Benefits of Bedside Nursing
The literature identifies several benefits of bedside nursing shift
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report. However, published studies have not adequately quantified outcomes
related to this process change, having either small or unreported sample sizes or
not testing for statistical significance.
Design. Quasi-experimental pre- and postimplementation design. Benefits of Bedside Nursing
Methods. Seven medical-surgical units in a large university hospital implemented a
blend of recorded and bedside nursing report. Outcomes monitored included patient
and nursing satisfaction, patient falls, nursing overtime and medication errors.
Results. We found statistically significant improvements postimplementation in
four patient survey items specifically impacted by the change to bedside report.
Nursing perceptions of report were significantly improved in the areas of patient
safety and involvement in care and nurse accountability postimplementation.
However, there was a decline in nurse perception that report took a reasonable
amount of time after bedside report implementation; contrary to these percep-
tions, there was no significant increase in nurse overtime. Patient falls at shift
change decreased substantially after the implementation of bedside report. An
intervening variable during the study period invalidated the comparison of medi-
cation errors pre- and postintervention. There was some indication from both
patients and nurses that bedside report was not always consistently implemented.
Conclusions. Several positive outcomes were documented in relation to the imple-
mentation of a blended bedside shift report, with few drawbacks. Nurse attitudes
about report at the final data collection were more positive than at the initial po-
stimplementation data collection. Benefits of Bedside Nursing
Relevance to clinical practice. If properly implemented, nursing bedside report can
result in improved patient and nursing satisfaction and patient safety outcomes. How-
ever, managers should involve staff nurses in the implementation process and con-
tinue to monitor consistency in report format as well as satisfaction with the process.
Key words: bedside shift report, nursing handover, nursing shift report, patient-
centred care, patient satisfaction
What does this paper contribute
to the wider global clinical
community?
• Previous nursing bedside report manuscripts have had very small or unreported sample sizes for patient and nursing bedside report surveys and have rarely attempted to calculate the statis- tical significance of their results.
• Our patient and nurse survey instruments examined a far greater number of factors/issues that are considered relevant to bedside nursing report than any other study of which we are cur- rently aware.
• We are also only the second pub- lished study to track changes in patient falls during the handover hour before and after implement- ing bedside report. Benefits of Bedside Nursing
Accepted for publication: 25 January 2014
Authors: Kari Sand-Jecklin, EdD, MSN, RN, AHN-BC, Associate
Professor of Nursing, West Virginia University, Morgantown; WV,
Jay Sherman, CNRN, ME, Clinical Research Nurse, West Virginia
University Healthcare, Morgantown, WV, USA
Correspondence: Jay Sherman, Clinical Research Nurse, WVU Eye
Institute, 3rd Floor, P.O. Box 782, Morgantown, WV 26506, USA.
Telephone: +1 304 598 6128.
E-mail: shermanj@wvuhealthcare.com
© 2014 John Wiley & Sons Ltd 2854 Journal of Clinical Nursing, 23, 2854–2863, doi: 10.1111/jocn.12575
Introduction
Improving upon the effectiveness of communication is a
Joint Commission National Patient Safety Goal (JCAHO
2013). According to the Joint Commission (2011), one of
the factors leading to sentinel patient events is miscommuni-
cation. A significant percentage of a nurse’s communications
each day occurs during patient handoffs, and the safety of
the patient can be compromised at this time (Friesen et al.
2008). A survey of over half a million hospital staff found
that respondents rated the safety of patient handoffs second
lowest among 12 areas of patient safety (Sorra et al. 2012). Benefits of Bedside Nursing
In a study concerning near miss incidents, nurses again iden-
tified patient handoffs as a factor (Ebright et al. 2004). In
recent years, bedside nursing handoffs have been presented
positively in the literature, with benefits such as improved
patient satisfaction, improved nurse communication and
shorter shift reports being identified. It was the goal of the
Medical Surgical Research Utilization Team at West Virginia
University to implement a change in practice to a blended
form of bedside nurse shift handoff, and to evaluate this new
format in terms of patient and nurse satisfaction as well as
impact on patient safety. Benefits of Bedside Nursing
Background
The literature on nursing bedside report is focused in two
general areas. The first focus area is the process of imple-
menting bedside report, either describing the experiences
related to implementation or explaining how other organi-
sations could implement this change. The second area of
focus is improving the process of bedside report, often
through observation and identifying common themes, or by
describing how others may improve their own reporting
process. Unfortunately, although there is strong consistency
in the suggested strategies for the implementation of bed-
side report, there is a gap in the literature in terms of docu-
menting quantitative patient and nurse outcomes
(Riesenberg et al. 2010, Novak & Fairchild 2012, Staggers
& Blaz 2012, Sherman et al. 2013). However, in the last
two years, several manuscripts have been published that in
some way quantified the potential outcomes of bedside
nursing report.
Identified benefits of bedside report
Numerous benefits of bedside nursing report have been
reported, with remarkably few drawbacks identified. The
most often reported benefit (identified by nine individual
manuscripts) is that patients are better informed (Searson
2000, Anderson & Mangino 2006, Laws & Amato 2010,
Tidwell et al. 2011, Maxson et al. 2012, Rush 2012, Tho-
mas & Donohue-Porter 2012, Wakefield et al. 2012, Sand-
Jecklin & Sherman 2013). However, several of these manu-
scripts did not report sample size or statistical significance
(Anderson & Mangino 2006, Laws & Amato 2010, Tho-
mas & Donohue-Porter 2012, Rush 2012, Wakefield et al.
2012), and others (Searson 2000, Maxson et al. 2012) were
based on small sample sizes. The study reported by Sand-
Jecklin and Sherman (2013) did find significant improve-
ments in patient information as a result of bedside report
using a large sample size of 302 patients/families preimple-
mentation and 250 postimplementation. Benefits of Bedside Nursing
The second most often reported benefit of moving nurs-
ing report to the bedside is related to general improvements
in patient satisfaction. Improvements in patient satisfaction
are a primary goal of nursing practice changes. Radtke
(2013) and Reinbeck and Fitzsimons (2013) reported
improvements in patient responses to the Hospital Con-
sumer Assessment of Healthcare Providers and Systems sur-
vey (HCAHPS). However, such general changes in patient
satisfaction could be affected by many uncontrolled vari-
ables in addition to the implementation of bedside report Benefits of Bedside Nursing
