Improving Nursing Shift Changes
Introduction
Nursing hand-offs rank high in situations where errors occur, often due to how shift changes are structured as much as mistakes by individual nurses (Halm, 2013). Wooldridge Place, for example, has a number of systemic deficiencies that contribute to communication breakdown between shifts and compromise patient care. It is anticipated that switching to a bedside handoff and addressing factors that contribute to negative outcomes from shift changes will allow Wooldridge to increase its patient safety and standards of care, and to meet National Patient Safety Goals and reduce overall costs to the organization.
Background Significance
While medical record-keeping is vital to patient care, nurses also …show more content…
Target Condition
The goal for Wooldridge Place for the month of May is to improve communication to ensure that the hospitalizations due to nursing errors is reduced to zero, that labs and reports are reported immediately, and that new orders are followed through per facility policy, within eight hours from receipt of standard orders and within one hour for stat orders. The implementation of bedside handoff will improve patient satisfaction and safety.
Problem Analysis
Analysis of the communication problem occurring during shift changes revealed the following impacting factors. Systemically, the seven minutes before and after shifts end/begin, lack of standardized hand-off process, and the location of handoffs at the nursing station do not provide adequate time, process, or environment for safe shift changes. Staff behavior, most notably coming in late and spending too much time in personal interactions also contribute to the problem, as do issues with the fax machine mentioned above. Finally, lack of training and follow-up protocols leave nurses uninformed about the benefits of bedside reporting and without clear guidance in how to hand off …show more content…
Reinforce nurses’ responsibility for arriving on time and not socializing during shift change. Staff will be trained on Evidence-Based Practice outcomes and use of the short version of SBAR for each patient and providing the patient the opportunity to ask questions. Cost analysis will be conducted based on an anticipated thirty-minute overlap on shift changes against savings from errors and near misses.
The nurse educator will survey a sample of floor nurses after one month to assess changes; the nurse educator will also review data to determine if error reduction and lab/report time goals were met. The payroll manager will also evaluate the amount of additional staff time under the new