication between nurses, includes the patient in care, and is paramount to the delivery of safe, high quality care. Discussion: Identification & Application of Research in Nurse Practice Literature Review Hospital leaders and satisfaction. healthcare organizations are making concentrated efforts to change their environments to assure patient safety and patient and nurse satisfaction. In the literature, changing the location of shift report from the desk or nurses’ station to the bedside has been identified as a means to increase patient safety and patient and nurse satisfaction. Shift report, when completed at the patient bedside, allows the nurse to visualize and assess the patient and the environment, as well as communicate with and involve the patient in the plan of care. Bedside shift report (BSR) enables accurate and timely communication between nurses, includes the patient in care, and is paramount to the delivery of safe, high quality care. Background A Midwestern, 532-bed, acute care, tertiary, Magnet® designated teaching hospital identified that fall rates were above the national average. Patient satisfaction, as A team of nursing measured by Press Ganey®, consistently scored below the administrators, target range of 90%, and the Hospital Consumer directors, staff Assessment of Healthcare Providers and Systems nurses, and a (HCAHPS) scores for questions related to nursing patient communication were below 85%, or the 90th percentile. representative was Nurse satisfaction scores, as measured by the National assembled to Database of Nursing Quality Indicators (NDNQI), were review the 69.7%, below the overall goal of 75%. A team of nursing literature and make administrators, directors, staff nurses, and a patient recommendations representative was assembled to review the literature and for practice make recommendations for practice changes. This article changes. begins with the background of the problem and brief literature review, and then presents the project methods, measures, and data analysis. We conclude with results and discussion of our findings and implications for nursing management.Discussion: Identification & Application of Research in Nurse Practice Literature Review Literature Review The team completed a literature review based upon the following PICO question: Does the implementation of BSR as compared to standard shift report at the nurses’ station increase patient safety and patient and nurse satisfaction? The practice of shift report at the bedside is not a new concept and is well documented in the literature. Numerous studies support the positive impact of BSR on patient fall rates, as well as patient and nurse satisfaction (Cairns, Dudjak, Hoffman, & Lorenz, 2013; Evans, Grunawalt, McClish, Wood, & Friese, 2012; Jeffs et al., 2013; Laws, & Amato, 2010; & Sand-Jecklin & Sherman, 2013). Patient participation in the report is paramount to delivery of safe, high quality care. After the literature review, the team defined BSR as the accurate and timely communication between nurses and also between the nurses and the patient. Patient participation in the report is paramount to delivery of safe, high quality care. Furthermore, through reading and discussion of the articles, the team concluded that report, when completed at the patient bedside, allows the nurse to visualize and assess patients and the environment, with better communication and patient involvement in care. Methods Written approval to conduct the quality improvement project was obtained from the university and hospital institutional review boards (IRB). The team completed a gap analysis to determine evidence-based best practices for shift report as compared to the current practice. At baseline, shift report was done in a conference room, at the desk, or in the hallways. BSR was not a practice on any of the units. Report was not standardized, though all nurses had some preferred form of communication. The team completed a gap analysis to determine evidence-based best practices for shift report as compared to the An organizational assessment completed using the current practice. strengths-weaknesses-opportunities-threats (SWOT) format revealed that the practice change to BSR was feasible and congruent with the hospital’s nursing model, Jean Watson’s theory of transpersonal caring (Watson, 1999), and Kristen Swanson’s middle range theory of caring (Swanson, 1993). Discussion: Identification & Application of Research in Nurse Practice Literature Review The team selected the Iowa Model of Evidence-Based Practice to Promote Quality Care (Titler, 2011) and Kotter’s Eight Stage Process for Major Change (Kotter, 1996) to guide implementation and sustain progress. Tests of change in Plan, Do, Study, Act (PDSA) cycles were used to evaluate the practice change in real-time and make necessary adjustments throughout implementation (The Deming Institute, n.d.). Three units were selected for implementation of the practice change based upon the directors’ desire and willingness to participate. The populations served on the chosen nursing units were patients undergoing general surgery, and those with orthopedic and neuroscience diagnoses. Members of these units volunteered to be part of the BSR team. Scripted Report The team developed two scripts to use for report: one for medical units and one for surgical units. Scripts were created with input and consensus of staff, based upon the We incorporated Introduction, Situation, Background, Assessment, fictitious patient Recommendation, Question (ISBARQ) format (Heinricks, information that Bauman, & Dev, 2012). We incorporated fictitious patient aligned with typical information that aligned with typical patient conditions patient conditions from each area. See Figure 1 for a sample of script from each area. content. Confidential aspects of report (e.g., abnormal laboratory and radiology test results indicative of poor prognosis) that had not been discussed between the patient and physician were discussed nurse-to-nurse, prior to completing BSR. Figure 1. Medical Unit Nurse Script ISBARQ: Introduction, Situation, Background, Assessment, Recommendation, Questions INTRODUCTION: Off-going nurse introduce the oncoming nurse SITUATION: Patient name Reason for admission Code status BACKGROUND: Pertinent history Laboratory and X-ray results Other testing results Consults . Discussion: Identification & Application of Research in Nurse Practice Literature Review ASSESSMENT: Assessment to include pertinent findings for assigned patient population Medications and treatments Pending tests White board update Safety and Environmental Check IVs, Drains, Pain Mobility Environmental scan: clutter, side rails, visual assessment of room safety RECOMMENDATION: Pertinent information from Plan of Care Follow up tests to be completed QUESTIONS: Thank the patient and ask if he/she has any questions. Education Staff education included reading two journal articles (Cairnes, Dudjak, Hoffman, & Lorenz, 2013, and Evans, Grunawalt, McClish, Wood, & Friese, 2012), and watching a recorded clip created by the team (six staff nurses, two directors, two video personnel) to demonstrate the BSR process. The clip utilized the scripts used in the training of staff. Educators helped to determine the information that should be shared confidentially via nurse-to-nurse communication and what was to be included in BSR. The BSR began with the outgoing nurse introducing the oncoming nurse to the patient, followed by an assessment of the patient and environment. The patient assessment The BSR began included a general overview of the patient’s condition and with the outgoing significant aspects of care (e.g. wound sites; dressings; nurse introducing abnormal breath or heart sounds; intravenous sites, the oncoming solutions, and rates; or anything considered out of the nurse to the ordinary). Nurses surveyed the room for safety issues, patient, followed by including the bed and side-rail position and presence of an assessment of clutter, and ensured that necessary items were within the patient and patient reach. Discussion: Identification & Application of Research in Nurse Practice Literature Review Prior to leaving the room, they updated the environment. white board in the room, reviewed pain medications, and inquired of patients, “Do you have any questions?” Following the education, staff members were given script cards to use during report. They had time to practice giving report using the ISBARQ format before demonstrating competency to a staff champion or BSR team member. Tests of Change The PDSA framework was utilized throughout the project and allowed staff input into the ongoing The PDSA framework was utilized throughout the project and allowed staff input into the ongoing process of BSR. During implementation of the project, we identified multiple items that required small process changes or what are called “linked process changes” (Taylor et al. 2013, p.5). These are defined as “two or more (PDSA) cycles with lessons learned from one cycle linking and informing a subsequent cycle” (Taylor et al. 2013, p.5). process of BSR. One example of a linked change that occurred was script changes based upon the patient; nurse familiarity with the history; and management of patient requests for privacy. Staff members were encouraged to discuss BSR process issues with BSR team members, who made frequent rounds throughout the project. To maintain consistency, suggested changes were discussed with BSR team members prior to implementation. Most requested changes were minor, such as asking patients how they would prefer to be addressed by staff. Changes were passed on to other nurses during unit rounds or through directors and champions at change of shift report. Measures Audits A BSR audit tool was implemented to assure compliance to the BSR process, including verifying that report was completed at the bedside; introducing the oncoming nurse; scripting in ISBARQ; updating the white board; and reviewing care. Shift report time audits, measured from the beginning of report until all handover communication ended, were completed pre-implementation and post-implementation. Discussion: Identification & Application of Research in Nurse Practice Literature Review A direct comparison of mean report times was completed on pre-implementation versus post-implementation shift times. An example of the audit report is illustrated in Figure 2. Figure 2. BSR Shift Report Time Audit Tool BSR Process Audit Tool Number of nurses/shift Time Report Shift/Date/Time Nursing Unit: Number of Nurses /Shift Report Start time Report End time Total time Census Auditor Falls The number of patient falls was obtained through the hospital incident reporting system and converted into a fall rate using the standard calculation of 1,000 patient days: the total number of falls divided by the number of patient days times 1,000 (AHRQ, 2013). The number of falls in the four-month period before BSR implementation was compared to the number of falls in the f … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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Discussion: Identification & Application of Research in Nurse Practice Literature Review

Discussion: Identification & Application of Research in Nurse Practice Literature Review ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Identification & Application of Research in Nurse Practice Literature Review In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project. Discussion: Identification & Application of Research in Nurse Practice Literature Review Provide a synopsis of the review of the research literature articles provided. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project. While APA style is not required for the body of this assignment, must use solid academic writing, and in-text citations and references should be presented using APA guidelines PICOT Question: Among patients admitted to the hospital (P) how do nurses’ bedside shift reports (I), compared totraditional reports outside of patients’ rooms (C), affect the occurrence of adverse events (O) during hospital stay (T)? Population: Patients admitted to the hospital Intervention: Nurses’ bedside shift reports Comparison: Traditional reports outside of patients’ rooms Outcome: The occurrence of adverse events Discussion: Identification & Application of Research in Nurse Practice Literature Review Time: During hospital stay *See Literature Review attachment and Capstone Articles 1-8. (Articles 1,3,4,7,8 Web Link Provided). Capstone Articles 2,5,6 Attached Separate Document: Create a list of measurable outcomes for your capstone project intervention (Improving Patients’ Quality of Care through Bedside Shift Report). Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a one or two sentence rationale. While APA style is not required for the body of this assignment, must use solid academic writing, and in-text citations and references should be presented using APA guidelines nrs_493_literature_review.docx capstone_article_1.pdf capstone_article_2.pdf capstone_article_3.pdf capstone_article_4.pdf capstone_article_2.pdf capstone_article_5.pdf capstone_article_6.pdf Literature Evaluation Table Student Name: Change Topic (2-3 sentences): Topic: Improving Patients’ Quality of Care through Bedside Shift Report. Criteria Article 1 Article 2 Article 3 Article 4 Author, Journal (PeerReviewed), and Permalink or Working Link to Access Article Reference: McAllen, E.R., Stephens, K., SwansonBiearman, B., Kerr, K., Whiteman, K (April 9, 2018) “Moving Shift Report to the Bedside: An EvidenceBased Quality Improvement Project” OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 2. Reference: Bigani, D. K., & Correia, A. M. (2018). On the Same Page: Nurse, Patient, and Family Perceptions of Change-of-shift Bedside Report. Journal of Pediatric Nursing, 41, 84–89. Reference: Grimshaw, J., Hatch, D., Willard, M., & Abraham, S. (2016). A Qualitative Study of the Change-of-Shift Report at the Patients’ Bedside. The Health Care Manager, 35(4), 294–304. https://doi.org/10.1097/hcm. 0000000000000125 Reference: Ford, Y., Heyman, A., & Chapman, Y. L. (2015). Patients? Perceptions of Bedside Handoff. Journal of Nursing Care Quality, 29(4), 371–378. https://doi.org/10.1 097/ncq.000000000 0000056 Web Link: https://ojin.nur singworld.org/ MainMenuCat egories/ANA Marketplace/A NAPeriodicals/ OJIN/TableofC ontents/Vol23-2018/No2May2018/Articles- Web Link: Permalink: https://journals.lww.com/he https://lopes.idm.oclc althcaremanagerjournal/Abs .org/login?url=https:// tract/2016/10000/A_Qualita search.ebscohost.com tive_Study_of_the_Change_ /login.aspx?direct=tru of_Shift_Report.3.aspx e&db=edo&AN=130 462037&site=edslive&scope=site&cus tid=s8333196&group id=main&profile=eds 1 © 2015. Grand Canyon University. All Rights Reserved. Web Link: https://journals.lwwDiscussion: Identification & Application of Research in Nurse Practice Literature Review .com/jncqjournal/A bstract/2014/10000/ Patients__Perceptio ns_of_Bedside_Ha ndoff__The_Need.1 0.aspx PreviousTopics/Moving -Shift-Reportto-theBedside.html Article Title and Year Published Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project On the Same Page: Nurse, Patient, and Family Perceptions of Change-of-shift Bedside Report A Qualitative Study of the Change-of-Shift Report at the Patients’ Bedside Patients’ Perceptions of Bedside Handoff The Need for a Culture of Always Year Published: 2016 Year Published: 2015 Year Published: 2018 Year Published: 2018 Research Questions (Qualitative) /Hypothesis (Quantitativ e) Purposes/Ai m of Study Design (Type of Quantitative , or Type of Qualitative) Setting/Sam ple Methods: Intervention /Instruments Analysis Key Findings Recommend ations Explanation of How the Article Supports EBP/Capsto ne Project © 2017. Grand Canyon University. All Rights Reserved. Criteria Article 5 Author, Journal (PeerReviewed), and Permalink or Working Link to Access Article Reference: Schirm, V., Banz, G., Swartz, C., & Richmond, M. (2018). Evaluation of bedside shift report: A research and evidencebased practice initiative. Applied Nursing Research, 40, 20–25. https://doiorg.lopes.idm.oclc.org/10. 1016/j.apnr.2017.12.004 Article Title and Year Published Article 7 Article 8 Reference: Foster-Hunt, T., Parush, A., Ellis, J., Thomas, M., & Rashotte, J. (2015). Information structure and organization in change of shift reports: An observational study of nursing hand-offs in a Pediatric Intensive Care Unit. Intensive & Critical Care Nursing, Permalink: 31(3), 155–164. https://lopes.idm.oclc.org/ https://doilogin?url=https://search.eb org.lopes.idm.oclc.org/1 scohost.com/login.aspx?di 0.1016/j.iccn.2014.09.00 rect=true&db=edselp&A 4 N=S0897189717301118& site=edsPermalink: live&scope=site&custid=s https://lopes.idm.oclc.or 8333196&groupid=main g/login?url=https://searc &profile=eds1 h.ebscohost.com/login.a spx?direct=true&db=cc m&AN=103357319&sit e=ehost-live&scope=site Reference: Radtke K. (2015). Improving patient satisfaction with nursing communication using bedside shift report. Clinical nurse specialist CNS, 27(1), 19– 25. https://doi.org/10. 1097/NUR.0b013Discussion: Identification & Application of Research in Nurse Practice Literature Review e3182777011 Reference: Ofori-Atta, Judymae MSN, BSN, RN; Binienda, Maura BSN, RN; Chalupka, Stephanie MSN, EdD Bedside shift report, Nursing2019: August 2015 Volume 45 Issue 8 – p 1-4 doi: 10.1097/01.NU RSE.000046925 2.96846.1a Evaluation of bedside shift report: A research and evidence-based practice initiative Improving Patient Satisfaction With Nursing Communication Using Bedside Shift Report Year Published: 2018 Article 6 Information structure and organization in change of shift reports: An observational study of nursing hand-offs in a Pediatric Intensive Care Unit Year Published: 2015 Web Link: https://pubmed.n cbi.nlm.nih.gov/2 Web Link: 3222024/ https://journals.l ww.com/nursing /Fulltext/2015/0 8000/Bedside_s hift_report__Im plications_for_p atient.20.aspx Year Published: 2015 Research Questions (Qualitative) /Hypothesis © 2017. Grand Canyon University. All Rights Reserved. Bedside shift report Implications for patient safety and quality of care Year Published 2015 (Quantitativ e) Purposes/Ai m of Study Design (Type of Quantitative , or Type of Qualitative) Setting/Sam ple Methods: Intervention /Instruments Analysis Key Findings Recommend ations Explanation of How the Article Supports EBP/Capsto ne © 2017. Grand Canyon University. All Rights Reserved. ANA Home About OJIN FAQs Author Guidelines Featured Authors Editorial Staff Board Contact Us Site Map search WHAT’S NEW JOURNAL TOPICS LOGIN » OJIN is a peer-reviewed, online publication that addresses current topics affecting nursing practice, research, education, and the wider health care sector. COLUMNS TABLE OF CONTENTS Home ANA Periodicals PreviousDiscussion: Identification & Application of Research in Nurse Practice Literature Review Topics LETTERS TO THE EDITOR OJIN Table of Contents CONTINUING ED Vol 23 2018 ANA HOME No2 May 2018 Articles Moving Shift Report to the Bedside Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project ^md Edward R. McAllen, Jr., DNP, MBA, BSN, BA, RN Kimberly Stephens, DNP, MSN, RN, DNP Brenda Swanson-Biearman, DNP, MPH, RN Kimberly Kerr, MSN, RN Kimberly Whiteman, DNP, MSN, RN, CCRN-K Find Out More… Abstract Announcements New Column in OJIN! Permission to Reprint OJIN Articles Planning a conference or class? Call for OJIN Manuscripts on a previous topics… Benefit for Members Members have access to current topic More… Letter to the Editor The delivery of healthcare in the United States has been static for the past century with care delivered through problem-based visits in an office or hospital setting. This model has not adapted to changing demographics and makes healthcare inaccessible to many. In this model, disparities in healthcare access are multifactorial. Continue Reading… View all Letters… A Midwestern, 532-bed, acute care, tertiary, Magnet® designated teaching hospital identified concerns about fall rates and patient and nurse satisfaction scores. Research has shown that the implementation of bedside report has increased patient safety and patient and nurse satisfaction. An evidence-based practice change incorporating bedside report into standard nursing care was implemented and evaluated over a four-month time period on three nursing units. Fall rates, HCAHPS and Press Ganey® scores, and nurses’ response to a satisfaction survey were measured before and after the project implementation. This article begins with the background of the problem and literature review, and then presents the project methods, measures, and data analysis. Results demonstrated that patient fall rates decreased by 24%, and nurse satisfaction improved with four of six nurse survey questions (67%) having percentage gains in the strongly agree or agree responses following implementation of bedside report. HCAHPS and Press Ganey® results demonstrated improvement in Press Ganey® scores on two of the three nursing units. Discussion: Identification & Application of Research in Nurse Practice Literature Review In this project, implementation of bedside report had a positive impact on patient safety, patient satisfaction, and nurse satisfaction. The authors conclude with discussion of findings and implications for nursing management. Citation: McAllen, E.R., Stephens, K., Swanson-Biearman, B., Kerr, K., Whiteman, K (April 9, 2018) “Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project” OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 2. DOI: 10.3912/OJIN.Vol23No02PPT22 Key Words: bedside report, shift report, handoff, patient safety, patient satisfaction, nurse satisfaction, evidence-based nursing practice, patient centered care, quality improvement, teamwork, work redesign, leadership, and organizational culture. In April 2011, the Centers for Medicare and Medicaid (CMS) enacted a hospital Value Based Purchasing (VBP) program that began to measure and pay for hospital quality performance (Medicare.gov, n.d.). By 2015, CMS focused on four domains: clinical process of care, patient experience of care, outcome, and efficiency. Patient safety and patient and nurse satisfaction are scored within these domains. For a health system to be successful and maintain its viability and future growth, patient safety and patient and nurse satisfaction are key components (Medicare.gov, n.d.). Hospital leaders and healthcare organizations are making concentrated efforts to change their environments to assure patient safety and patient and nurse Bedside shift report (BSR) enables accurate and timely communication between nurses, includes the patient in care, and is paramount to the delivery of safe, high quality care. Discussion: Identification & Application of Research in Nurse Practice Literature Review Hospital leaders and satisfaction. healthcare organizations are making concentrated efforts to change their environments to assure patient safety and patient and nurse satisfaction. In the literature, changing the location of shift report from the desk or nurses’ station to the bedside has been identified as a means to increase patient safety and patient and nurse satisfaction. Shift report, when completed at the patient bedside, allows the nurse to visualize and assess the patient and the environment, as well as communicate with and involve the patient in the plan of care. Bedside shift report (BSR) enables accurate and timely communication between nurses, includes the patient in care, and is paramount to the delivery of safe, high quality care. Background A Midwestern, 532-bed, acute care, tertiary, Magnet® designated teaching hospital identified that fall rates were above the national average. Patient satisfaction, as A team of nursing measured by Press Ganey®, consistently scored below the administrators, target range of 90%, and the Hospital Consumer directors, staff Assessment of Healthcare Providers and Systems nurses, and a (HCAHPS) scores for questions related to nursing patient communication were below 85%, or the 90th percentile. representative was Nurse satisfaction scores, as measured by the National assembled to Database of Nursing Quality Indicators (NDNQI), were review the 69.7%, below the overall goal of 75%. A team of nursing literature and make administrators, directors, staff nurses, and a patient recommendations representative was assembled to review the literature and for practice make recommendations for practice changes. This article changes. begins with the background of the problem and brief literature review, and then presents the project methods, measures, and data analysis. We conclude with results and discussion of our findings and implications for nursing management.Discussion: Identification & Application of Research in Nurse Practice Literature Review Literature Review The team completed a literature review based upon the following PICO question: Does the implementation of BSR as compared to standard shift report at the nurses’ station increase patient safety and patient and nurse satisfaction? The practice of shift report at the bedside is not a new concept and is well documented in the literature. Numerous studies support the positive impact of BSR on patient fall rates, as well as patient and nurse satisfaction (Cairns, Dudjak, Hoffman, & Lorenz, 2013; Evans, Grunawalt, McClish, Wood, & Friese, 2012; Jeffs et al., 2013; Laws, & Amato, 2010; & Sand-Jecklin & Sherman, 2013). Patient participation in the report is paramount to delivery of safe, high quality care. After the literature review, the team defined BSR as the accurate and timely communication between nurses and also between the nurses and the patient. Patient participation in the report is paramount to delivery of safe, high quality care. Furthermore, through reading and discussion of the articles, the team concluded that report, when completed at the patient bedside, allows the nurse to visualize and assess patients and the environment, with better communication and patient involvement in care. Methods Written approval to conduct the quality improvement project was obtained from the university and hospital institutional review boards (IRB). The team completed a gap analysis to determine evidence-based best practices for shift report as compared to the current practice. At baseline, shift report was done in a conference room, at the desk, or in the hallways. BSR was not a practice on any of the units. Report was not standardized, though all nurses had some preferred form of communication. The team completed a gap analysis to determine evidence-based best practices for shift report as compared to the An organizational assessment completed using the current practice. strengths-weaknesses-opportunities-threats (SWOT) format revealed that the practice change to BSR was feasible and congruent with the hospital’s nursing model, Jean Watson’s theory of transpersonal caring (Watson, 1999), and Kristen Swanson’s middle range theory of caring (Swanson, 1993). Discussion: Identification & Application of Research in Nurse Practice Literature Review The team selected the Iowa Model of Evidence-Based Practice to Promote Quality Care (Titler, 2011) and Kotter’s Eight Stage Process for Major Change (Kotter, 1996) to guide implementation and sustain progress. Tests of change in Plan, Do, Study, Act (PDSA) cycles were used to evaluate the practice change in real-time and make necessary adjustments throughout implementation (The Deming Institute, n.d.). Three units were selected for implementation of the practice change based upon the directors’ desire and willingness to participate. The populations served on the chosen nursing units were patients undergoing general surgery, and those with orthopedic and neuroscience diagnoses. Members of these units volunteered to be part of the BSR team. Scripted Report The team developed two scripts to use for report: one for medical units and one for surgical units. Scripts were created with input and consensus of staff, based upon the We incorporated Introduction, Situation, Background, Assessment, fictitious patient Recommendation, Question (ISBARQ) format (Heinricks, information that Bauman, & Dev, 2012). We incorporated fictitious patient aligned with typical information that aligned with typical patient conditions patient conditions from each area. See Figure 1 for a sample of script from each area. content. Confidential aspects of report (e.g., abnormal laboratory and radiology test results indicative of poor prognosis) that had not been discussed between the patient and physician were discussed nurse-to-nurse, prior to completing BSR. Figure 1. Medical Unit Nurse Script ISBARQ: Introduction, Situation, Background, Assessment, Recommendation, Questions INTRODUCTION: Off-going nurse introduce the oncoming nurse SITUATION: Patient name Reason for admission Code status BACKGROUND: Pertinent history Laboratory and X-ray results Other testing results Consults . Discussion: Identification & Application of Research in Nurse Practice Literature Review ASSESSMENT: Assessment to include pertinent findings for assigned patient population Medications and treatments Pending tests White board update Safety and Environmental Check IVs, Drains, Pain Mobility Environmental scan: clutter, side rails, visual assessment of room safety RECOMMENDATION: Pertinent information from Plan of Care Follow up tests to be completed QUESTIONS: Thank the patient and ask if he/she has any questions. Education Staff education included reading two journal articles (Cairnes, Dudjak, Hoffman, & Lorenz, 2013, and Evans, Grunawalt, McClish, Wood, & Friese, 2012), and watching a recorded clip created by the team (six staff nurses, two directors, two video personnel) to demonstrate the BSR process. The clip utilized the scripts used in the training of staff. Educators helped to determine the information that should be shared confidentially via nurse-to-nurse communication and what was to be included in BSR. The BSR began with the outgoing nurse introducing the oncoming nurse to the patient, followed by an assessment of the patient and environment. The patient assessment The BSR began included a general overview of the patient’s condition and with the outgoing significant aspects of care (e.g. wound sites; dressings; nurse introducing abnormal breath or heart sounds; intravenous sites, the oncoming solutions, and rates; or anything considered out of the nurse to the ordinary). Nurses surveyed the room for safety issues, patient, followed by including the bed and side-rail position and presence of an assessment of clutter, and ensured that necessary items were within the patient and patient reach. Discussion: Identification & Application of Research in Nurse Practice Literature Review Prior to leaving the room, they updated the environment. white board in the room, reviewed pain medications, and inquired of patients, “Do you have any questions?” Following the education, staff members were given script cards to use during report. They had time to practice giving report using the ISBARQ format before demonstrating competency to a staff champion or BSR team member. Tests of Change The PDSA framework was utilized throughout the project and allowed staff input into the ongoing The PDSA framework was utilized throughout the project and allowed staff input into the ongoing process of BSR. During implementation of the project, we identified multiple items that required small process changes or what are called “linked process changes” (Taylor et al. 2013, p.5). These are defined as “two or more (PDSA) cycles with lessons learned from one cycle linking and informing a subsequent cycle” (Taylor et al. 2013, p.5). process of BSR. One example of a linked change that occurred was script changes based upon the patient; nurse familiarity with the history; and management of patient requests for privacy. Staff members were encouraged to discuss BSR process issues with BSR team members, who made frequent rounds throughout the project. To maintain consistency, suggested changes were discussed with BSR team members prior to implementation. Most requested changes were minor, such as asking patients how they would prefer to be addressed by staff. Changes were passed on to other nurses during unit rounds or through directors and champions at change of shift report. Measures Audits A BSR audit tool was implemented to assure compliance to the BSR process, including verifying that report was completed at the bedside; introducing the oncoming nurse; scripting in ISBARQ; updating the white board; and reviewing care. Shift report time audits, measured from the beginning of report until all handover communication ended, were completed pre-implementation and post-implementation. Discussion: Identification & Application of Research in Nurse Practice Literature Review A direct comparison of mean report times was completed on pre-implementation versus post-implementation shift times. An example of the audit report is illustrated in Figure 2. Figure 2. BSR Shift Report Time Audit Tool BSR Process Audit Tool Number of nurses/shift Time Report Shift/Date/Time Nursing Unit: Number of Nurses /Shift Report Start time Report End time Total time Census Auditor Falls The number of patient falls was obtained through the hospital incident reporting system and converted into a fall rate using the standard calculation of 1,000 patient days: the total number of falls divided by the number of patient days times 1,000 (AHRQ, 2013). The number of falls in the four-month period before BSR implementation was compared to the number of falls in the f … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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