How To Implement Bedside Report In The LTAC Hospitals

HOW TO IMPLEMENT BEDSIDE REPORT IN THE LTAC HOSPITALS
By:
Institutional Affiliation
How to Implement Bedside Report in the LTAC Hospitals
Introduction
The element of communication between care providers remains an important aspect of patient care. Accurate and constituent exchange of patient information is therefore posited as imperative in a bid to maintain patient focus, with this enshrined in promoting a culture of trust and safety. According to the Joint Commission, close to 80% of acute medical errors involve miscommunication between the care providers at handoff report. Given this, the Joint Commission initiated safety goals to improve the effectiveness of communication between the care providers, hence reduce medical errors. The need to improve health literacy in protecting patient safety as tailored by the Joint Commission, therefore, denotes the need to create organizational cultures of safety and quality in the dispensation of health care services in a patient-centered manner (Wakefield et al, 2012). Additionally, estimates provide that up to 4 out of 5 acute medical errors that include sentinel events such as severe physical or physiological injuries and deaths happen as a result of miscommunication between the care providers during handoffs. The implementation and hardwiring of bed shift reports are considered as a significant aspect that impacts these areas across an entire health organization. This paper, therefore, seeks to conduct a research study on the manner in which bedside reports can be efficiently implemented in LTAC hospitals and the manner in which this process benefits both the patients and the caregivers.
How to Implement Bedside Report in the LTAC Hospitals
Historically, nursing shift to shift reports were considered to occur way from the bedside at a patient care unit or a central nursing station. Given this, it is essential to understand that patient history, information, and plan of care are vital aspects to the care of a patient, with these details exchanged during the process of care. This traditional practice is constituted on a single way of communication from the off-going care providers to the oncoming nurses are considered to be lengthy, incomplete, and freighted with several interruptions. Nurses, in this case, turn frustrated with issues related to workflow, an aspect that makes them lose valuable time that would be better utilized and served at the bedside (Agency for Healthcare Research and Quality, 2013).
Handoff reports within the nurses’ station occur with no patient involvement, thus resulting in more errors and confusions about the diagnosis and treatment of patients. This results in an overall dissatisfaction in the exchange of information and communication between the nurses and the patients. Bedside reports are therefore effective in empowering the staffs, improving patient involvement and providing safer transitions of care between the care providers. It consequently establishes and promotes trustful relationships between the care providers and patients, aspects that serve as a foundation for teamwork.
Problem Statement:
Despite evidence-based practice and a few attempts at implementation, the nursing bedside shift-to-shift report is still not in regular practice at my workplace.
The Reason for Safety Concerns
According to Joint Commission Center for Transforming Healthcare (2009), 37% of reports between caregivers didn’t correctly reflect data related to the patient's condition that adversely influenced provided care and jeopardized the patient safety. The same source stated that 4 out of 5 serious medical errors (including “sentinel events”) occurred due to miscommunication between caregivers during reports. An unintended omission of some vital information causes gaps or discontinuity in the provision of the necessary care that can represent a significant threat to patient safety. Working in the LTAC hospital, I take care of patients who experience multiple health problems, and their condition can deteriorate easily. Any misunderstanding and omission in reporting can be detrimental for our patients’ conditions. The bedside shift report leaves fewer chances for that type of mistakes. Also, it is very helpful to visualize and communicate with patients at the beginning of the shift and involve them in their care that helps in prioritizing of the care and addressing all necessary needs better. The nursing bedside shift report should be implemented in my workplace through staff education and following step by step strategy provided by the Agency for Health Research and Quality adjusted to my healthcare organization with to advance our patient safety to a higher level, an aspect that posits the primary purpose of this research paper.
Subcultures of Patient Safety Identified
The inclusion of a safety climate is considered as a point in time measurement within an organizations culture of safety. Safety for both the care providers and patients remains an important goal for any healthcare organization in eliminating errors and confusions about the diagnosis and treatment of patients (Sammer et al, 2010). Health organizations are therefore motivated to develop quality and safety measures in several ways aimed at addressing the improvement of processes and systems and in the production of improved outcomes while also considering the cultural aspects of producing high levels of quality and safe healthcare services as established by Sammer et al. Given this, the need to take consideration of the seven subcultures of patient safety culture requires that organizations develop:
Leadership:
One of the common themes running through several kinds of literature is the suggestion of the roles of senior leaders in designing, fostering, and nurturing a culture of safety within an organization that embraces the aspect of bedside reporting with the aim of reducing medical errors experienced in the process of care (Sammer et al, 2010). Leadership, in this case, plays a significant role in establishing a culture of safety within an organization, an aspect that posits the need for establishing efficient leadership systems and structures.
Teamwork:
On the other hand, teamwork is another subculture identified in implementing a safety culture within a health institution. Care providers handle patients with complex diseases that require complex treatment approaches and technologies (Sammer et al, 2010). This, therefore, necessitates the need for stronger efforts through the inclusion of teamwork and collaborative efforts among the caregivers in a bid to achieve a system-wide culture that embraces bedside reporting as a patient safety culture.
Evidence-Based:
Healthcare institutions need to demonstrate evidence-based practices that support bedside reporting through the development of standardized processes, procedures, and guidelines that exhibit a culture of safety in this process (Sammer et al, 2010). The incorporation of best practices in bedside reporting would go a long way in reducing some of the medical errors witnessed within the healthcare industry.
Communication:
The initiation of communication techniques among teams such as the use of assertive and structured languages remain of the essence in creating a safety culture that embraces bedside reporting (Sammer et al, 2010). This, therefore, denotes the need to develop different forms of communication such as short discussions and briefings at the beginning of procedures that assure the team members on the processes involved in establishing bedside reports.
Learning:
A culture of learning consequently exists within a medical institution when this organizational culture seeks approaches to learning from the mistakes witnessed in the rise of medical errors from hand-off reports, hence necessitating the need for performance improvement processes in the establishment and implementation of bedside reports in the care delivery system (Chapman, 2016). Leaders in this case are required to demonstrate their willingness to learn not only from the challenges exhibited and internal sources, but from other sources outside healthcare in displaying a successful safety culture.
Just:
An approach to establishing whether the bedside reporting system is a just culture remains in thinking of its two-sided scale of justice. On one side of the scale lies the aspect of individual accountability that holds accountable the leaders and teams on the implementation of the bedside report mechanism, while on the other side is the systems failure (Sand-Jecklin & Sherman, 2014). This therefore establishes whether the errors experienced are individual or system failures.
Patient-Centered
The development of a patient-centered culture takes into consideration the benefits of implementing the bedside reporting model in benefiting patients and their families, considered as the sole reason for the existence of a medical facility (Rynes et al, 2014). Given this, the implementation of the bedside reporting approach values the patients by promoting their well-being and health, as well as establishing an error-free environment as a continuum of care.
Literature Review
Bedside shift report in a LTAC hospital is considered as a process which requires the nurses exchanging shits to shift their reports at the bedside of the patient, an aspect aimed at involving the patients more in their treatment plans of care. According to Oermann et al (2014), a recent systematic review of nursing shift report procedures revealed that the lack of adequate research on the most efficient processes of conducting a structured shift report remains a looming element that affects several care providers. Given this, Rynes et al. (2015) allude to the need for change in the implementation of bedside reports, an aspect that denotes the need for relationship building between the care providers and the patients. This is evident in Murphy et al. (2014) who alludes to that bedside shift report can reduce communication deficits and the traditional systems of nurse reporting.
Jette (2016) in his journal reports on some of the inconsistencies that make the implementation of bedside reporting a challenge in several medical institutions. This author points out that handoff reports vary from unit to unit, nurse-to-nurse, with different information passed on to t...