1. Introduction The American Nurses Association estimates that eighty percent of serious medical errors involve miscommunication between caregivers when patients are transferred or handed off (Reinbeck & Fitzsimons, 2013). Ineffective handoffs or reports can contribute to gaps in patient care and breaches in patient safety, including medication errors, wrong-site surgery and patient deaths (Friesen, White, & Byers, 2008). As hospitals continue to be faced with pay for performance; the hospital consumer assessment of healthcare providers and systems (HCAHPS) continues to be the focus for inpatient units in the hospital. Hospitals are focused on moving their HCAHPS scores to the ninety-ninth percentile and nurse communication is one area to target. Among hospitalized patients, does implementing bedside shift report lead to greater patient satisfaction with nurse communication when compared to traditional nursing shift report that is given at the nurse’s station? PICO Question EBP Model/Change Theory/Leadership Team and Demographics Improving Nurse Communication Scores Through Bedside Nurse Report Aubree Slayman, RN, BSN Friesen, M. A., White, S. V., & Byers, J. F. (2008). Patient safety and quality: An evidence-based handbook for nurses. Retrieved from ncbi.nlm.nih.gov/books/NBK2649 Mazurek Melnyk, B., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Retrieved from www.bookshelf.com Vines, M. M., Dupler, A. E., Von Son, C. R., & Duido, G. W. (2014, July/August). Improving client and nurse satisfaction through the utilization of bedside report. Journal for Nurses in Professional Development, 30, 166-173. http://dx.doi.org/10.1097/NND.00000000000000057 References MidAmerica Nazarene University Significance for Nursing In 2006 the Joint Commission established a National Patient Safety Goal that requires institutions to develop a standardized approach to “handoff communication”, including the opportunity for staff to ask and respond to questions (Evans, Grunawalt, McClish, Wood, & Friese, 2012). Additionally, National Patient Safety Goal 13.01.01 was added to encourage patients to be actively involved in their own care as a patient safety strategy (Evans et al., 2012). Figure 1: Mean patient satisfaction scores on question: nurse kept you informed. With implementation of Bedside Nurse Report in October (Vines, Dupler, Von Son, & Duido, 2014). The Model for Evidence-Based Practice (Mazurek Melnyk & Fineout-Overholt, 2015) is the practice model that was chosen as it integrates principles of improvement, the use of team work tools and evidence- based translation strategies to promote adoption of a new practice (Mazurek Melnyk & Fineout-Overholt, 2015. The Lewin’s Change Theory of Unfreezing and Freezing (Amer, 2015) was chosen for to utilize its unfreezing of a process (standardized nurse to nurse report at the nursing station) has been routine for years and it will be necessary for the transformational leadership style to step in an motivate staff to implement the bedside shift report. The staff nurses will all react in different manners, the goal is to encourage positive change to increase the likelihood of freezing the process (Amer, 2015). Evaluation and Outcome The Director of Patient Care will lead the project while the Nurse Manager and Supervisor will train the staff and monitor for change. Bedside shift report will begin in the adult medical surgical unit but within three month the process will be hospital wide. The medical surgical patients range from thirteen to geriatric and consist of both male and females. The majority of the patient population comes from a middle class to below poverty. With majority of patients’ education level less than high school the need for clear communication at the patients level is necessary. After full implementation and the freeze of the new bedside shift report it is expected that the department will achieve and maintain ninety percentile within three months of implementation. The Director of Patient Care will be monitoring the HCAHPS report on a weekly basis to assess the outcomes of nurse communication scores. While the Nurse Managers and Supervisors will be monitoring the percentage of bedside shift report through leader rounding on patients and rounding documentation by bedside nurses. Bedside Nurse Report Results Amer, K. S. (2015). Quality and safety for transformation nursing: Core competencies (1st ed.). Retrieved from www.online.vitalsource.com www.online.vitalsource.com Evans, D., Grunawalt, J., McClish, D., Wood, W., & Friese, C. R. (2012, September 1). Bedside shift-to-shift nursing report: Implementation and outcomes. MEDSURG Nursing, 21 (5), 281-292. Retrieved from http://cmps- ezproxy.mnu.edu:2252/eds/pdfviewer/pdfviewer?vid=12&sid=ef1af342-5988-4ea5-a022- 46384fd1ac85%40sessionmgr4003&hid=4105 Plan Implementation 1.Literature Review 2.Design Pilot, Develop Training and Evaluation Plan 3.Gather 3 Month of HCAHPS Data 4.Train Staff and Unfreeze Traditional Nurse Report 5.Go-Live Bedside Nurse Report on Medical Surgical Unit 6.Monitor Change/Celebrate Successes 7.Evaluation of Change for 3 Months 8.Repeat Steps 3-7 for Hospital Wide Bedside Nurse Report Go-Live