Tracy Tidwell, RN, MSN, CPNP Are You READY? Jessica Edwards, RN, BSN Connie Lindsey, RN, MSN Ann Reed, RN, MSN Iva Scroggins, RN, BSN Emily Snider, RN, BSN Tracy Tidwell, RN, MSN, CPNP Christy Zarski, RN Le Bonheur Children’s Medical Center Memphis, TN Service, Quality, Integrity, Teamwork

Recognized high level of family stress Our story… Recognized high level of family stress Families continually voiced “feeling of loss of control” Desire to improve patient/family satisfaction Service, Quality, Integrity, Teamwork

READY… to Make a Change? Problem: Nurses on 5-South were frustrated with method of reporting and low patient satisfaction scores Families on 5-South were frustrated with lack of information and ability to influence plan of care Unit as a whole realized that we needed to focus more on involving the parent/patient in the decision process Bedside Nurse-to-Nurse Report was one of the methods selected to begin our “NEW” way of looking at things Old Shift Change Reporting system: on-coming nurse listened to report on every patient on the neuroscience unit, even though each nurse would care for approximately four of those patients Patients and Caregivers were not involved in the process Report took 35-45 minutes, with numerous interruptions from various sources, which resulted in fragmented, lengthy, and disorganized report. Staff commented that often pertinent information regarding the patient was forgotten or neglected due to the numerous interruptions Due to the need to give information on each patient quickly, the environment was not conducive for many questions, leaving blame between shifts or increasing error. Service, Quality, Integrity, Teamwork 3

Why we do what we do… A Picture Tells It All Parents/Caregivers know their children best. Involving the family in the care plan instills trust and cooperation Everyone has a need to feel involved and important Service, Quality, Integrity, Teamwork

Are You READY? WE ARE… Bedside Nurse to Nurse Report Is A Great Method of Practicing Family-Centered Care R Reassures patients and caregivers that we work as a team E Ensures interaction between staff and caregivers A Ability to visualize and prioritize care D Decrease caregivers anxiety over plan of care Y Yields happier staff, patients, and families! Service, Quality, Integrity, Teamwork

Our Research Team A group of nurses were selected from the neuroscience unit that all showed interest in being leaders to implement change & were interested in family centered care. ADN, BSN, and MSN prepared nurses Staff nurses, patient coordinators, director, upper management and nurse practitioner Various levels of experience on neuroscience unit 6

Bedside Report Design A retrospective analysis to analyze data from the previous six month of patient satisfaction surveys A retrospective analysis of clock-out times of 5S RN’s over a six month period A prospective analysis using convenient sampling to collect data from the patient satisfaction surveys Nurses were asked to complete a questionnaire prior to and six months after the implementation of bedside reporting Data was statistically compared to determine, if any, correlation existed between bedside reporting and patient satisfaction surveys Specific 4 questions on the patient satisfaction survey that focus on overall nursing care and communication 7

Data Analysis: Bedside Report Answers to the patient satisfaction survey were collected and plotted by the QI department to determine if there was increase in satisfaction after implementation of bedside reporting Answers obtained from nursing questionnaires were evaluated to determine if RN satisfaction with the reporting system improved after implementation of bedside reporting 8

Measurement Tools Patient Satisfaction Surveys How would you rate concern of the nursing unit staff for your requests How would you rate the availability of your child’s nurses How well did nurses keep you informed about your child’s treatment and condition Did the staff on your nursing unit show respect for you and your child’s needs How would you rate the overall teamwork of the hospital staff who took care of your child

Service, Quality, Integrity, Teamwork

Service, Quality, Integrity, Teamwork

Service, Quality, Integrity, Teamwork

$18,494 $12,019 Service, Quality, Integrity, Teamwork

Service, Quality, Integrity, Teamwork

Advantages of Bedside Report Accountability Relay accurate information on patient Both nurses visualize patient Increased patient and family involvement Service, Quality, Integrity, Teamwork 18

Disadvantages of Bedside Report Time consuming when staffing does not permit a free charge nurse Some families not receptive 19

Outcomes of Bedside Report Increase in Satisfaction of Patients/Parents/Caregivers Increase in Satisfaction of Nurses Decrease in the amount of time Nurses stayed “Over Shift”

Future Recommendations Add other elements such as 100% Utilization of Updating White Boards during Bedside Report Computer Documentation Check Ongoing evaluation of ways to engage parental/patient involvement in the formal plan of care