1. Bedside Handoff Part 2 Research Utilization Report Kara Ackerman & Jennifer Garello

2. Research for Handoff Ineffective communication has been cited by the Joint Commission as the root cause of most reported sentinel events. (Pierce & Dietz, 2013) Research indicates that there are advantages to reorganizing the delivery of care in order to include the patient as an active participant in the treatment and care they receive. (Friesen, Herbst, Turner, Speroni, & Robinson, 2013)

3. Handoff Recommendations The Joint Commission (2008) originally established improved effectiveness of communication among caregivers” as a National Patient Safety Goal in 2006. This goal requires institutions to develop a standardized approach to 'handoff’ communication, including opportunity for staff to ask and respond to questions” Additionally, National Patient Safety Goal 13.01.01 was added to encourage patients to be actively involved in their own care as a patient safety strategy. (Evans, Grunawalt, McClish, Wood, & Friese, 2012)

4. Improvements with Handoff An increase in nursing accountability as a result of bedside shift report was noted. Reduction in patient safety incidents (burns, medication errors, skin tears and falls) after implementing a bedside nursing report. (Friesen, Herbst, Turner, Speroni, & Robinson, 2013)

5. Concerns with Handoff Several staff members voiced a concern that conducting report in a semi-private room would violate the Protected Health Information tenets of the Health Insurance Portability and Accountability Act (HIPAA). (Evans, Grunawalt, McClish, Wood, & Friese, 2012) Critical and private information were discussed in a brief report outside the patients’ rooms. (Cacal & Moy, 2013)

6. Patient Opinions Patients who have experienced bedside handoffs report feeling safer. They also appreciate knowing their plans of care. (Maxson, Derby, Wrobleski, & Foss, 2016) “I would strongly encourage you to continue the practice of coordinating the shift change in front of the patient. It gave me a sense of involvement in the process and confidence that the incoming staff knew of the concerns that I had.” (Maxson, Derby, Wrobleski, & Foss, 2016)

7. Staff Opinions Relocation of report to the bedside resulted in greater nurse satisfaction because nurses could give and receive a much more accurate handoff without distractions, assess the patient and the immediate area (IV fluids/FV site/ pump rates) in real time, and avoid delays in receiving report and asking questions. (Evans, Grunawalt, McClish, Wood, & Friese, 2012) Staff nurses found bedside handoff a better way for them to prioritize their shift work because they could visualize all their patients. (Maxson, Derby, Wrobleski, & Foss, 2016)

8. How to Implement Expectations, goals, and evaluations were developed and probable challenges and barriers were recognized and identified. Information regarding the new initiative was communicated through e-mails before implementation. (Cacal & Moy, 2013)

9. Plan of Action Draft plan and policy Present to administration Present to staff/coworkers Institute plan of action

10. Policy The purpose of this policy is to provide safe, effective, communication between day shift and night shift, while providing continuity of care, and allowing patients to participate and ask questions regarding their medical care. It has been shown that both nurses and patients report higher change of shift satisfaction rates when reports are given at bedside. Bedside change of shift report will be implemented and monitored for positive or negative outcomes by the management staff. This is a unit-wide policy. Concerns can be addressed with the management.

11. Follow-Up Provide Questionnaire to patients and employees. Review Results Determine Effectiveness Revise if Necessary

12. Summary Goal Summary Research Summary

13. References Cacal, F., & Moy, P. (2013). Blending Caring and Excellence: Translating Culture of Caring and Safety in Bedside Handoff. Journal Of Obstetric, Gynecologic & Neonatal Nursing, 42, S57. http://dx.doi.org/ 10.1111/1552-6909.12134 http://dx.doi.org/ Deby, E., Grunawalt, J., McClish, D., Wood, W., & Friese, C. (2012). Bedside Shift-to-Shift Nursing Report: Implementation and Outcomes. Medsurg Nursing, 21(5), 281-292. Friesen, M., Herbst, A., Turner, J., Speroni, K., & Robinson, J. (2013). Developing a Patient-Centered ISHAPED Handoff With Patient/Family and Parent Advisory Councils. Journal Of Nursing Care Quality, 28(3), 208-216. http://dx.doi.org/10.1097/ncq.0b013e31828b8c9c http://dx.doi.org/10.1097/ncq.0b013e31828b8c9c Herbst, A., Friesen, M., & Speroni, K. (2013). Caring, Connecting, and Communicating: Reflections on Developing a Patient- Centered Bedside Handoff. International Journal For Human Caring, 17(2), 16-22. Maxson, P., Derby, K., Wrobleski, D., & Foss, D. (2016). Bedside Nurse-to-Nurse Handoff Promotes Patient Safety. Medsurg Nursing, 21(3), 140-145. Pierce, J., & Dietz, J. (2013). Bedside Handoff: Enhancing the Patient Experience. Journal Of Obstetric, Gynecologic & Neonatal Nursing, 42, S64-S65. http://dx.doi.org/10.1111/1552-6909.12147 Sand-Jecklin, K., & Sherman, J. (2014). A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation. J Clin Nurs, 23(19-20), 2854-2863. http://dx.doi.org/10.1111/jocn.12575http://dx.doi.org/10.1111/jocn