Implementing Evidence-Based Practice
NURS FPX 6011 Assessment 3 Interactions in healthcare are a fundamental part of every healthcare organization and delivery system to promote quality patient care. Nursing shifts are among the segments that might have problems with information passage. This process involves transferring patient information from one nurse and passing it on to the other at the end of a shift. However, Appendices to scientific evidence indicate that errors and omissions can occur with this process to jeopardize the safety of patients. A study on the incidence of adverse events due to communication failure was conducted by Raeisi et al. in the Journal of Education and Health Promotion; the study found that handover-related adverse events are prevalent (Raeisi et al., 2019). This study also reveals concerns regarding nursing shift handover, so it is crucial to resolve all of them.
NURS FPX 6011 Assessment 3 PICOT Question
In this assessment, we described how we would discuss enhancing the quality of the care bed handover and designed a poster outlining our plans for the change involved. In general, for patients undergoing care in the Acute Care Settings – Does the nursing bedside change of shift handoff, which is implemented in a standard and formalized way as compared to traditional ways of handoff, decrease adverse incidents related to patient safety?
- Population: It is focused on the improvement of the general well-being of the patients receiving care in acute care settings
- Intervention: Currently, most patients receive care from different caregivers, and shift handoffs at the nursing bedside require strict monitoring, mainly because communication errors are most likely to occur in this setting due to incorruptibility.
- Comparison: Traditional handoff process
- Outcome: This chapter focuses on two common goals in healthcare organizations and is essential to PTs: improving patient safety and decreasing adverse events.
- Time: 6 months period
Backgrounds
A nurse handoff refers to transferring information regarding the patients under a particular nurse from the latter to another nurse taking over from them. Despite its significance, failure and negligence occur through different stages, resulting in adverse consequences and decreased levels of patient safety (Hada & Coyer, 2021). The Joint Commission found the handover of the nursing bed shifts to be the primary factor in communication breakdowns and subsequent shift incidents (Bukoh & Siah, 2020). Hence, it would be beneficial to understand and adopt good practices to reduce the risks of adverse events and enhance the patient’s health.
Action Plan
Recommended Practice Change
Nursing identifies and understands the factors affecting the bedside Co conduct communication at the bedside through standard frameworks and, where possible, face-to-face handovers (Ghosh et al., 2021).
NURS FPX 6011 Assessment 3 Proposed Timeline for Implementation
The implementation process will be carried out in three phases: planning and preparation, which is estimated to take two months; implementation/ training, which is estimated to take three months; and evaluation/sustainability, which will take six months.
The tools or resources required to support the project are as follows: An enhanced version of written information transfer will be achieved through structured, effective communication methods, such as the SBAR tool (Ruhomauly et al., 2019). To optimize the performance of the new process, education and training of the care staff will be suggested.
Stakeholders and Potential Barriers
Stakeholders
these will include nurses, patients admitted to the hospital, patients’ families, and any other health care provider.
Innovation Opportunities
More advanced forms of technology include using smartphones or tablets to enhance the methods and feasibility of new processes (da Fonseca et al., 2021).
Potential Barriers
Among the challenges that may threaten the successful adoption of new processes include poor knowledge of the institutional change processes, inadequate time and resistance to the change, and scarce resource base.
Measures to eliminate barriers At this point, the following measures can be taken to overcome the barriers: Barrier I Lack of understanding. To overcome this barrier, the following actions will be taken: Academic work: Barrier II Timely teaching and Learning To overcome this barrier, the following actions will be taken: Barrier III Presentation Skills To overcome this barrier, the following actions will be taken: Barrier IV Lack of networking and research skills To overcome this barrier the following actions will be taken.
NURS FPX 6011 Assessment 3 potential barriers include nurse education/training on incorporating bedside shifts into their current schedules, resistance to change, and utilisation of available resources. When addressing obstacles to the implementation of bedside nursing shifts, Pevec (2020) postulated that the following approaches may be effective in improving this situation: It aids in eliminating possible hurdles, for instance, ignorance, time issues, rigorous opposition to change, and finite resources to enhance the chances of practical implementation.
NURS FPX 6011 Assessment 3 CriteriaThe outcome measurement will include minimising adverse events resulting from communication dismal during the handover process and improving the satisfaction level of patients and staff. This will consist of general surveys reinforced with data from chart reviews, focus group questionnaires, and interviews.
Alignment with Quadruple Aim
The outcomes also successfully address the four benchmarks of patient satisfaction, employee satisfaction, decreased staff burnout rate, and lower healthcare expenditures. Outcome measures will serve as feedback when implementing new practices intended to identify the efficacy of the new process and its possibilities for constituting guidelines for nursing handover.
Evaluation of Evidence
NURS FPX 6011 Assessment 3 literature search was conducted using the PubMed and CINAHL databases using the following search terms: bed change, nursing handover, communication, and patient safety. The chosen papers for comparison include Handover by the Bedside: A Tool to Improve Patient Safety, Standardised Handover Tool: An Effective Way to Avoid Patient Harm and Postoperative Severe Adverse Events and Quality of Handovers in Surgical Patients [11 Published Online May 2010]: Peer review (of which two were randomized controlled trials).
Findings
Effective communication management or handovers, especially where there are changes in the shift timing of the nursing staff, minimises the risk of communication errors. Hence, a standardised nurse handover process is needed to enhance patient safety and outcomes. The literature review also underpins the need for clear, measured communication interfaces, such as face-to-face handovers.
References
Bukoh, M. X., & Siah, C.-J. R. (2020). A systematic review on the structured handover interventions between nurses in improving patient safety outcomes. Journal of Nursing Management, 28(3), 744–755. https://doi.org/10.1111/jonm.12936
da Fonseca, M. H., Kovaleski, F., Picinin, C. T., Pedroso, B., & Rubbo, P. (2021). E-health practices and technologies: A systematic review from 2014 to 2019. Healthcare (Basel, Switzerland), 9(9), 1192. https://doi.org/10.3390/healthcare9091192
Ghosh, S., Ramamoorthy, L., & Pottakat, B. (2021). Impact of structured clinical handover protocol on communication and patient satisfaction. Journal of Patient Experience, 8. https://doi.org/10.1177/2374373521997733
Hada, A., & Coyer, F. (2021). Shift-to-shift nursing handover interventions associated with improved inpatient outcomes, pressure injuries, and medication administration errors: An integrative review. Nursing & Health Sciences, 23(2), 337–351. https://doi.org/10.1111/nhs.12825
Pevec, A. (2020). Bedside shift report: A way to improve patient and family satisfaction with nursing care. University of St. Augustine for Health Sciences Library.
Raeisi, A., Rarani, M. A., & Soltani, F. (2019). Challenges of the patient handover process in healthcare services: A systematic review. Journal of Education and Health Promotion, 8, 173. https://doi.org/10.4103/jehp.jehp_460_18
Ruhomauly, Z., Betts, K., Jayne-Coupe, K., Karanfilian, L., Szekely, M., Relwani, A., McCay, J., & Jaffry, Z. (2019). Improving the quality of handover: Implementing SBAR. Future Healthcare Journal, 6(Suppl 2), p. 54. https://doi.org/10.7861/futurehosp.6-2s-s54
