- Shank, Heidi M; Walsh, Mary Eileen
- Final DNP project was an IRB approved Quality Improvement Evidence-based practice project completed in conjunction with ProMedica Bay Park Hospital. Mary Eileen Walsh severed as my committee chair. The project summary follows: As a part of my DNP program of study at UT, College of Nursing, I worked on my DNP quality improvement project collaboratively with ProMedica Bay Park Hospital to evaluate the “Effects and Process of Nurse Bedside Shift Report on Nurse’s Perceptions of Communication Patterns, Nurse Satisfaction, and Patient Involvement.” Background information revealed a growing body of evidence identified transitions of care as vulnerable points in the care continuum where vital information is often omitted and inadequate communication occurs. Nurse shift report has been identified as a vulnerable communication point. Research has suggested that more effective communication between healthcare providers can improve care to patients and subsequently result in better outcomes. An observational evaluation identified nurse shift report lacks consistency and was not done at the patient bedside. An effective nurse bedside shift report process that provides for a focused assessment of key items and involves patients. The Agency for Healthcare Research and Quality Nurse Bedside Shift Report Checklist was identified as the choice validated evidence-based practice tool to implement for this project. A validated 17-item Nurse Assessment of Shift Report Survey was used to evaluate the effects of the process change on nurse perceptions of communication patterns, nurse satisfaction, and patient involvement. There was clear process change adoption of the nurse bedside shift report tool during this quality improvement project. A total of 55 nurses participated in education about the process change; 25 nurses completed the survey pre-implementation and at 3 months post implementation. The sole statistically significant difference was improved patient involvement in care (p = .004). However, positive trends in nurse’s perceptions of patient involvement in nurse bedside shift report on communication patterns, nurse satisfaction, and patient involvement was noted. I am currently working to conduct a one year post-implementation follow- up survey to gather stronger result data. The exciting result of this is the unexpected effects that were discovered by unit managers through analysis of patient satisfaction surveys. The impact of the project improved patient’s perceptions of nurse communication and being included in decisions about their care improved their overall experience. Because of these overarching improvements, the Regional Chief Nursing Officer for ProMedica is planning to replicate and implement this standard nurse bedside shift report process in other medical surgical units at other ProMedica hospitals system wide. I would like to examine other aspects of patient care such as impacts to patient safety as we work to move forward with this practice change initiative.
presented at event
- Doctoral Project Defense Conference