Implementing Bedside Handover

1
Implementing
Bedside Handover
Ashley Bell
2
Health Issue

• There are many instances for error at shift
  report
• Studies have shown that there is much unneeded
  information during shift change and much critical
  information that is missing
• Time, miscommunication and stress all contribute
  to errors in communication
• These errors compromise the safety and care of
  the patients

3
Statistics

• 70 of all sentinel events are the result of poor
  communication
• 50 of nurses feel that the biggest concern
  during shift report is missing information
• 42 of nurses feel that distractions cause
  miscommunications during report
• Clearly it is a recognized problem within the
  nursing population

Boutilier, 2007, p. 137 Currie, 2002, p. 25
4
Target Group

• The target group is the nursing population within
  the hospital
• Nurses are often overworked, stressed, fatigued
  and under time restraints

5
Lewin's Change Theory

• Lewins change theory takes into account three
  stages for change and driving and restraining
  forces.
• These stages are
• Unfreezing
• Moving
• Refreezing

6
Driving Forces

• The driving forces are those factors which
  promote the change.
• Factors promoting bedside report
• Improved communication between nurses
• Patient involvement in handover
• Improved patient safety and care

7
Restraining Forces

• Restraining forces are factors that oppose
  change.
• Factors opposing bedside report
• Lack of confidentiality
• May take more time for report
• Nurses in a routine and dont want to change
• Nurses uncomfortable doing report in front of
  patients

8
Unfreezing

• Goal to recognize the need for change, to build
  trust, to encourage participation
• Strategies
• Present concept to nursing staff
• Promote discussion among nursing staff
• Address concerns voiced by the nursing staff
• Recruit interested and enthusiastic nursing staff
  to help implement change

Caruso, 2007, p. 18
9
Moving

• Goals plan the change, initiate the change,
  revise process based on feedback
• Strategies
• Create a reporting template, process and
  implementation plan
• Assist and monitor implementation process
• Collect feedback from nursing staff
• Revise process based on nursing staff feedback

Caruso, 2007, p. 18
10
Refreezing

• Goals integrate the change into practice
• Strategies
• Identify stage of change nursing staff is in and
  mentor accordingly
• Provide ongoing reminders and support related to
  the process
• Incorporate reporting processes into related
  clinical education

Caruso, 2007, p. 18
11
Conclusion

• What will this change achieve?
• Improved patient safety and care
• Enhanced nurse to nurse communication
• Increased patient involvement in care
• Decreased sentinel events due to poor
  communication

12
References

• Boutilier, S. (2007). Leaving critical care
  Facilitating a smooth transition. Critical Care
• Nursing (4) 26, 137-142
• Caruso, E. (2007). The evolution of nurse to
  nurse bedside report on a medical surgical
• cardiology unit. MEDSURG Nursing (1) 16, 17-22
• Currie, J. (2002). Improving the efficiency of
  patient handover. Emergency Nurse (10)
• 3, 24-27