The Move from Recorded to Bedside Shift Report: Evaluating Barriers to Full Implementation.

摘要

Many sentinel events in acute care centers can be attributed to miscommunication of patient information at shift change. A growing body of evidence supports the implementation of bedside shift report as the standardized approach to ensure effective communication by staff. The purpose of this study was to identify the barriers that impede nurses from fully participating in bedside shift report in order to create an educational initiative to develop the nursing staff's proficiency in performing bedside report. Lewin's change theory served as the framework for the project. Data for the staff development project were collected using a focus group approach with 18 nurse participants. A classic method of analysis, defined and outlined by Krueger and Casey (2009), was used to identify themes and categorize results. A second evaluator of the data supported thematic findings. Nurses revealed barriers consistent with the literature including frequent interruptions, patient confidentiality, sensitive issues, and inconsistent report content. Barriers identified by this study, but not evident in the reviewed literature, included staff unavailability to answer call lights and having to receive report and transfers during report. An education plan was developed based on perceived barriers and evidence in the literature. Implications for positive social change include interventions to refine the current practice of bedside shift report in order to promote effective and efficient communication at change of shift. Findings can inform nursing units in the hospital and other facilities to achieve patient-centered care and improved outcomes. It is critical that nurses understand the positive impact that consistent, timely, and effective shift reports have on providing safe, quality patient care.