Is Bedside Shift Report Associated with Improved Patient Outcomes?

Purpose:
To determine the impact of nursing bedside shift report on patient falls, medication administration errors and patient satisfaction with nurse communication.

Background/Significance:
Experts identify bedside shift report as an effective means of improving patient safety, nurse accountability, and patient perceptions of involvement in their care. A number of qualitative studies have examined both nurse and patient perceptions of the practice supports this perspective. However, there are few quantitative studies that examine the impact of bedside handover on nursing sensitive patient outcomes such as falls and medication administration errors.

Methods:
A quasi-experimental study design was used to retrospectively evaluate the impact of implementing bedside nursing shift report on specific patient outcomes in 15 adult inpatient units at a large academic medical center. Existing sources were mined for data on RN education and certification, patient volumes, and worked hours to determine if there were significant changes over time. Total fall data and medication error occurence reports were extracted and incident rates constructed to allow comparison across units. Responses to patient satisfaction questions specific to nurse communication were also extracted. Statistical control charts and comparison of means were used to analyze the data.

Results:
While there was not a statistically significant change in the rate of patient falls, the medication administration error rate decreased by almost half p<0.05)after the implementation of bedside shift report. Patient satisfaction with nurse communication was measured using a composite score of patient responses to three items: “The nursing staff asked me for input about my daily care,” “When nurses changed shift, the nurse caring for me introduced me to the new nurse,” and “The nurse reviewed my daily care with me in a way that I could understand.” The mean composite score for patient satisfaction demonstrated a statistically significant increase (p = 0.046) for these data.

Conclusions and Implications for Practice:
The results of this study add to the evidence that supports the use of bedside shift report to improve patient satisfaction with nurse communication and to reduce adverse outcomes related to medication administration errors.