Best evidence statement (BESt). Increasing patient satisfaction by moving nursing shift report to the bedside.
General
Guideline Title
Best evidence statement (BESt). Increasing patient satisfaction by moving nursing shift report to the bedside.
Bibliographic Source(s)
- Cincinnati Children’s Hospital Medical Center. Best evidence statement (BESt). Increasing patient satisfaction by moving nursing shift report to the bedside. Cincinnati (OH): Cincinnati Children’s Hospital Medical Center; 2013 Aug 12. 4 p. [6 references]
Guideline Status
This is the current release of the guideline.
Recommendations
Major Recommendations
The strength of the recommendation (strongly recommended, recommended, or no recommendation) and the quality of the evidence (1a‒5b) are defined at the end of the “Major Recommendations” field.
It is recommended that nurses perform bedside shift to shift report to increase patient/family satisfaction (Maxson et al., 2012 [4a]; Radtke, 2013 [4a]; Sand-Jecklin & Sherman, 2013 [4a]; Tidwell et al., 2011 [4a]; Thomas & Donohue-Porter, 2012 [4b]).
Definitions:
Table of Evidence Levels
| Quality Level | Definition |
|---|---|
| 1a† or 1b† | Systematic review, meta-analysis, or meta-synthesis of multiple studies |
| 2a or 2b | Best study design for domain |
| 3a or 3b | Fair study design for domain |
| 4a or 4b | Weak study design for domain |
| 5a or 5b | General review, expert opinion, case report, consensus report, or guideline |
| 5 | Local Consensus |
†a = good quality study; b = lesser quality study
Table of Language and Definitions for Recommendation Strength
| Language for Strength | Definition |
|---|---|
|
It is strongly recommended that… It is strongly recommended that…not… |
When the dimensions for judging the strength of the evidence are applied, there is high support that benefits clearly outweigh risks and burdens (or vice versa for negative recommendations). |
|
It is recommended that… It is recommended that… not… |
When the dimensions for judging the strength of the evidence are applied, there is moderate support that benefits are closely balanced with risks and burdens. |
|
There is insufficient evidence and a lack of consensus to make a recommendation… |
|
Note : See the original guideline document for the dimensions used for judging the strength of the recommendation.
Clinical Algorithm(s)
None provided
Scope
Disease/Condition(s)
Any disease or condition requiring hospitalization
Guideline Category
- Management
Clinical Specialty
- Nursing
- Pediatrics
Intended Users
- Advanced Practice Nurses
- Hospitals
- Nurses
Guideline Objective(s)
To evaluate, among patients and families, if implementation of bedside nurse to nurse shift report versus a non-bedside nurse to nurse shift report increase patient/family satisfaction during hospitalization
Target Population
All hospitalized patients; if under age of 18, with caregiver present
Note : Patients/parents electing not to participate were excluded.
Interventions and Practices Considered
Bedside nurse to nurse shift reporting
Major Outcomes Considered
- Patient/family satisfaction during hospitalization
- Medication errors
- Patient falls
Methodology
Methods Used to Collect/Select the Evidence
- Searches of Electronic Databases
Description of Methods Used to Collect/Select the Evidence
Search Strategy
- Databases : PubMed, Cochrane Library, CINAHL, OVID MEDLINE
- Search Terms : Nursing; handoff; shift report; patient satisfaction; bedside handoff
- Limits, Filters : English language, Search dates: 2006 to 2013
- Date last searched : February 26, 2013
Number of Source Documents
Not stated
Methods Used to Assess the Quality and Strength of the Evidence
- Weighting According to a Rating Scheme (Scheme Given)
Rating Scheme for the Strength of the Evidence
Table of Evidence Levels
| Quality Level | Definition |
|---|---|
| 1a† or 1b† | Systematic review, meta-analysis, or meta-synthesis of multiple studies |
| 2a or 2b | Best study design for domain |
| 3a or 3b | Fair study design for domain |
| 4a or 4b | Weak study design for domain |
| 5a or 5b | General review, expert opinion, case report, consensus report, or guideline |
| 5 | Local Consensus |
†a = good quality study; b = lesser quality study
Methods Used to Analyze the Evidence
- Systematic Review
Description of the Methods Used to Analyze the Evidence
Not stated
Methods Used to Formulate the Recommendations
- Expert Consensus
Description of Methods Used to Formulate the Recommendations
Not stated
Rating Scheme for the Strength of the Recommendations
Table of Language and Definitions for Recommendation Strength
| Language for Strength | Definition |
|---|---|
| It is strongly recommended that… It is strongly recommended that…not… | When the dimensions for judging the strength of the evidence are applied, there is high support that benefits clearly outweigh risks and burdens (or vice versa for negative recommendations). |
| It is recommended that… It is recommended that… not… | When the dimensions for judging the strength of the evidence are applied, there is moderate support that benefits are closely balanced with risks and burdens. |
| There is insufficient evidence and a lack of consensus to make a recommendation… |
Note : See the original guideline document for the dimensions used for judging the strength of the recommendation.
Cost Analysis
One published study showed that bedside shift report was shown to decrease overtime by nurses.
Method of Guideline Validation
- Peer Review
Description of Method of Guideline Validation
This Best Evidence Statement (BESt) has been reviewed against quality criteria by two independent reviewers from the Cincinnati Children’s Hospital Medical Center (CCHMC) Evidence Collaboration.
Evidence Supporting the Recommendations
References Supporting the Recommendations
- Maxson PM, Derby KM, Wrobleski DM, Foss DM. Bedside nurse-to-nurse handoff promotes patient safety. Medsurg Nurs. 2012 May-Jun;21(3):140-4. PubMed
- Radtke K. Improving patient satisfaction with nursing communication using bedside shift report. Clin Nurse Spec. 2013 Jan-Feb;27(1):19-25. PubMed
- Sand-Jecklin K, Sherman J. Incorporating bedside report into nursing handoff: evaluation of change in practice. J Nurs Care Qual. 2013 Apr-Jun;28(2):186-94. PubMed
- Thomas L, Donohue-Porter P. Blending evidence and innovation: improving intershift handoffs in a multihospital setting. J Nurs Care Qual. 2012 Apr-Jun;27(2):116-24. PubMed
- Tidwell T, Edwards J, Snider E, Lindsey C, Reed A, Scroggins I, Zarski C, Brigance J. A nursing pilot study on bedside reporting to promote best practice and patient/family-centered care. J Neurosci Nurs. 2011 Aug;43(4):E1-5. PubMed
Type of Evidence Supporting the Recommendations
The type of supporting evidence is identified and graded for each recommendation (see the “Major Recommendations” field).
Benefits/Harms of Implementing the Guideline Recommendations
Potential Benefits
Increased patient/family satisfaction during hospitalization
Potential Harms
Not stated
Qualifying Statements
Qualifying Statements
This Best Evidence Statement addresses only key points of care for the target population; it is not intended to be a comprehensive practice guideline. These recommendations result from review of literature and practices current at the time of their formulation. This Best Evidence Statement does not preclude using care modalities proven efficacious in studies published subsequent to the current revision of this document. This document is not intended to impose standards of care preventing selective variances from the recommendations to meet the specific and unique requirements of individual patients. Adherence to this Statement is voluntary. The clinician in light of the individual circumstances presented by the patient must make the ultimate judgment regarding the priority of any specific procedure.
Implementation of the Guideline
Description of Implementation Strategy
Applicability Issues
Recommendation adherence will require the support of administration, unit managers, and nursing leaders to act as champions of change. It will be important for this support team and nursing staff to understand and be able to articulate the identified goals and outcomes to be achieved by implementing bedside nursing report to the nursing staff. Creating a standardized reporting sheet, which will include a head to toe assessment report, electronic medical record check, patient plan of care check, safety check, and introductory cues for communicating with the patient and family, will support the implementation of this change. In addition, patient assignments should be allocated to the same nurse if possible, to help with clustering report. Providing staff with adequate time to become accustomed to the new report methods and also encouraging their feedback can help resolve issues and identify areas of concern and assist them in the transition.
Implementation Tools
- Audit Criteria/Indicators
Institute of Medicine (IOM) National Healthcare Quality Report Categories
IOM Care Need
- Getting Better
IOM Domain
- Effectiveness
- Patient-centeredness
- Safety
Identifying Information and Availability
Bibliographic Source(s)
- Cincinnati Children’s Hospital Medical Center. Best evidence statement (BESt). Increasing patient satisfaction by moving nursing shift report to the bedside. Cincinnati (OH): Cincinnati Children’s Hospital Medical Center; 2013 Aug 12. 4 p. [6 references]
Adaptation
Not applicable: The guideline was not adapted from another source.
Date Released
2013 Aug 12
Guideline Developer(s)
- Cincinnati Children’s Hospital Medical Center - Hospital/Medical Center
Source(s) of Funding
Cincinnati Children’s Hospital Medical Center
No external funding was received for development of this Best Evidence Statement (BESt).
Guideline Committee
Not stated
Composition of Group That Authored the Guideline
Team Leader/Author : Sarah Barker, RN, BSN
Team Members : Kathleen Dressman RN, MS, Senior Clinical Director, TCC, A7C1 Complex Pulmonary; Deborah Warden RN, BSN, Clinical manager, A7C1 Complex Pulmonary
Support/Consultant : Patti Besuner RN, MN, EBP Mentor, Center for Professional Excellence, Research, & Evidence Based Practice
Financial Disclosures/Conflicts of Interest
Conflict of interest declaration forms are filed with the Cincinnati Children’s Hospital Medical Center (CCHMC) Evidence-Based Decision Making (EBDM) group. No financial conflicts of interest were found.
Guideline Status
This is the current release of the guideline.
Guideline Availability
Available from the Cincinnati Children’s Hospital Medical Web site.
Availability of Companion Documents
The following are available:
- Judging the strength of a recommendation. Cincinnati (OH): Cincinnati Children’s Hospital Medical Center; 2008 Jan. 1 p. Available from the Cincinnati Children’s Hospital Medical Center.
- Grading a body of evidence to answer a clinical question. Cincinnati (OH): Cincinnati Children’s Hospital Medical Center; 1 p.
- Table of evidence levels. Cincinnati (OH): Cincinnati Children’s Hospital Medical Center; 2008 Feb 29. 1 p. Available from the Cincinnati Children’s Hospital Medical Center.
In addition, suggested process or outcome measures are available in the original guideline document.
Patient Resources
None available
NGC Status
This NGC summary was completed by ECRI Institute on January 20, 2014.
Copyright Statement
This NGC summary is based on the original full-text guideline, which is subject to the following copyright restrictions:
Copies of this Cincinnati Children’s Hospital Medical Center (CCHMC) Best Evidence Statement (BESt) are available online and may be distributed by any organization for the global purpose of improving child health outcomes. Examples of approved uses of the BESt include the following:
- Copies may be provided to anyone involved in the organization’s process for developing and implementing evidence based care.
- Hyperlinks to the CCHMC website may be placed on the organization’s website.
- The BESt may be adopted or adapted for use within the organization, provided that CCHMC receives appropriate attribution on all written or electronic documents.
- Copies may be provided to patients and the clinicians who manage their care.
Notification of CCHMC at EBDMInfo@cchmc.org for any BESt adopted, adapted, implemented or hyperlinked by the organization is appreciated.
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