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Chelsea Woodmore
4/19/17
I pledge.
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 2
Abstract
The purpose of this integrative review is to appraise literature relating to the use of
bedside shift reporting and the effects it has on patient care satisfaction. One of the
patient information. The implementation of bedside shift reporting allows for better
communication between nurses, and also helps ensure that misinformation is not
passed on between care providers. Databases such as EBSCO and PubMed were
utilized to find research articles. The search yielded 47 articles form the Nursing
Reference Center and 22 articles from PubMed. The results of these five articles
satisfaction. Due to the researchers limited experience and first attempt at writing
an integrative review, there are some limitations to this review. Additional research
hospitals.
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 3
the use of bedside shift reporting and the effects it has on patient care satisfaction. A
facilitating the transition of care from one provider to another (Cairns, Dudjak,
Hoffmann, & Lorenz, 2013). The most frequently cited root cause of sentinel events
(Cairns et al., 2013). Shift report routinely takes place behind the nurses station or
outside the patients room, opening the door for misinformation. Also, this type of
reporting rarely gives the patient or family a place to exchange information that may
be important to the oncoming shift (Radtke, 2015). This area interests the
researcher due to the decrease in patient care satisfaction that impacts many
aspects of the organization, including the health care providers. Therefore, the
medical-surgical unit, does implementing bedside shift report lead to greater patient
satisfaction with care when compared to traditional shift change report at the
nurses station?
Design/Search Methods
The research design is an integrative review, which was conducted for a class
assignment for an undergraduate nursing program. The search for research was
conducted utilizing the computer-based search engines EBSCO and PubMed. The
search terms included, bedside shift report, patient satisfaction, traditional shift
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 4
report, and patient care. The search yielded 47 articles from the Nursing Reference
topic. To obtain current articles, the search was limited to quantitative and
reviewed and in English. The articles also needed to pertain to the researchers PICO
bedside shift report lead to greater patient satisfaction with care when compared to
traditional shift change report at the nurses station? The articles were then
selected based on the following inclusion criteria: med-surg units, bedside shift
reporting, and patient satisfaction about care. The research articles were screened
based on inclusion criteria and PICO question significance. Articles that did not meet
criteria were excluded from the review. The screening produced 5 bedside shift
review.
Findings/Results
The findings and results of the five reviewed studies indicated an increase in
evidenced by clinical measure outcomes (Cairns, Dudjak, Hoffman, & Lorenz, 2013;
Gregory, Tan, Tilrico, Edwardson, & Gamm, 2014; Luthy et al., 2017; Radtke, 2013; &
et al., 2013
; Radtke, 2013; & Sand-Jecklin & Sherman, 2014). In the quantitative study
between bedside shift reporting and patient satisfaction. Utilizing a 5-point Likert
scale (1 = strongly agree to 5 = strongly disagree), data was collected from patients
model as the framework, the surveys were administered pre and post
implementation of bedside reporting. No mention was made of the sample size, but
it was concluded that patients felt as the nurses kept them better informed of their
care.
Nursing Care survey tool, the authors engaged patients views on communication
including, if important information was reported from shift to shift and if patients
were included in shift report discussion. All data was analyzed using ANOVA
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 6
comparisons, and the authors found that patients perceived better nurse
communication and felt that they were continually informed of their care.
1100 patients were surveyed during the course of one year. As their framework,
Radtke used Peplaus interpersonal relations theory that is based on the idea that
assess, plan, and put context behind the care delivered to their patients (Radtke,
2013). The author also used Lewins Theory of Planned Change to drive the pilot
study for bedside implementation. Patients were surveyed before the change to
and again three-months after. After completion of the study, the author found that
75% in the previous six months. The author concluded that using bedside shift
patients felt that they were more involved in their own care (Gregory et al., 2014;
Luthy et al., 2017 and Sand-Jecklin & Sherman, 2014). In the two quasi-experimental
controlled studies, patients were more involved with the day-to-day decision of
their care and that more family involvement also occurred with bedside shift
reporting (Luthy et al., 2017 & Sand-Jecklin & Sherman, 2014). Sand-Jecklin used a
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 7
and the authors found that patients were encouraged more by the nurses to be
involved in their own care and were offered good explanations about their care.
medical unit. 90 patients from each ward were asked such questions as whether
they felt sufficiently involved in treatment and if they felt family was given the
opportunity to be involved in care. The authors found that patients in the bedside
report group felt more involved in their care compared to the group that kept the
review of bedside shift reporting as it relates to patient safety and satisfaction. Using
narrowing down the number to 33. These articles had to have met the inclusion
criteria and the summary of their findings yielded six major themes. Two themes,
patients felt more comfortable asking nurses about their health, felt more involved
with their care, and felt more empowered with their health care.
Discussions/Implications
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 8
The findings of the integrative review address the effects of bedside shift
reporting versus traditional shift reporting at the nurses station concerning patient
satisfaction of care received. Therefore, the review findings relate to and support
the researchers PICO question. The PICO question specifically asked about the
effects of bedside shift reporting on patient care satisfaction. The four quantitative
increased patient satisfaction (Cairns, Dudjak, Hoffmann, & Lorenz, 2013; Luthy et
Bedside shift reporting has proved beneficial for both the patient and the
nurse, but one of the biggest challenges comes with maintaining implementation of
bedside shift reporting (Gregory et al., 2014). Hospitals must find a way to ensure
satisfaction and driving up HCAPH scores. One issue that will continually need to be
reporting, as some studies found that patients and nurses alike were concerned
about relaying private information during bedside reporting (Cairns et al., 2013).
Limitations
influenced this integrative review. The review is a final class assignment being
nursing student who commutes two hours every day, with limited time available
due to class schedule and other commitments. This is the researchers first attempt
affecting the project. The assignment criteria were limited to 5 nursing journal
Conclusion
showed that bedside reporting made patients feel more involved in their care and
created better communication between them and their care providers (Cairns et al.,
2013; Gregory et al., 2014; Luthy et al., 2017; Radtke, 2013; & Sand-Jecklin &
Sherman, 2014). Bedside shift reporting also improved nurse perception, as nurses
felt more prepared at taking on the responsibility of their patients and were able to
form a more trusting relationship with their patients (Cairns et al., 2014 & Gregory
better communication between nurses and patients can increase patient safety and
References
Cairns, L. L., Dudjak, L. A., Hoffmann, R. L., & Lorenz, H. L. (2013). Utilizing bedside
Gregory, S., Tan, D., Tilrico, M., Edwardson, N., & Gamm, L. (2014). Bedside shift
doi:10.1097/NNA.0000000000000115
Luthy, C., Francis Gerstel, P., Pugliesi, A., Piguet, V., Allaz, A., & Cerraschi, C. (2017).
doi:10.1371/journal.pone.0170474
bedside shift report. Clinical Nurse Specialist: The Journal For Advanced
Sample/ Setting/Ethical 3 wards were used in the hospital, with 90 patients from each ward were included in
Considerations the study and completed the PiQ
Because this study was not considered a human subjects research, but instead an
institutional quality improvement study, it was exempt from the Institutional Review
Board of the Geneva University Hospitals
Major Variables Studied Independent variable: one group of four units were assigned to conduct bedside
(and their definition), if rounds, while the other group of four units were assigned to round as usual, whether
appropriate that be bedside or outside the patients room
Measurement Tool/Data
Collection Method Patient satisfaction was measured using the Picker questionnaire
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 12
Data Analysis Chi-square tests were used to analyze the differences in individual items of
satisfaction
One-way ANOVA tests were utilized to analyze the 9 satisfaction dimensions
between groups
Findings/Discussion
Significant improvement in patient satisfaction was seen in the group that conducted
bedside reporting, including increased satisfaction in involvement of family and
friends, discharge planning, and coordination of care
There was also increased patient satisfaction regarding patients being able to
identify the attending physician and nurse, receiving more information about their
health, and the opportunity to discuss treatment tailored to the patients needs.
Appraisal/Worth to
practice Bedside shift reporting is an essential part of inpatient care and contributes to
increased patient satisfaction, with better family involvement, care coordination, and
transition of care.
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 13
Sample/ Setting/Ethical The sample size for the patient survey was 233 at baseline data collection, 157 at
Considerations three-month post implementation, and 154 patient at 13-month implementation
The sample size at baseline for the nurse perception survey was 148, at three-
month post implementation it was 98, and at 13-month post implementation it was
54
The researchers stated their research was approved by an internal review board
Major Variables Studied Patient satisfaction of bedside reporting
(and their definition), if Nurse perception of bedside reporting
appropriate Three-month post implementation of bedside reporting
13-month post implementation of bedside reporting
Measurement Tool/Data The Patient Views on Nursing Care patient survey tool was used to engage
Collection Method patients views on different aspects of patient satisfaction
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 14
17 items were surveyed and each item had a five-point Likert-type response option,
with five indicating excellent care and one indicating poor care
Nurse perception of bedside report was collected using the Nursing Assessment
Shift Report; survey
Appraisal/Worth to Bedside shift reporting may improve patient satisfaction, perception of care,
practice involvement in care and could also impact the frequency of medication errors and
patient falls at shift change.
More quantitative research is needed to measure the efficiency of bedside reporting
in the nurses perception
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 15
Sample/ Setting/Ethical 33 studies met all inclusion criteria including: data specific to nurses and shift
Considerations reports at patients bedside
Data Analysis Studies were used that met specific inclusion criteria: (i) data specific to nurses and
(ii) shift reports at the patients bedside
Studies with (i) non-empirical data, (ii) non-peer reviewed articles, (iii) overlapping
cohort studies, (iv) articles not in the English language, and (v) published abstracts
were excluded
Findings/Discussion Strong evidence supports the benefits of bedside reporting, however issues still
remain about sustaining implementation of bedside reporting.
Appraisal/Worth to Evidence continues to support the benefits of bedside reporting, but one of the
practice biggest concerns is staff continuing to implement the change which may require a
more standardize approach to implementation
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 17
Sample/ Setting/Ethical A sample size of an average of 280 patient per quarter, with a total of more than
Considerations 1100 patients annually
Major Variables Studied Unfreezing stage: getting rid of the old way of nurse reporting and implementing
(and their definition), if bedside shift reporting
appropriate Moving stage: Once the goal was reviewed, a proposal was developed
Refreezing: the process of bedside reporting was implemented
Measurement Tool/Data Data was collected via survey and interviews
Collection Method
Data Analysis The researchers did not state how they analyzed the data
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 18
Findings/Discussion There was a rise in patient satisfaction in nurse communication after implementation
of bedside reporting.
The unit did not reach its goal of 90% HCAPHS score, but did show that practice
change did impact this particular area of patient satisfaction
Appraisal/Worth to This article showed that it is possible to sufficiently organize the implementation of a
practice new type of reporting process
It highlighted the different complications for implementing new policies and how an
organization can overcome them
AN INTEGRATIVE REVIEW: BEDSIDE SHIFT REPORTING 19
Conceptual/theoretical This particular study was conducted as a result of a unit staff nurse concerns about
Framework the length, accuracy, and disorganization of the current method of automated shift
report
W. Edwards Demings plan-do-study-act (PDSA) model was the framework used for
this study
The PDSA model is a method of performance improvement incorporating tracking,
defining, and evaluating a practice or process change
Design/ Quantitative experiment
Method/Philosophical
Underpinnings
Sample/ Setting/Ethical The researchers did not mention how many nurses and patients were involved in
Considerations this study
The article did not mention if the study was approved from the ethics board
Major Variables Studied The survey was given to the nurses 3 months before implementation of bedside
(and their definition), if shift reporting and 3 months after implementation
appropriate
Data Analysis The researchers did not mention how the data was analyzed
Findings/Discussion Positive outcomes of the implementation of bedside shift report included reductions
in shift overtime and call light usage and an increase in patient satisfaction
Appraisal/Worth to The reduction in call light usage has significant safety implications for those patients
practice that pose a fall risk
The decrease in overtime can help the organization save money
Increased patient satisfaction helps increase HCAPH scores and therefore increase
business for the organization