Date of Conferral

2015

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Marisa Wilson

Abstract

Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) survey results from 2013 revealed a need for improvement in nurse-patient communication at the unit level. In response, nursing administrators at an acute-care hospital asked bedside nurses to develop a protocol for bedside shift report according to best practices. The protocol was implemented in May 2014. Three months later, a postimplementation survey was distributed. Work from Lewin and Kotter theoretical concepts were used to evaluate this organizational change. The purpose of this study was to determine whether re-educating staff nurses on the bedside shift report protocol increased compliance with evidence-based practice performance standards for bedside shift reporting. In the initial phase of this project, a review of a 3-month postimplementation survey revealed consensus that bedside shift report had not been universally accepted and implemented. Based on these findings, a re-education program was developed and implemented. A 2-week post re-education survey elicited 89 respondents' perspectives on bedside shift report. Analysis of the survey results revealed that nurses had strong perceptions of this significant change to their practice. The re-education revealed that nurses could show commitment to performing daily bedside shift report if specific conditions are supported, such as nurses understanding that the process improves satisfaction levels, and if nurses' misconceptions are addressed. Social change of this magnitude indicated that the voices of bedside nurses must be heard. To make this goal a reality ongoing evaluation is required to promote patient safety, improve patient outcomes, and improve HCAHPS results related to nurse-patient communication. Positive social change results in this project impacting patients by providing a better quality of care in this facility.

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