Re-Standardization of Bedside Shift Report in an Acute Inpatient Rehabilitation Facility

Abstract

Problem: The lack of consistency in bedside shift report (BSR) in a 42-bed acute inpatient rehabilitation hospital (IRH) has contributed to a decrease in patient experience scores, specifically patient participation at shift change. Data indicated the 52% goal for including patients during change of shift report was not consistently met. Best evidence supports 68% patient involvement in BSR. The aim of this 15-week quality improvement project was to increase nurse adherence with the current BSR, policy, and to improve scores for patient inclusion during shift change. Method: Pre-implementation surveys were emailed to staff about their perceptions of BSR.The survey consisted of 10 questions with a Likert response format ranging from 1 to 5 with 1 being strongly disagree and 5 being strongly agree. Education on BSR was provided using a checklist from the Agency for Healthcare Research and Quality (AHRQ, 2017). Audits were done by direct observation. Results: Out of N=48, nurses, 79% (n=38) did the pre-implementation survey and 81%(n=39) were educated on BSR; 38% (n=18) complemented the post-implementation survey. For pre-implementation survey results, 82%(n=31) nurses strongly agreed that BSR promotes patient involvement in care and 29%(n=11) strongly agreed to practicing BSR regularly. For post-implementation survey, 95%(n=17) strongly agreed that BSR promotes patient involvement in care and 56% (n=10) strongly agreed to practicing BSR regularly. A total of 224 encounters were observed in 15 weeks; 75% (n=168) took place at the bedside. Out of the 168 encounters that took place by the bedside, 74% (n=124), included the patient in BSR. The facility’s Process measure scores for patient inclusion in BSR showed an average increase from 39%, four mouths pre-implementation to 60% four months post-implementation. Conclusion: Re-standardization of BSR improved nurse adherence and patient inclusion at shift change report.