A Multi-Pronged Collaborative Approach to Harness the Implementation and Sustainability of Bedside Shift Report

Background: Implementing nurse bedside shift report (BSR) remains a critical practice during shift changes that improves the delivery of safe patient care. The practice of BSR remains susceptible to variability and sustainability in the acute care setting. The purpose of this quality improvement project was to harness the implementation and sustainability of BSR using a multi-pronged approach. We aimed to improve nurse-sensitive indicators discussed during the BSR process and include patients in the BSR process. Methods: Implementing Lorenzi and Riley's change cycle methodology, executives, leaders, and educators collaborated to create a multi-pronged approach to standardize the BSR process for nurses in acute care. Stakeholders were educated on the revised BSR process and observation tool. Nurse leaders conducted supportive BSR observations. Data monitoring of quality nurse-sensitive indicators and weekly BSR observation results were discussed at huddles, unit staff meetings, and monthly leadership meetings. The Chief Nursing Officer hosted monthly welcome sessions to onboard new nurses with the BSR process. Results: Notable changes in standardization and sustainability of the BSR process were observed. There was an improvement in nurse-sensitive indicators related to falls, central-line infections, urinary tract infections, and hospital-acquired pressure injuries. There was a 23% improvement in patient experience metrics and a 58% improvement in nurse-sensitive quality metrics (falls, hospital-acquired pressure injuries, central-line associated bloodstream infections, and catheter-associated urinary tract infections) over 24 months. These results demonstrate the effectiveness of standardized education and leadership support in achieving consistent BSR practices. Conclusion: A collaborative approach involving leaders, educators, and bedside nurses was critical to hardwiring BSR processes and improving patient quality outcomes.