Nursing Capstone Change Proposal

Running head: CAPSTONE PROJECT BSR Capstone Project Topic 1 CAPSTONE PROJECT 2 BSR Capstone Project Initiative Bedside shift report (BSR) is an exercise that enhances patient security, as well as improves the nature of care and lessens unnecessary human services expenses. It is one of the numerous systems healthcare facilities around the United States are taking to enhance patient security and also experience and contribution in their caring. Apart from being evidence-based practice, BSR is additionally observed to improve patient fulfillment scores, particularly on the communication with nurses. The objective behind this capstone is to assess the nurses’ attitudes after the usage of bedside shift report at a nearby healthcare facility. Additionally, it will evaluate the utilization of BSR with the help of the Logic Model. Setting The capstone undertaking will be followed on all the nursing units at 120-bed teaching on a local healthcare facility. The different units at this health center will be an emergency department, two intensive care units, an orthopedic unit, a birthing center, and pediatric unit, and lastly a medical telemetry unit. Description Patient safety is an essential issue in all parts of healthcare facilities. It is directly influenced by medical errors Poor or insufficient communication among the healthcare providers is one of the significant reasons for medical errors. BSR does not give nurses a chance to evaluate their patient with an associate outwardly and additionally incorporates patients in the exchange of their care services. Communication and medical errors profoundly affect patient safety daily. By diminishing these preventable errors, hospitals can enhance patient safety, CAPSTONE PROJECT 3 diminish high healthcare costs, and enhance patient fulfillment scores. BSR is one of the numerous ways that medicinal and communication errors can be decreased. Impacts The following are the impacts to the healthcare: a) Reduced time spent in shift report. b) Enhance patient with knowledge for their disease and care process. c) Reduced communication errors among providers. d) Nurses are encouraging each other to exercise shift report at the bedside. e) Nurses will exercise BSR during shift change. Significance Patient safety in the healthcare facility is a public health problem. This subject has numerous ramifications for general society, for medicinal services providers, therapeutic costs, and human services repayment. BSR is one strategy that influences all parts of patient security. The Agency for Healthcare Research and Quality (AHRQ) evidence that BSR is useful to all patients since it enhances these four critical areas: accountability and time management between nurses, nursing staff satisfaction, patient experience of care, patient quality and safety. Patient experience of care, patient safety, and quality are major essential parts and profoundly impact public health. As evident by many healthcare that has established BSR, it enhances the power of strengthening patient-nurse relationships (Agency for Healthcare Research and Quality, 2013). Nursing Capstone Change Proposal

Proposal It will be essential if various units build up a standard report sheet that each nurse will pursue. Making a lanyard that medical attendants could bear on their identifications will be another idea. The SBAR identification lanyard will be a visual suggestion to the nurses who CAPSTONE PROJECT 4 might not feel sure when giving the patient report, or for those who often neglect to give report utilizing SBAR. There may likewise be a requirement for additional training for the nurses on the SBAR afresh. Articles Summary 1. Williams, C. L. (January 03, 2018). A Comparison of the Risks and Benefits of Nursing Bedside Shift Report vs. Traditional Shift Report: A Systematic Review of the Literature. International Journal of Studies in Nursing, 3, 2, 40. The study compares the risks and benefits of BSR against traditional shift report (TSR). For a legitimate evidence-based outline, the findings were analyzed, and efficiently pieced utilizing the best four levels of evidence-based measures. Some of the examples provided by the article are risks of shift report and communication. It stresses the fact that guaranteeing appropriate correspondence is an essential part of nursing practice. It provides evidence backings on the utilization of BSR to decrease therapeutic errors, dangers, and enhance the care quality. 2. Ghosh, K., Curl, K., Goodwin, M., Morrell, P., & Guidroz, P. (2018). An exploratory study on how to improve bedside change-of-shift process: Evidence from one hospital using technology to support verbal reporting. Hawaii International Conference on System Sciences, 3180-3187.Available at: https://doi.org/10.24251/HICSS.2018.401 The article emphasizes the inefficiency in communication which massively adds to medical errors, inflicting patient safety, and care quality. The article uses qualitative content and thematic analysis to provide a clear proof on the importance of implementing CAPSTONE PROJECT 5 Bedside Change-of -Shift Process. Provides some information on why communication failures leading to medical errors ranked third cause of deaths in the U.S. Yes, it does support my topic since it emphasizes the need to Improve Bedside Change-of -Shift Process. 3. Miller, K. BA., Hamza, A., Metersky, K., Gaffney, D, M. (2018). Nursing transfer of accountability at the bedside: partnering with patients to pilot a new initiative in Ontario community hospitals. Patient Experience Journal: Vol. 5: Iss. 1 , Article 12. Available at: http://pxjournal.org/journal/vol5/iss1/12 The article emphasizes the need to improve the quality and safety of the patient experience and patient care via the patient’s engagement and bedside implementation. The article uses qualitative in establishing more profound comprehension of the effect and issues of bedside TOA for both patients and nurses. It provides patient engagement, communication, a patient experience which will be the central part of the capstone project. The article is in line with the proposed essence of BSR implementation by highlighting the importance and challenges in implementing bedside TOA from both patients/family members and nurses perspectives. 4. &NA;,. (January 01, 2014). Improving Client and Nurse Satisfaction Through the Utilization of Bedside Report. Journal for Nurses in Professional Development, 30, 4. Available at https://nursing.ceconnection.com/ovidfiles/01709760-201407000-00002.pdf It evaluates bedside report as a way of determining whether evidence support its utilization as a fundamental shift handover exercise that advances wellbeing and CAPSTONE PROJECT 6 encourages customer and medical attendant satisfaction. It used different evidence-based literatures that relates to BSR importance to the patients and the nurses. It provides client safety and satisfaction, communication errors and teamwork. It supports my research by providing BSR implementation through Lewin’s Theory of Planned Change. 5. Gregory, S. Tan, D. Tilrico, M. Edwardson, N. & Gamm, L. (2014). Bedside shift reports: What does the evidence say? The Journal of nursing administration, 44(10),541545. DOI: 10.1097 /NNA.0000000000000115. Retrieved from: http://www.researchgate.net/publication/265516718_Bedside_Shift_Reports_What_Does theEvidenceSay The article outlines a deliberate literature review of BSRs and acts as a component to relate the need for enhancing quality care and patient-centered consideration. Nursing Capstone Change Proposal

The article used computerized search to combine all the evidence-based articles on BSR sustainability after implementation. It emphasizes the importance of communication, coaching and mentoring, and the provision of emotional support. It recommends the need to assess staff demeanors before and after BSR implementation that may be expected to maintain the desired change. 6. Bradley, S., & Mott, S. (2014). Nursing Capstone Change Proposal

Adopting a patient-centered approach: an investigation into the introduction of bedside handover to three rural hospitals. Journal of Clinical Nursing, 23(13/14), 1927-1936 10p. doi:10.1111/jocn.12403 It empirically studies the process and outcomes of the implementation of nurse‐to‐nurse BSR handover in 3 rural South Australian healthcare. The article used ethnographic CAPSTONE PROJECT 7 interviewing and 7‐point Likert scale to obtain patient perceptions. The study provides that implementing bedside handover leads to a patient‐centered system. It does by demonstrating that both staff and patients take patients to be more engaged in their care as per the bedside handover system. 7. Tobiano, G., Whitty, J.A., Bucknall, T., & Chaboyer, W. (2017). Nursing Capstone Change Proposal

Nurses’ perceived barriers to bedside handover and their implication for clinical practice. Worldviews on Evidence-Based Nursing, 14(5). https://doi.org/10.1111/wvn.12241 It explores barriers nurses go through in undertaking bedside handover. They conducted a cross‐sectional finding on 200 nurses recruited from two public and private Australian hospitals, employed on medical wards. It supports that inhibiting characteristics depicts that individual nurse and patient views, communication, or abilities hinders bedside handover. It supports my proposal since it establishes that barriers to bedside handover relate to individual patient factors and nurse factors, such as legal, political, and social factors. 8. Scheidenhelm, S., & Reitz, O.E. (2017). Nursing Capstone Change Proposal

Hardwiring bedside shift report. The Journal of Nursing Administration, 47(3), 147-153. Available at: https://doi.org/10.1097/NNA.0000000000000457 The article emphasizes the need to increase nurse compliance with bedside report and increase patient satisfaction scores. It compared nurse compliance with bedside report pre-implementation and post-implementation. The article provides that post to utilizing change management strategy, bedside report, nurse compliance with bedside CAPSTONE PROJECT 8 report and patient satisfaction scores improved in both intervention units. It does support my proposal since it proves that change management strategy approach to BSR increases nurse compliance with the process, hence enhanced patient satisfaction. CAPSTONE PROJECT 9 References Agency for Healthcare Research and Quality. (2013). Strategy 3: Nurse Bedside Shift Report (Implementation Handbook). Available at: https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagin families/strategy3/Strat3_Implement_Hndbook_508.pdf Literature Evaluation Table Student Name: Change Topic (2-3 sentences): Prior to implementing the bedside shift reporting program, a review of past studies on the topic was conducted. The aim of this review was to find resources which support the implementation process and offer guidelines on how to undertake the implementation process. Criteria Article 1 Article 2 Article 3 Article 4 Author, Journal (PeerReviewed), and Permalink or Working Link to Access Article Williams, C. L. (January 03, 2018). A Comparison of the Risks and Benefits of Nursing Bedside Shift Report vs. Traditional Shift Report: A Systematic Review of the Literature. Internati onal Journal of Studies in Nursing, 3, 2, 40. Miller, K. BA., Hamza, A., Metersky, K., Gaffney, D, M. (2018). Nursing Capstone Change Proposal

Nursing transfer of accountability at the bedside: partnering with patients to pilot a new initiative in Ontario community hospitals. Patient Experience Journal: Vol. 5: Iss. 1 , Article 12. Available at: http://pxjournal.org/ journal/vol5/iss1/12 &NA;,. (January 01, 2014). Improving Client and Nurse Satisfaction Through the Utilization of Bedside Report. Journal for Nurses in Professional Development, 30, 4. Available at https://nursing.c econnection.co m/ovidfiles/017 0976020140700000002.pdf Article Title and Year Published A Comparison of the Risks and Benefits of Nursing Bedside Shift Report vs. Traditional Shift Report: A Ghosh, K., Curl, K., Goodwin, M., Morrell, P., & Guidroz, P. (2018). An exploratory study on how to improve bedside change-of-shift process: Evidence from one hospital using technology to support verbal reporting. Hawaii International Conference on System Sciences, 31803187.Available at: https://doi.org/1 0.24251/HICSS. 2018.401 An exploratory study on how to improve bedside change-of-shift process: Evidence from one hospital using Nursing transfer of accountability at the bedside: partnering with patients to pilot a new initiative in Ontario Improving Client and Nurse Satisfaction Through the Utilization of Bedside Report. (2014) © 2015. Grand Canyon University. All Rights Reserved. Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study Systematic Review of the Literature 2018 The aim of the study was to compare the risks and benefits of bedside shift report versus traditional shift report (TSR). Does the implementation and use of bedside shift report by nursing staff reduce the potential risks of adverse outcomes, medication errors, or inaccurate or missing information, while providing benefits within the acute-care setting? Design (Type of Quantitative, or Type of Qualitative) Qualitative research design – Analysis of articles were done Setting/Sample Several reports were analyzed technology to support verbal reporting. (2018) The aim of the study was to evaluate the role of effective communication in improving patient care and reducing medical errors. Nursing Capstone Change Proposal

The current study is an attempt to understand the issues that cause inefficiencies in the bedside reporting process in various units of one hospital. The study hypothesizes that effective communication would help reduce medical errors, improve care, and improve patient satisfaction. Descriptive qualitative study. The study was conducted at a hospital 431bed acute care hospital located in the Southeast region of Texas with 900 RNs. community hospitals. (2018) The transfer of accountability (TOA) study was implemented to explore nurses’, patients’ and family members’ perceptions associated with the implementation of bedside nurse to nurse TOA. The purpose of this study was to evaluate bedside report and determine whether evidence supports its use as an essential shift handover practice that promotes safety and facilitates client and nurse satisfaction within an adult clinical care environment. Mixed method evaluative research design, comprising of both quantitative and qualitative strategies. The study was conducted at St. Mary’s Memorial Hospital, 20-bed acute and complex continuing care hospital and Qualitative descriptive © 2017. Grand Canyon University. All Rights Reserved. Ninety-five publications were reviewed Methods: Literature Intervention/Instruments review was performed through investigation and exploration using Google Scholar, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Ovid databases. Analysis Studies were precisely analyzed, and systematically pieced using the top four tiers of evidence hierarchy. Thematic analysis of prerecorded audiorecordings of interviews with registered nurses was conducted. Key Findings A structured end-of-shift report can significantly reduce content omissions and redundancies. Bedside report allows the nurse to visually meet and see their patient within the first 30 minutes of their shift. Audiotaped RN interviews were transcribed word for-word and verified by two of the authors for accuracy SGH a, 113-bed acute care hospital. Focus groups The focus groups were audio-recorded, transcribed and analyzed using directed content analysis. Findings were divided into positive outcomes and challenges to bedside nurse to nurse TOA. TOA implementation found an increase in patient safety, a personalized and timely introduction to the oncoming nurse, as well as the ability for patients and family members to ask questions. © 2017. ‘ Nursing Capstone Change Proposal

Grand Canyon University. All Rights Reserved. A review of literature on ninety-five publications was conducted. The reports were categorized into two sections: client satisfaction and nursing satisfaction The reviewed studies provide evidence that supports using bedside report as an essential shift handover practice within an adult clinical care environment, with improvements in client and nurse satisfaction determined repeatedly. Recommendations For BSR to be sustained within nursing practice, it will need to involve leadership from management and senior nurses. Bedside reporting process could be more effective if nurses share mental models. Explanation of How the Article Supports EBP/Capstone Project Provides a new body of information and evidence to support the implementation of BSR. The study also cites the importance of leadership in implementing BSR. The articles underlines the importance of effective communication in implementing BSR. Article 5 Gregory, S. Tan, D. Tilrico, M. Edwardson, N. & Gamm, L. (2014). Bedside shift reports: What does the evidence say? The Journal of nursing administration, 44(10),541-545. DOI: 10.1097 Criteria Author, Journal (PeerReviewed), and Permalink or Working Link to Access Article Prior to implementing beside reporting, it is important to provide ongoing education, support and mentoring of staff following the initial implementation until the staff are comfortable with the process, and it is embedded in their practice. This study highlights the benefits and challenges to implementing bedside TOA from the perspectives of both nurses and patients/family members Further investigation into the role of bedside report and its connection to client outcomes is warranted. Article 6 Article 7 Article 8 Bradley, S., & Mott, S. (2014). Adopting a patient-centered approach: an investigation into the introduction of bedside handover to three rural hospitals. Journal of Tobiano, G., Whitty, J.A., Bucknall, T., & Chaboyer, W. (2017). Nursing Capstone Change Proposal

Nurses’ perceived barriers to bedside handover and their implication for clinical practice. Worldviews on Scheidenhelm, S., & Reitz, O.E. (2017). Hardwiring bedside shift report. The Journal of Nursing Administration, 47(3), 147-153. Available at: https://doi.org/1 0.1097/NNA.00 © 2017. Grand Canyon University. All Rights Reserved. The article provides details on how the Lewin’s theory of planned change can provide the foundational framework to achieve success when implementing bedside report. Article Title and Year Published Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study Design (Type of Quantitative, or Type of Qualitative) Setting/Sample /NNA.0000000 000000115. Retrieved from: http://www.rese archgate.net/pub lication/265516 718_Bedside_S hift_Reports_W hat_DoestheEvi denceSay Bedside shift reports: What does the evidence say? (2014) The study conducts a systematic literature review of BSRs and serves as a mechanism to relate the support for improving quality of care, patient safety, and patientcentered care. Quantitative 100 were reviewed. Clinical Nursing, 23(13/14), 1927-1936 10p. doi:10.1111/joc n.12403 Evidence-Based Nursing, 14(5). https://doi.org/1 0.1111/wvn.122 41 0000000000045 7 Adopting a patient-centered approach: an investigation into the introduction of bedside handover to three rural hospitals. (2014) Nurses’ perceived barriers to bedside handover and their implication for clinical practice. (2017) Hardwiring bedside shift report. (2017) To explore and understand barriers nurses perceive in undertaking bedside handover. The purpose of this project was to increase nurse compliance with bedside report and increase patient satisfaction scores. Cross‐sectional survey Quasiexperimental Participants were 200 nurses working on A 149-bed community hospital The study used mixed-method, pretest post-test evaluative approach involving quantitative (quasiexperimental) and qualitative (ethnographic) elements. The study was conduc … Nursing Capstone Change Proposal