• Standardized Handoff Tool for Bedside Shift Report in a Cardiac Surgery Telemetry Unit

      Gan, Geraldine C.; Fornili, Katherine
      Problem and Purpose: Bedside shift report (BSR) is an evidence-based practice utilized by nurses to communicate patient information and plan of care. An unstandardized shift report delivered at the nursing station may lead to miscommunication about important patient information, negate patient involvement, and may lead to unsatisfactory patient experience. Standardized BSR can improve patient safety, outcomes, and satisfaction (Scheidenhelm & Reitz, 2017). On the Cardiac Surgery Telemetry unit (CSTU) at a large teaching hospital, shift reporting lacked standardization. This ultimately was reflected in low patient satisfaction scores on the overall patient hospital experience, as measured by the Hospital Consumers Assessment of Healthcare Providers and Systems (HCAHPS). The purpose of this quality improvement project was to implement and evaluate the effectiveness of a standardized Situation, Background, Assessment, Recommendation (SBAR) handoff tool during BSR on the CSTU to promote patient and family involvement and improve nurse communication. Methods: A BSR team was created that consisted of the project lead, unit manager, and four change champions. All staff nurses were educated and trained on the benefits of BSR and utilizing the Agency of Health Research and Quality (AHRQ) Bedside Shift Report Checklist as a guide (Appendix B). A Bedside Shift Report Staff Training Checklist was used to track nurse training completion and competency. A Bedside Shift Report Audit Form was used to track adherence with performing nurse handoff reports at the bedside (Appendix D). Results: 100% of unit nurses completed education and training prior to project implementation. The mean weekly rate of adherence to BSR was 85.4% (range = 77.1%-91.2%) during the implementation period. Total BSRs expected were 1,626; actual BSRs performed were 1,388 (85.4%); and missed opportunities to perform BSRs were 238 (14.6%). Conclusions: Standardizing nurse handoff report at the bedside is expected to increased nurse adherence to BSR and may have improved patients’ perception on nurse communication, as well as patient safety. The unit manager will continue to monitor quarterly HCAPHS scores to determine whether nurse communication scores have improved over time, but these results will not be evaluated as a part of this QI project.