Date of Graduation

Spring 5-19-2016

Document Type

Project/Capstone

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Elena Capella

Abstract

ABSTRACT

Patient safety is a very broad and general term used to ensure that all aspects of patient care, from medical and nursing services to social and spiritual, are provided with the best interest of the patient. The aim statement for the project is improving patient safety by ensuring the implementation of bedside shift report by 80% of nurses by August 2016. Kurt Lewin’s change theory is going to be used to effect the change.

There were in-services given to nurses on the floor and the project was also discussed in staff meetings. Flyers were posted around the units to help build up and maintain enthusiasm for the implementation of BSR. Implementation was initiated behind schedule due to conflict in schedules and bureaucratic hoops. The implementation was started on April 28, 2016 and so there are no exact numbers at this time because there is a two week trial period. But I have had conversations with the some nurses that have started the project since initiation. So far they seem to be very receptive of the change. Most of the patients have been neutral at this time but we’ll see if that’s going to be the case in two weeks.

There are numerous publications that support the efficacy of bedside shift report in relation to patient care and safety. Publications from the Agency for healthcare research & quality (AHRQ), MEDSURG Nursing, American nurse today, Journal of Clinical Nursing and the Nursing journal are some of the articles that were used to investigate and develop ideas and policies for the project.

Patient experience with the bedside shift report (BSR) will be tracked and the data collected will be used to improve the process in order to enhance the patient experience. Patient experience would include if the patient felt more engaged in their care, if they felt safer and had more confidence in the personnel helping out with the care. Also nurse satisfaction is another benchmark that would be measured by sending out surveys periodically in an effort to gauge the opinions of the staff members. The data collected from the surveys will be used to develop improvements to the process and increase the comfort level of the nurses in giving BSR. We would also track if the nurses feel more accountable for the care they delivered during the shift and if the accountability translates to nurses being more responsible in the care that they deliver.

Periodic collection of data will be used to monitor patient satisfaction and nursing compliance. The data would be monitored by the appointed BSR champions because they would be able to monitor and collect data on compliance of the floor nurses in real time and compare it with data collected from patient satisfaction surveys. There are going to be bi-weekly meetings to analyze and improve the process by applying PDSA cycle. Analysis of the data can also help to recognize fallouts earlier and provide opportunity to make corrections.

In conclusion, sustainability is what is important. One of the ways I recommend to ensure continuity of the project by making sure that the new employees, regardless of experience, are trained during their eight to twelve week floor orientation. After conducting a failure mode effect analysis coupled with experience, I concluded that continuity is also dependent on proper training of new employees. I concluded this because nursing is a high turnover profession and if the current nurses don't teach the new nurses before they leave the facility then the whole process will have to be restarted.

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Nursing Commons

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