Name
Chamberlain University
NR-584: Quality and Safety for Advanced Nursing Practice
Prof. Name
Date
The client-centered care initiative selected is client/family engagement. In the emergency department (ED), patient satisfaction scores are consistently lower than other hospital departments. One major concern is the limited nurse-to-patient interaction, which often results in poor experiences and communication breakdowns.
To address this issue, the department is implementing bedside shift reporting. This practice ensures that at the beginning and end of each nursing shift, patients are directly included in the handoff process. Bedside reports allow patients to voice their concerns, clarify care plans, and receive reassurance regarding their safety and treatment (O’Donnell et al., 2023). Furthermore, this practice fosters transparency and strengthens the trust between patients, families, and healthcare staff.
Kaiser and Ashby (2024) note that bedside reporting provides an opportunity for nurses to communicate directly with patients and their families without distractions, minimizing miscommunication and ensuring alignment in care expectations.
The Plan, Do, Study, Act (PDSA) cycle is a widely recognized CQI framework that can be applied to this initiative. Its iterative process enables healthcare teams to continuously refine interventions until the desired outcomes are achieved.
| PDSA Step | Application to Bedside Reporting |
|---|---|
| Plan | Identify the goal of improving patient satisfaction and communication by integrating bedside reports. Develop clear guidelines and prepare educational sessions for staff. |
| Do | Pilot bedside reporting across both day and night shifts to maintain consistency for patients. Provide real-time coaching to staff during implementation. |
| Study | Collect data on patient satisfaction, nurse feedback, and communication errors. Analyze whether bedside reporting improved outcomes compared to baseline measures. |
| Act | If results are positive, standardize bedside reporting hospital-wide. If outcomes are insufficient, revise the strategy (e.g., additional training, scripting, or family engagement techniques) and restart the PDSA cycle. |
The PDSA framework enhances client-centered care by promoting continuous evaluation and adaptation. Bedside reporting improves transparency, ensures patients and families remain informed, and encourages collaborative decision-making. Reviewing outcomes at each stage ensures that the intervention is not only implemented but also refined based on measurable improvements.
This framework also fosters accountability, as patient satisfaction data are regularly reviewed, and strategies are modified if goals are not met. Over time, this iterative process builds a culture of safety, open communication, and patient empowerment in the ED.
Successful implementation of bedside reporting requires active involvement from the entire interprofessional team. Nurses, physicians, patient care technicians, and even administrative staff play essential roles.
To engage team members:
Education and Training: Staff can participate in role-play scenarios to practice effective communication and familiarize themselves with bedside reporting protocols.
Standardized Communication Tools: Using structured communication models like SBAR (Situation, Background, Assessment, Recommendation) can streamline reporting and ensure important details are consistently conveyed.
Collaborative Feedback: Holding debrief sessions after implementation phases allows the team to identify barriers and share solutions.
Shared Accountability: Establishing clear goals and metrics ensures that every professional understands their responsibility in enhancing patient experiences.
Ultimately, CQI efforts are strengthened when interprofessional collaboration is prioritized, as it combines diverse expertise to achieve shared goals in patient-centered care.
CQI processes, such as the PDSA cycle, are crucial for advancing client-centered care initiatives like client/family engagement. By implementing bedside reporting, emergency departments can address gaps in patient satisfaction and communication while ensuring patients and families actively participate in their care. Interprofessional collaboration, consistent evaluation, and structured communication all contribute to improved patient outcomes and sustainable quality improvements.
Kaiser, A., & Ashby, T. (2024). Bedside handoff and patient’s perception of the quality of their care. Oncology Nursing Forum, 51(2), 61C–61C.
O’Donnell, L., George, E., Donnelly, J., Bilderback, A., & Buchanan, D. (2023). Coaching to bedside shift report and its correlation to Hospital Consumer Assessment of Healthcare Providers and Systems and value-based purchasing dimension scores: A multihospital implementation study. The Journal of Nursing Administration, 53(1), 12–18. https://doi.org/10.1097/NNA.0000000000001236
