NRS 493 Grand Canyon University Improving Patients Quality Presentation

Running head: PROJECT CHANGE 1 Improving Patient Care through Bedside Report Chelsea Mull Grand Canyon University NRS 493 Professional Capstone and Practicum Prof. Colleen Darrow September 23, 2020 PROJECT CHANGE 2 Background Current evidence shows that one of the primary goals of healthcare organizations is to provide high-quality care to patients. By providing high-quality care to patients, healthcare institutions not only contributed to the overall well-being of a country but also improve the productivity of its citizens. The latter concept of improving the quality of care is often associated with improvement in patients’ experience as well as their satisfaction while undergoing treatment. Patient care is a broad concept in healthcare. It entails various aspects including treatment, prevention, management of illnesses, and the maintenance of physical and mental well-being through various services within a healthcare setting. In addition to this, patient care also entails healthcare activities related to enhancing safety, reducing pain, pallor, and pulse to improve their conditions. However, patient care is not always a smooth process as it experiences numerous challenges, including disconnections in terms of doctorpatient communication, especially when bedside reports are poorly handled. Current research, therefore, proposes that with effective bedside shift reporting, patient care can be improved in the healthcare system. NRS 493 Grand Canyon University Improving Patients Quality Presentation

Therefore, this paper seeks to analyze how patient care can be enhanced through effective bedside shift reporting. Clinical Problem Statement Effective communication and a good doctor-patient relationship are vital to the success of treatment plans. Through the two aspects, doctors can acquire adequate information, especially regarding a patient’s history, to effectively provide the right diagnosis. With an effective diagnosis, appropriate treatment is administered, resulting in the effective management and treatment of illnesses. Bigani and Correia (2018) noted that incidences of healthcare personnel dissatisfaction are common in the healthcare sector and majority of them PROJECT CHANGE 3 are rooted in the provision of inadequate information by patients. Further, the latter incidences have also become rampant with the use of electronic health records as healthcare personnel rarely make efforts to note their patient’s history, especially when they have to attend to many patients. As a result of this, healthcare professionals have numerous information gaps that affect their treatment programs’ effectiveness and the quality of care delivered. Therefore, a shift in the manner of patient-information collection and recording is necessary to solve the existing gap in quality patient care. Purpose of the Change Proposal Habitually, healthcare facilities are mostly focused on increasing the quality of care and revenue generation while ignoring the issue of nurse and patient satisfaction in patient care. While nurses’ and patients’ satisfaction is fundamental to improve healthcare organizations’ productivity and performance, the change proposal could revolutionize the healthcare sector by improving the effectiveness of patient care delivery. Traditional reporting systems are often characterized by inequities in time, low patient safety, poor nurse and patient satisfaction, which are detrimental to an organization’s reputation, productivity, and performance. According to McAllen et al. (2018), one of the notable outcomes of effective bedside shift reporting is increased patient safety and satisfaction. Further research also proposes that inefficient bedside reporting often results in inefficient and inconsistent patient care, which triggers patients’ dissatisfaction. Bedside shift reporting not only involves the capturing and relaying accurate patient information but also incorporates detailed communications and proper awareness in patient health and safety. Most importantly, it also involves abiding by the ethical principle of autonomy, which requires nurses to ensure that their colleagues have all the necessary information to make decisions about medical care and continuing with the PROJECT CHANGE 4 patient’s treatment. The latter change proposal should most importantly complement existing interventions of improving patient safety and care. PICOT Question How do admitted patients (P) benefit better from effective bedside shift reporting (I) compared to traditional reporting (C) with respect to the occurrence of adverse outcomes (O) during their hospital stay (T)? Typically, the change proposal seeks to increase patient admissions within a given healthcare organization by providing quality care. The proposed intervention that brings about this change is implementing effective bedside shift reporting, which involves patients and the incoming and outgoing nurses. The change proposal compares the benefits of the proposed intervention to traditional reporting, which doesn’t occur at the patient’s bed. To determine these benefits of the two interventions, the occurrence of adverse outcomes is considered. NRS 493 Grand Canyon University Improving Patients Quality Presentation

The proposal seeks to reduce the patient stay in the hospital and, at the same time, improve patient care efficiency and effectiveness. Literature Search Strategy Employed The literature search in this analysis is guided by the research question for the proposed change. This analysis seeks to answer the question of how to improve patient care through effective bedside shift reporting. Basically, the literature search will aim at gathering vital information using a cross-sectional approach. Apart from crucial concepts relating to bedside shift reporting, key terms, words and phrases will also be emphasized in the literature search. Considering that the literature analysis will be from peer-reviewed articles, various databases that provide such journal articles will be used to find them. In addition to this, the literature search will also take advantage of government agencies and the internet. Evaluation of the Literature PROJECT CHANGE 5 Patient care is a broad concept in healthcare and it entails various aspects including treatment, prevention, management of illnesses, and the maintenance of physical and mental well-being. According to Schirm et al. (2018), nurses have a crucial role in ensuring patient information exchange, maintaining accountability, and being responsible amongst the nurses is to their colleagues, which are vital to patient safety. The latter authors also acknowledge that the gap in the clarity of patient information and faults in technological tools adversely affects patient experiences. One of the typical problems that the paper identifies is the existence of low space drives, limiting the recording of patient education. Applicable Change or Nursing Theory Employed The change proposal employs concepts of the practice-level nursing theory to focus on the benefits of bedside shift reporting. A bedside shift report seeks to address patients’ issues at a particular time during clinical treatment, including their safety issues, treatment details, history, and conditions (McAllen et al., 2018). Therefore, the proposal provides a framework to improve the interaction between nurses regarding admitted patients being treated. With the latter proposal, patient outcomes would be improved. As earlier mentioned, the disconnection between individual nurses and patients usually occurs due to poor communication. Nonetheless, with the proposal’s implementation, nurses incoming nurses would get first-hand information from outgoing nurses at the patient’s presence, allowing them to better understand their progress, treatment, and conditions. With the proposal in place, patients can clarify and engaged more with their nurses regarding their treatment outcomes. Proposed Implementation Plan with Outcome Measures Implementation of health care interventions demands due diligence as inefficiencies can influence the delivery of patient care and healthcare outcomes. Therefore, the piloting of PROJECT CHANGE 6 the propped change should first occur within a single unit to monitor and measure the intervention’s resulting change. Nonetheless, the piloting unit should be carefully selected to ensure that the results are relatively reliable. Afterward, healthcare institutions can now generalize the intervention in all units and departments depending on the scale of its benefits compared to those of the traditional reporting systems. NRS 493 Grand Canyon University Improving Patients Quality Presentation

To ensure that the change proposal is effectively implemented, a multi-disciplinary team including nurses, physicians, patients and their family members need to be developed. The bedside this the implementation process should also abide by management and logistic policies that guide the effective delivery of care. Lastly, the management team will also educate and train all staff affected staff on conducting bedside shift reporting effectively. Decisively continuous monitoring and evaluation of the change proposal will also be vital in enhancing the intervention’s continuous effectiveness. How Evidence-Based Practice was Utilized in Creating the Intervention Plan Healthcare planning a cumbersome process and it requires decisions to be supported by both scientific and literally research. Gap identification in patient care processes requires evaluating nurses’ practice, which is compared with the patient’s preferences (Ford, Heyman, and Chapman¸2015). The latter comparison provides vital leads to understanding patient care gaps and hints the level of satisfaction among patients. After understanding this, we now focus on finding relevant evidence-based sources that discuss and provide solutions on how the identified gaps can be linked. Similarly, this is what happened in the creation of the intervention plan. Various evidence-based sources were used to provide knowledge about bedside shift reporting and how it closes gaps in patient care and how such interventions need to be implemented. Plan for Evaluating the Proposed Nursing Intervention PROJECT CHANGE 7 Considering that patients and nurses will be the latter intervention’s primary beneficiaries, they will be the major participants during the evaluation process. Their responses will thus be used to determine the benefits and effectiveness of the latter intervention. To do this, the management will first highlight the objectives and goals of intervention, which will be compared against. Nonetheless, the actual evaluation will be conducted through surveys, interviews, and questionnaires since they provide current and timely data (Grimshaw et al., 2016). After collecting data about the patients’ and nurses’ perceptions about bedside shift reporting outcomes, it will be rigorously evaluated in terms of how much the intervention meets the set goals and objectives. Eventually, the organization will be able to review the entire intervention’s framework to determine whether it is beneficial to admitted patients and nurses. With this, its contribution to the quality of patient care will be better understood. Identification of Potential Barriers to Plan Implementation and How to Overcome Them Some of the significant barriers to the plan’s implementation on an organization may include inadequate resources and lack of support from the stakeholders. Inadequate capital is one of the possible barriers as a limited allocation of funds to the implementation process could result in delays in the plan’s implementation and ineffective implementation. The other barrier that may affect the plan’s implementation is the lack of support from stakeholders, especially when the stakeholders negatively perceive the plan. NRS 493 Grand Canyon University Improving Patients Quality Presentation

This may incapacitate its implementation by causing resistance and delays during decision making. According to Ofori-Atta (2019), if a plan brings changes in financial utilization and also lacks clarity and adherence to guidelines, it may face significant opposition from the stakeholders. PROJECT CHANGE 8 Nonetheless, to overcome the two problems, the management team needs to create a budget and secure adequate allocation of resources from the healthcare organization to overcome resource shortages in the plan’s implementation. In addition to this, the management can draft the plan’s existing problems and its importance. Doing so will ensure that the stakeholders understand the value of the new intervention plan, thus buying in the idea of its implementation. Conclusion To achieve healthcare goals within healthcare organizations, they need to address the existing problems within their workplace. By solving issues such as the lack of adequate communication and interaction between nurses and patients, which are common problems, patient care quality can consequently be improved (Radtke¸2015). With the bedside shift reporting being one of the possible interventions, these organizations can be bound to numerous benefits, including improving patient information clarity. Conclusively, service delivery can also be eased with access to reliable information from patients and families and colleagues. PROJECT CHANGE 9 References Bigani, D. K., & Correia, A. M. (2018). On the Same Page: Nurse, Patient, and Family Perceptions of Change-of-shift Bedside Report. Journal of Pediatric Nursing, 41, 84– 89. Ford, Y., Heyman, A., & Chapman, Y. L. (2015). Patientsʼ Perceptions of Bedside Handoff. Journal of Nursing Care Quality, 29(4), 371–378.l Foster-Hunt, T., Parush, A., Ellis, J., Thomas, M., & Rashotte, J. (2015). Information structure and organization in a change of shift report An observational study of nursing hand-offs in a Pediatric Intensive Care Unit. Intensive & Critical Care Nursing, 31(3), 155–164. Grimshaw, J., Hatch, D., Willard, M., & Abraham, S. (2016). A Qualitative Study of the Change-of-Shift Report at the Patients’ Bedside. The Health Care Manager, 35(4), 294–304. McAllen, E. R., Stephens, K., Swanson-Biearman, B., Kerr, K., & Whiteman, K. (2018). Moving shift report to the bedside: An evidence-based quality improvement project. OJIN: The Online Journal of Issues in Nursing, 23(2). Ofori-Atta, Judymae MSN, BSN, RN; Binienda, Maura BSN, RN; Chalupka, Stephanie MSN, EdD Bedside shift report, Nursing (2019): August 2015 – Volume 45 – Issue 8 p 1-4 Radtke, K. (2015). Improving patient satisfaction with nursing communication using bedside shift report. Clinical nurse specialist CNS, 27(1), 19–25. PROJECT CHANGE 10 Schirm, V., Banz, G., Swartz, C., & Richmond, M. (2018). Evaluation of bedside shift report: A research and evidence-based practice initiative. Applied Nursing Research, 40, 20– 25. Running head: PROJECT CHANGE Improving Patient Care through Bedside Report Grand Canyon University NRS 493 Professional Capstone and Practicum Prof. Colleen Darrow September 23, 2020 1 PROJECT CHANGE 2 Background Current evidence shows that one of the primary goals of healthcare organizations is to provide high-quality care to patients. By providing high-quality care to patients, healthcare institutions not only contributed to the overall well-being of a country but also improve the productivity of its citizens. The latter concept of improving the quality of care is often associated with improvement in patients’ experience as well as their satisfaction while undergoing treatment. NRS 493 Grand Canyon University Improving Patients Quality Presentation

Patient care is a broad concept in healthcare. It entails various aspects including treatment, prevention, management of illnesses, and the maintenance of physical and mental well-being through various services within a healthcare setting. In addition to this, patient care also entails healthcare activities related to enhancing safety, reducing pain, pallor, and pulse to improve their conditions. However, patient care is not always a smooth process as it experiences numerous challenges, including disconnections in terms of doctorpatient communication, especially when bedside reports are poorly handled. Current research, therefore, proposes that with effective bedside shift reporting, patient care can be improved in the healthcare system. Therefore, this paper seeks to analyze how patient care can be enhanced through effective bedside shift reporting. Clinical Problem Statement Effective communication and a good doctor-patient relationship are vital to the success of treatment plans. Through the two aspects, doctors can acquire adequate information, especially regarding a patient’s history, to effectively provide the right diagnosis. With an effective diagnosis, appropriate treatment is administered, resulting in the effective management and treatment of illnesses. Bigani and Correia (2018) noted that incidences of healthcare personnel dissatisfaction are common in the healthcare sector and majority of them are rooted in the provision of inadequate information by patients. Further, the latter PROJECT CHANGE 3 incidences have also become rampant with the use of electronic health records as healthcare personnel rarely make efforts to note their patient’s history, especially when they have to attend to many patients. As a result of this, healthcare professionals have numerous information gaps that affect their treatment programs’ effectiveness and the quality of care delivered. Therefore, a shift in the manner of patient-information collection and recording is necessary to solve the existing gap in quality patient care. Purpose of the Change Proposal Habitually, healthcare facilities are mostly focused on increasing the quality of care and revenue generation while ignoring the issue of nurse and patient satisfaction in patient care. While nurses’ and patients’ satisfaction is fundamental to improve healthcare organizations’ productivity and performance, the change proposal could revolutionize the healthcare sector by improving the effectiveness of patient care delivery. Traditional reporting systems are often characterized by inequities in time, low patient safety, poor nurse and patient satisfaction, which are detrimental to an organization’s reputation, productivity, and performance. NRS 493 Grand Canyon University Improving Patients Quality Presentation

According to McAllen et al. (2018), one of the notable outcomes of effective bedside shift reporting is increased patient safety and satisfaction. Further research also proposes that inefficient bedside reporting often results in inefficient and inconsistent patient care, which triggers patients’ dissatisfaction. Bedside shift reporting not only involves the capturing and relaying accurate patient information but also incorporates detailed communications and proper awareness in patient health and safety. Most importantly, it also involves abiding by the ethical principle of autonomy, which requires nurses to ensure that their colleagues have all the necessary information to make decisions about medical care and continuing with the PROJECT CHANGE 4 patient’s treatment. The latter change proposal should most importantly complement existing interventions of improving patient safety and care. PICOT Question How do admitted patients (P) benefit better from effective bedside shift reporting (I) compared to traditional reporting (C) with respect to the occurrence of adverse outcomes (O) during their hospital stay (T)? Typically, the change proposal seeks to increase patient admissions within a given healthcare organization by providing quality care. The proposed intervention that brings about this change is implementing effective bedside shift reporting, which involves patients and the incoming and outgoing nurses. The change proposal compares the benefits of the proposed intervention to traditional reporting, which doesn’t occur at the patient’s bed. To determine these benefits of the two interventions, the occurrence of adverse outcomes is considered. The proposal seeks to reduce the patient stay in the hospital and, at the same time, improve patient care efficiency and effectiveness. Literature Search Strategy Employed The literature search in …