NR 505 Week 7: Exploring Research Results

NR 505 Week 7: Exploring Research Results

PICo questions: How do nurses in an inpatient setting perceive the value of bedside shift report?

Completing last week’s research, it is apparent that bedside shift report adds a layer of safety for the patients. A qualitative study in an inner-city, acute care teaching hospital, was done to gain insight on what experiences nurses had with BSR. Jeffs et al. (2013) interviewed 43 female nurses from various clinical specialties. The participants were asked to list the positive and the negatives about BSR. Topics that were covered included describing the positives and negatives of face to face interactions with nursing colleagues; the negative outcomes associated with the interactions and involvement of patients in care planning; and if they felt that the care was more patient-centered and safer. Over six months, the nurses took in observations and found that they could identify, intercept and correct potential errors. In addition, they could clarify the care plan and patient needs. The nurses were also able to prioritize care with a quick assessment. The results may be affected by the limitation of the study only taking place in one hospital. The study was well rounded to include nurses from different units.

My plan in implementing a change to bedside shift report is to improve patient safety

by improving nurse to nurse communication and reducing hospital events including patient falls. I would gather the baseline quality data for the hospital units involved in the study. Once the plan is discussed with all members involved and the education on how to conduct the BSR is provided to the nurses involved in the implementation the next step is to do. Set the date and start monitoring and evaluating the new process of BSR. Conducting interviews with nurses at the beginning and several weeks later to understand barriers and successes from the new process. The length of time to conduct interviews can be difficult to determine in a qualitative study. In this process change scenario, I would continue to conduct interviews until I started to receive redundant responses to questions multiple times. Next, I will study the data obtained through the interviews and the quality data collected over that same time period. I should be able to determine if I reached the outcome I predicted and if the implementation went as I planned. This is a good time to evaluate any barriers or challenges encountered during the implementation. The step in the PDSA is act. Taking the information learned during the implementation and ensuring that the solutions remain sustainable.

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), 226-232. doi:10.1097/NCQ.0b013e3182852f46

I think using a pilot as a way to test an Evidence Based Practice concept is the best way to roll new ideas out in the clinical area. Using the Plan-Do-Study-Act (PDSA) model ensures the trial has the best chance for appropriate results. Currently in our ED we have several trials going on at one time. Many times, we find that we need to make small corrections to the process based on the feedback from staff. No one concept will work in every environment in the exact same way so a trial allows the team to strive towards meeting the ultimate goal with specific components included, but maybe using different methods or processes. We wanted to solve the problem of having outdated supplies in the patient rooms. During our Gemba walks we discovered wasted steps, time, and resources to this one issue. We needed someone to restock the rooms when we needed those minutes of work doing actual patient care. So our ED LEAN staff members went to work to identify possible solutions with their co-workers during their multiple daily huddles. Our trial based on their ideas consisted of pulling all stocked supplies out of our ED patient rooms and created areas in the hallways in proximity to their ‘pods’. Each pod has a quick supply cart, IV cart, EKG machine, portable vital signs machine, and a crash cart. We placed ta

NR 505 Week 7 Exploring Research Results

pe on the floor where each cart should be placed and color coded each cart with the coordinating color of the pod and floor tape. We have four areas in our main ED space so we have a red, orange, blue and green pod with equipment in the hall for each. This has proven to be a great success and we are now having the tape professionally applied to the floor so our EVS can seal it to the floor.

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Your post regarding bedside shift report (BSR) is quite interesting.  I believe there is a need for more data supporting the efficacy and benefits associated with bedside shift report.  I have worked in facilities where the staff was transitioned to bedside shift report. For the most part, staff was extremely resistant to the idea for a myriad of reasons that varied from BSR extends the length of time it takes to report off to concerns regarding the risk of breaks in patient confidentiality to the staff just simply did not see a need to do so.  Roslan and Lim (2016) conducted an interpretive, descriptive, qualitative study using focus group interviews with semi-structured questions.  Twenty nurses were asked about their perception of bedside clinical handover. Results of this study concluded that the nurses found bedside clinical handover to be a possible cause of breaks in patient confidentiality, a source of interruption and distraction by patients and family members.  On the other hand, research subjects also found bedside clinical handover to be a foundation for communication between patients and nurses.  As an acute care nurse, I know and understand the angst caused from bedside report.  Despite this fact, I remain a staunch supporter of bedside shift report. When I was a manager, I cannot recall the number of times I received complaints from staff who complained because the patient in room 301 had an infiltrated IV at the start of the shift or the patient in room 345 was dirty at the beginning of the shift or the patient in room 320 was complaining because they have been asking for pain meds for over an hour.  Each of the issues would have been known and could have been addressed during shift report.  Most nurses do not intentionally leave work undone but there is the occasional unicorn who leaves work undone on a consistent basis.  Although healthcare is a 24-hour rotation, no nurse wants to follow someone who consistently leaves a mess for the next shift. BSR hinders the possibility of this becoming a persistent issue.

I look forward to your continued research on this matter.


Roslan, S. & Lim, M. (2016). Nurses’ perceptions of bedside clinical handover in a medical-surgical unit: An interpretive descriptive study. Retrieved from: