Strategies that improve communication between nurses, patients, and their families

Strategies that improve communication between nurses, patients, and their families

In the field of nursing, there are patient goals that are set as standards to improve the way that nurses care for and communicate with patients. For nurses to provide high-quality, Patient-centered care, they have to recognize that there are existing approaches that limit their ability to perform exemplarily. The following study has meticulously assessed the effects of the bedside shift report approach on patient satisfaction based on the reported HCAHPS scores. The metric system can be used to provide nurses with information on how the patients perceived the quality of care they received at the hospital. According to research, the adoption of BSR in hospitals reinforces patient-nurse communication since they are more actively engaged during shift report. More hospitals are advised to develop a BSR nursing policy to optimize patient care, standardize procedures, and ultimately improve their HCAHPS scores in communication.

Overview of the problem statement

Since a decade ago, relevant medical authorities have been urged to come up with strategies that improve communication between nurses, patients, and their families. There has been a need to improve the way that nurses communicate with their patients during the provision of care. The aspect of communication is inherently essential to the care delivery process because it ensures patient safety. The Bedside Shift Report is a standardized report method that would not only make hospitals more effective but also improve communication between nurses and caregivers.

Background

One of the most fundamental components of quality nurse-patient care is effective communication that ensures patient safety. The literature on effective patient care suggests that patient satisfaction is closely related to the following elements: an individual’s characteristics, their interaction with the nurse, and their perceptions of the time they have to wait for care to be provided. Effective communication is achieved by ensuring that patients are elaborately involved in boosting nursing accountability. More practitioners are adopting the use of bedside shift reports because they increase the Patient’s involvement in the treatment process.

Furthermore, using this approach improves communication between the nurses and the patients’ caregivers. In the scholars’ views, BSR can be relevantly explored to facilitate the creation of an environment that promotes patient participation (Caruso, 2007). Since recent research and literature indicated that the bedside shift report improved patient outcomes and safety, this study seeks to compare the results of the approach with those of shift reports outside the Patient’s room.

Purpose

The study will communicate relevant results reported by patients that have experienced the use of BSR. Compared to shift reports done outside the Patient’s room, there is a notable observation that BSR saves more time and saves hospitals a lot of money. Therefore, hospitals are recommended to adopt the more streamlined process of bedside reporting that promotes efficiency by discouraging the reporting of irrelevant or wrong information. The education that researchers will gain from the collected data will assist them positively influence the delivery of care and communication among patients and nurses.

Significance

Some factors have led to the development of the following paper; among them, the significant gaps in knowledge existing about the BSR model. In today’s advancing age, patients are more likely to access the internet whenever they want to diagnose their illnesses. As a result, they expose themselves to misdiagnosis since they are not appropriately educated in healthcare. Through this particular study, nurses can create a working relationship with the patients through the progressive implementation of BSR. The model creates a peaceful atmosphere that is centered on the Patient’s safety by allowing nurses to check on their physical safety quickly.

Nature of the Project

The goal of the study is to establish the results of the BSM model and compare them to those of shift reports done outside the hospital. It will be measured using HCAHPS scores that will be used to evaluate the outcomes in nurse-patient communication after the implementation of BSR. Objectives to achieve the project’s set outcomes can be achieved through the progressive application of traditional shift reports at the Patient’s bedside, but with increased patient and caregiver participation. The results that are discussed within the projects are derived from secondary data from published online sources.

Question Guiding the PICOT

For adult patients on a cardiac unit, does the Bedside Shift Report compared to Shift Reports outside the Patient’s room increase HCAHPS survey scores in the communication with nurses’ dimension.

Population- Adult patients in the cardiac unit

Intervention- Bedside Shift Report

Comparison- Shift Report outside the Patient’s room

Outcome- Increase HCAHPS survey scores in the communication with nurses’ dimension.

Hypothesis

There is a clear relationship that exists between excellent patient satisfaction scores and clear communication between nurses and patients. Hospital units that have adopted the carefully planned implementation of Bedside shift reports report higher HCAHPS survey scores in the communication with nurses section. BSR reduces medical errors associated with miscommunication by increasing teamwork among the healthcare team, providing patient-centered care.

Theoretical Framework

The field of healthcare is complex and calls for constant collaboration of ideas to improve and sustain positive impacts. This may usually require the combination of several theories that may offer different views and, thus, outcomes. The three-step model change management Framework by Lewin is rapidly adopted to transform the procedures used to provide care at the Patient’s bedside (Wojciechowski et al., 2016). The positive outcomes of the BSR approach can be realized if only various hospital units follow the three-step stage proposed by Lewin in his change model theory. The first step will be to unfreeze through persuading people of the benefits and ensuring that they are mentally prepared to accept change. The next step, according to Lewin, involves getting used to the new changes through exposure to the procedures. The final step that is known as refreezing ensures that there is constant monitoring of the changes. This way, the incorporated changes can be stressed upon and internalized by nurses and patients alike. For the changes to be effective, they have to be enforced by those promoting change as well as the resisting forces that maintain the status quo.

Key Definitions

HCAHPS survey: Hospital Consumer Assessment of Healthcare Providers and Systems survey is a standardized survey that reports patients’ perspectives of different hospitals’ delivery of care.

Patient-centered care: That is respectful to the individual needs of the Patient’s needs and also respects their values and preferences.

Scope and Limitation

The study focuses on comparing the results of adult patients treated using bedside shift reports to those treated using shift reports outside their rooms. It addresses the research question by exploring the benefits that nurses, patients, and caregivers derive from utilizing the bedside shift report. The transition from the traditional report approach to BSR is necessary for the cardiac unit because it is not patient-focused and results in poor HCAHPS scores. The case studies used to derive the results of the survey were solely focused on one group, which suggests that they do not represent different groups. There is a need for more research into the assessment of BSR based on various research groups for more conclusive data.

Chapter Summary

The introductory chapter summarizes the research by concluding that the bedside shift report would be beneficial to the cardiac unit. The approach not only increases the nurses’ satisfaction but also improves the Patient’s engagement with the healthcare providers. When utilized, the model can promote the nurses’ understanding of the Patient; consequently, this will enhance their ability to discern and address their immediate needs. Through this study, nurses and practitioners will realize the need to involve patients more in the care delivery process.

Historical Literature Review

The first reviewed literature was a study conducted to investigate the transition to Bedside Shift Reports (BSR) in nursing. The authors report that the approach is preferred because it addresses most of the barriers that limit effective communication between the Patient and nurse (Wakefield et al., 2012). They note that although some resistance met the transition, it can be made easier by careful planning and progressive implementation. The development was a significant change for the hospital; therefore, it was necessary to create an implementation plan. The collection of data was inclusive of both nurses and patients because they have different views. The nurses were required to interview post-implementing BSR; this information was used to measure patient satisfaction. The study proposed that the nurses shift to using BSR to improve the current low levels of patient satisfaction scores. For the implementation process to be successful, facilitators are required to comprehend the existing systems and identify the potential challenges that may come up during the designing of a new shift report approach.

There should be a thorough assessment of the staff’s perception before and after its implementation to evaluate the factors that influence their attitudes and readiness to use it (Tidwell et al., 2011). The same way, new nurses and staff that join the unit (the cardiac unit) have to be duly trained on the new approach before using it. Within the study, the authors note that there is a group of nurses that were still not in full support of the bedside shift report approach. They claimed that teaching the new process took a long time and is therefore not appropriate for problems that need a quick fix. One of the study’s limitation was that it was based on the results of one unit in a single academic medical unit. Other centers, such as this one, may share a few characteristics, but there may exist fundamental differences in their communication culture that may affect the implementation process (Wakefield et al., 2012). Using structured interviews on hospitalized patients may have exposed the study to bias as they may respond differently compared to if they were discharged.

LIT 2:

In the next study, the authors sought to gather evidence about the bedside report through a computer-assisted search. The journal is introduced by the observation that BSR is focused on the provision of Patient-centered care and improving the quality of patient safety. Initially, the main objective was to investigate whether breakdowns in patient-nurse communication cause medical errors. Handing off patients across different hospital settings during care is risky; and, therefore, a point of concern for nurses (Rush, 2012). Nurses are becoming increasingly careful during these handoffs, but the results are negligently minimal. Bedside Shift Report is seen as a chance to enhance communication among nurses and reduce errors through the constant engagement of the patients and caregivers (Gregory et al., 2014).

According to the studies used to make the report, caregivers agreed to use the BSR models more quickly as they enhanced communication with the nurses and medical practitioners. Members of the family are also able to listen to the patient information that nurses communicate with other nurses during the bedside transitions (Riesenberg et al., 2009). Eight articles out of 33 commented that the model also promoted teamwork among different groups of nurses by improving their timeliness and consistency. Five articles were used to cite information that supported the model’s contribution to enhancing the coordination of patient care. Coordination is particularly fundamental to a hospital setting as teams function in a complex dynamic environment. There were 29 articles that had focused on highlighting the individual benefits that the use of BSR models brought the various stakeholders of the treatment process; the Patient, nurse, and caregiver (Gregory et al., 2014). Individuals gain an advantage from the perspective of understanding the treatment process better. Furthermore, patients benefit from the timely delivery of care that is possible from the coordination of communication.

Nurses thought that the implementation of BSR had greatly improved various aspects of their relationships with their patients. The relationship between patients and nurses is usually dynamic and therefore requires honest and open communication. BSR develops aspects of information sharing, mainly because the patients are free to ask questions, share their medical history and also contribute to the making of decisions regarding their health and wellbeing (Baker, 2010). Patients are allowed to clarify whatever they want to know to clear misunderstandings and have their expectations met. Concerning the dyadic relationship between the nurses and their patients, nurses cited that through the BSR model, they were able to overcome anxiety and feelings of discomfort when they shared their stories with people that understand their frustrations. After the implementation of the model, the nurse’s average reporting time decreased by approximately 16 minutes from 45 minutes. Nurse and patient satisfaction increased by 41% from 37%. Besides, the studies were congruent with the claim that BSR led to the collection of more relevant data compared to other report approaches.

Lit 3: Bedside handover is most appropriately and effectively done during the Patient’s bed shift change process. During the process, the Patient is free to ask any questions that may concern them about their health, treatment as well as air their complaints. The study’s objective was to assess the bedside handover activities that enhanced patients’ positive attitude towards treatment at a military hospital in Jember. It used a quantitative design to collect data through conducting the sampling technique on 100 participants (Rifai et al., 2020). The nurses gathered the data through survey questionnaires that were designed to measure bedside handover techniques based on the Patient’s attitudes and perceptions.

The nurses at the hospital used the traditional method of handover before the study’s facilitators approached them. Therefore, the transfer was only carried out at the head nurse’s desk, where the nurses did not communicate directly. The lack of direct communication causes the nurses not to confirm the actual condition of the Patient at the time of the handover; compromising efficient patient care and communication. However, the introduction of the bedside handover reporting process improved patient care since it is more patient-centered. The careful implementation of BSR By nurses positively impacts the Patient’s ability and willingness to adhere to treatment plans since they have a better understanding of the process. Some of the challenges that nurses reported to facing included the lack of awareness and skills in the implementation of the model. Besides, teaching new staff the process of adopting the BSR approach used up too much and financial resources (Rifai et al., 2020). Whenever nurses and medical practitioners used medical terms during bedside shift reports, they increased the Patient’s anxiety and confusion. As a result, the authors concluded that patients felt that their privacy was disrupted when nurses used impulsive medical jargon to describe their conditions.

The research used a descriptive research design survey to collect quantitative data across 100 participants. The data collected was assessed through univariate analysis and generated in the form of frequencies and percentages. The results are indeed credible because it was conducted after approval by the Health and Research Ethics Commission (KEPK) and the university’s faculty of nursing. When the study was conducted according to the prescribed standards, patient satisfaction increased by 11.1% in 3 months. The results of the study are congruent with those of a survey conducted before to investigate the implementation of bedside handovers at the University of North Sumatra Medan. Although researchers assume that the model is being implemented in most hospitals, the process is not yet optimal because there are still nurses that skip some stages. Out of the 100 respondents, 59 strongly agreed with the opinion that bedside handover was an effective strategy to involve patients in the treatment process. Lastly, more than 50% of the participants reported that they felt more comfortable when nurses used the BSR model since it ensured that their privacy was well respected.

Literature 4:

The research by Sand & Sherman (2014) reports that significant improvements were observed after the implementation of the model to four patient survey cases. After a survey of over half a million hospital staff, researchers found that respondents related poor communication to aspects of patient handoffs that eliminate their participation. Recent literature has presented bedside shift reports so positively that the Medical-Surgical Research Utilization Team of West Virginia has sought to evaluate the new format against its reported benefits (Chaboyer & Wallis, 2010). Of the published sources used to support the results of the study, nine described in detail the correct ways to utilize the BSR model. Nurses are supposed to discuss relevant information that is related to the health of the Patient at the bedside; it is therefore not necessary to hold a group meeting like before where the off-going nurse briefs the oncoming nurse. The data collected throughout this research also sought to investigate incidences of Patient falls during a change of shift, medical errors related to the shift, and challenges faced during implementation. The number of Patient falls during shifts fell by 7 in 13 months, whereas medical errors decreased by 10 cases ten months after implementation of BSR. Since the nurses here were used to using the shift report approach, they were educated on the various benefits of the BSR beforehand. Then an ‘Improving Bedside Report’ brochure was distributed by the research team to promote the comprehension of the process. By the end of the research period, nurses reported that they were perceived to be more accountable and that patients were increasingly involved in the care process, contributing to the prevention of patient safety problems.

Methodology

In the current cardiac unit, the implementation of BSR is limited and not standardized, which causes miscommunication and avoidable medical errors. Through strengths, weaknesses, opportunities, and threats analysis, the hospital can analyze the unit’s feasibility to shift to BSR. This study uses the PICOT criteria to compare the results of using the Bedside Shift Report approach with those of shift reports outside the Patient’s room. The BSR model is reported to increase the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores concerning communication in n

ursing. The study was initially prompted by the gap in knowledge that was discovered after thorough research of literature on the material.

The study applied qualitative analysis through conventional analysis; since there are limited theories to explain the relatively new approach. Although most of the published literature focused on elaborating on the benefits derived from using the model, they mostly used a small and insignificant number of participants. The various research used to assess the model was acquired from Google Scholar. The search was conducted in the line of critical terms such as Bedside shift report (s), shift report (s), patient satisfaction, and HCAHPS scores. A total of about 43,000 results were obtained from the search; however, only ten books were used to comprehend the topic further. The articles used for reference met the following criteria: they were written in English, based on nursing, and published within the last ten years. Nonetheless, the reference sections were all reviewed for additional information and articles.

Results

According to the studies reviewed on the subject, nurse communication is fundamental to the Patient’s perception of quality healthcare. When a hospital improves communication efforts in the nurses’ dimension, at least four other dimensions experience improvements and relevant gains (Tan, 2015). Studies additionally report that bedside nurses experience a higher degree of engagement within the first six months on the job. However, on analysis, the most engaged group of nurses was usually the ones in leadership positions. This can be explained by noting that the leading nurses are more exposed to the broader working environment than the midrange nurse. There were four key areas that most studies focused on when measuring the outcomes of BSR: how well the patients were informed, how effective the care provided was, how much pain the patients experienced and how well involved in decision making the patients were. Other outcomes of the bedside shift model include improved financial savings and increased patient satisfaction. After the implementation of BSR, more nurses commented that they were able to prioritize their work more and thus provide better care to patients.

Discussion

When patients are satisfied with the care they receive in a hospital, they are more likely to revisit the center. Using the bedside shift report leads to more satisfied patients since patients not only feel safer but also have a clear scope of the nurse attending to them. The hospital setting is quickly becoming more sophisticated with technology and developments that require proper management and coordination. As a result, some of the traditional methods of doing things are getting replaced by more efficient systems and techniques. Although there are a few challenges that face the implementation of BSR, research suggests that the rewards are more than the limitations (Anderson & Ruthie, 2006). One of the most important strategies is the standardization of the process, which will ensure that nurses follow the same care protocol in all hospitals without bias. Communication-related challenges can be overcome by addressing hierarchical issues as well as providing training to new staff.

Conclusion and recommendation