JLH and Rambo Final Poster

Getting Emergency Department Nurses to do Bedside Handoff
Janet Heath and Jennifer Rambo

Bon Secours Memorial College of Nursing
Synthesis in Nursing Practice
NUR 4242
W. Liverman
Purpose of Project PDSA Before & After

The purpose of this Quality Improvement Project is to increase awareness and
educate Emergency Department nurses about the importance of bedside
handoffs. Since it is not being practiced in the department, emphasis was
placed on how evidence validates improved patient safety resulting in better Plan
patient outcomes when bedside reporting is put into effect. The goal is to The long term plan is to transition to bedside
hand-off for 100% of all nurse to nurse hand-offs.
improve compliance and to increase awareness regarding the advantages of The plan for the first cycle of this PSDA cycle is to
give an in-service during our daily huddles. This
engaging in bedside reporting. It has been proven to decrease adverse events, will introduce the staff to the concept and make
as well as, encouraging communication between staff members. Studies have them aware of what is expected of them. The
importance of bedside hand-off will be discussed.
shown that .good communication also increases satisfaction of patients and Evidence based practice research will be
available for staff to read .
their family members and decreases error, ensuring safe passage for patients
(Rogers, Li, Clements, Casperson, & Sifri, 2017, p. 105). Study
Some nurses will resist changing to bedside hand-
off. Do
Due to limited time and resources, it would be We will plan to observe nurse hand-off for 4 days
difficult to obtain adequate results. throughout the weeks of June 30th through July
Overlap of assignments will result in prolonged 14th.
length of time to start report to oncoming nurses.
Some nurses adapt well to bedside reporting.
Aim of Study Act

The next PSDA cycle will involve a larger section
of the emergency room. It will include feedback
The Aim of this study is to improve the compliance of bedside shift exchange from the nurses on what works best for them, what
between incoming and outgoing nurses in the Emergency Department to >90% are the obstacles they face that prevents them
from participating in bedside handoff, and receive
by July 14, 2017. Transforming Care at the Bedside (TCAB) was a national feedback about what the unit could do to help Baseline data was observed prior to the start of the project. It was determined
initiative developed by the Robert Wood Johnson Foundation in collaboration improve compliance.
that 85% of the time nurses did not engage in bedside hand-off. On day 2, after
with the Institute of Healthcare Improvement (IHI) that ran from 2003 through
the implementation of the Bedside Handoff Quality Improvement Project, we
2008 ("TCAB," 2011, p. 328). This initiative alone, along with additional
research has proven that successful implementation of bedside handoff observed a significant increase in bedside hand off. Bedside hand-off
contributes to the global aim of patient safety and satisfaction. increased to 75% during a 24 hour observation window. We can predict, that
with further education and reinforcement we can get that number to improve to
greater than 95% nurse to nurse hand-off at the bedside.
Conclusions
Method
Improved patient outcomes were not seen in the short period of time during this
project. However, research shows that when patients are engaged in their
Data analysis was obtained by observation of nurses in the emergency department health care, it can lead to measurable improvements in safety and the quality of
giving bedside report prior to the initiation of the Quality Improvement Project. Two days
after the project was implemented, measurements were obtained once more by the same
care received. The agency of healthcare research and quality (AHRQ) stated
that research shows that when patients are engaged in their health care, it References:
method. Results were compared using percentages with pie charts. can lead to measurable improvements in safety and quality ("AHRQ," 2013, Agency for healthcare research & quality. 2013, June). Strategy 3: nurse bedside shift
Education and emphasis on the importance of bedside reporting was communicated to para. 7). report agency for healthcare research & quality. Retrieved July17,
the staff nurses during Huddles, providing information regarding the correlation 2017fromhttp://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/stratgy
between evidence based practice and positive outcomes related to bedside handoffs. 3/index.html
Initially, the staff was introduced to the concept during Huddle. Awareness of the
expectation was discussed and the initiative was accepted. Additionally, the Project and Rambo, J. (2017). Pass It On Star. Richmond, VA.
Unit Coordinators reinforced implementation of bedside reporting during Huddle for the
duration of the project.
Rogers, J., Li, R., Clements, R., Casperson, S., & Sifri, C. (2017, April). Can
We Talk? The bedside report project. Critical Care Nurse, 37(2), 104-107.
Laminated, bright, yellow signs were placed near and around the nurses station as a http://dx.doi.org/10.4037/ccn2017369
reminder to do bedside reporting with the catchy phrase to pass it on, shift to shift,
ensure a safe handoff, take it to the bedside (Rambo, 2017). Strategy 3: Nurse Bedside Shift Report. (2013). Retrieved from
https://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy3/index.
Pass if on,
shift to shift, html
ensure a safe
hand-off, take
it to the
bedside Transforming Care at the Bedside. (2011). Retrieved from
http://www.ihi.org/Engage/Initiatives/Completed/TCAB

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Getting Emergency Department Nurses to do Bedside Handoff

Janet Heath and Jennifer Rambo

Purpose of Project PDSA Before & After

Aim of Study Act

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