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In the last six-eight months my hospital has tried to implement the use of bedside report (BSR) in order to be in compliance with Joint Commission Standards. Evidence-based research shows that when a new procedure is introduced into a hospital, it is best piloted in a small unit to work out the kinks before rolling it out to the entire hospital. My unit, the Maternal Unit, was selected for this roll-out based on our size and our staffing ratios. The request to start doing this form of shift report has been and is still being met with a great amount of resistance. Having been the pilot unit, at this point our unit should be setting the example for other units and introducing it in our practice when nurses from larger units either float into ours or we float down to their units. It is to be the gold standard in shift change reporting. One of the two implications to nurses is first the change in habit. Traditionally shift report has taken the nurses away from the bedside. Often nurses are preparing their report, delivering the report, and then looking at items in the chart which is mostly done at the nurses station. This means for nearly an hour the patient is without a nurse at the bedside. Changing to bedside report will put two patients in the room during change of shift, even if for only 5-10 minutes. However, these 5-10 minutes could be life-saving minutes. According to the Joint Commission, the “alone time” that patients experience during change of shift is the time when sentinel events are most likely to occur (The Joint Commission, 2017). By changing the process, nurses will be able to identify safety hazards, get a visual of patient’s condition and double check alarms and monitoring equipment while involving the patient in the situation, background, assessment and recommendation (SBAR) report for the coming shift. The second implication of changing to this method of report is improved communication between staff. BSR allows staff to work together at the bedside, ensuring accountability (Ofori-Atta, Binienda, & Chalupka, 2015). Capstone Project Topic Selection – (Nursing}
What has not happened with the implementation of the BSR at my facility thus far is the introduction of a standardized format, such as SBAR. When bedside report is done, particularly with a standardized format, communication is faster, more streamlined, and nurses are better able to prioritize. Teamwork can be improved when communication between the nurses improves. When this is done at the bedside, it assures patients and family members that their team of caretakers are working diligently together to improve their health and thus also improves patient satisfaction. I suspect the change at my facility will duplicate the evidence already reported by other studies describing not only improved communication and a decrease in sentinel events, but will also show a decrease in medication errors, less nurse overtime, and increased patient satisfaction (Ofori-Atta et al., 2015). References Ofori-Atta, J., Binienda, M., & Chalupka, S. (2015, August). Bedside shift report: implications for patient safety and quality of care. Nursing 2015, 45(8), 1-4. http://dx.doi.org/10.1097/01.NURSE.0000469252.96846.1a The Joint Commission. (2017, September 12). Inadequate hand-off communication. Sentinel Event Alert, (58). NRS-490 Capstone Project: Developing a Question Recall the components of PICOT from your research course: (P) Population of Focus (I) Intervention (C) Comparison (O) Outcome (T) Time Identify each of the components in relation to your approved Capstone Project topic. P: I: C: O: T: Then, develop a PICOT question/statement. Examples of PICOT questions/statements: • • In adult cardiac surgery patients experiencing post-operative pain (P) immediately following surgery (P), is morphine (I) or fentanyl (C), administered intravenously, more effective in reducing postoperative (T) pain (O)? For immune-compromised patients, 50 years and older (P), does the use of pneumonia vaccine (I) reduce the future risk (T) of pneumonia (O) compared with patients who have not received the vaccine (C)? © 2015. Grand Canyon University. Capstone Project Topic Selection – (Nursing}
All Rights Reserved. Project Topic Checklist Identifying a Project Topic, Developing a Question, and Selecting Sources of Literature Instructions: This checklist is designed to help students organize the weekly exercises/assignments to be completed as preparation for the final, capstone project proposal. This checklist will also serve as a communication tool between students and faculty. Comments, feedback and grading for Topics 1-4 will be documented using this checklist. Topic Task Completion Comments/Feedback Points Project Topic Identification Capstone Project Topic Selection – (Nursing}
• Explains setting and/or context in which nursing problem, issue, suggestion, initiative, or educational need is observed. ☐ • Explains the problem, issue, suggestion, initiative, or educational need. ☐ • Describes the impact of the project topic on a) the work environment, b) the quality of care provision, and c) patient outcomes. ☐ • Discusses the significance of and the implications to the nursing profession. ☐ _____ / 5 • Proposes a solution to the identified project topic. ☐ _____ / 10 _____ / 10 _____ / 10 _____ / 5 Total © 2015. Grand Canyon University. All Rights Reserved. _____ / 40 • Identified components of PICOT: P – Population of Focus I – Intervention Question Development ☐ C – Comparison O – Outcome (T – Time) _____ / 30 • PICO (T) question/statement development. ☐ _____ / 10 Total Literature Source Selection • Performance of Rapid Appraisal (see below) on a minimum of 8 peerreviewed articles. _____ / 40 ☐ _____ / 100 Total _____ / 100 Rapid Appraisal This step requires the selection of a minimum of 8 peer-reviewed articles that have been published within 5 years. Perform a rapid appraisal of each article selected by addressing the following (one to two sentences per item are sufficient): 1. How does the article describe the nature of the problem, issue, suggestion, initiative, or educational need you have identified? Capstone Project Topic Selection – (Nursing}
2. Does the article provide statistical information to demonstrate the significance of the problem, issue, suggestion, initiative, or educational need? 3. Does the article provide example(s) that apply, such as: morbidity, mortality, rate of incidence or rate of occurrence in the general population? 4. Does the article support your proposed change? How so? © 2015. Grand Canyon University. All Rights Reserved. .. Capstone Project Topic Selection – (Nursing}