Feasibility, Appropriateness, Meaningfulness and Effectiveness of Bedside Shift Reporting

Ghent University Hospital (UZ)

Status: Completed

Conditions: Bedside Shift Report; Nursing; Patient Participation

Treatments: Behavioral: Bedside shift report

Study type: Interventional

Funder types: Other

Identifiers

NCT02714582

B670201627044 (Other Identifier)

HA/RP/2015/086/EC

Details and patient eligibility

About

Hospitals face the challenge to continually improve their quality of care. In order to achieve this goal, they have to focus on both improving clinical practice and increasing the involvement of patients in the healthcare process. Both factors are equally important to quality of care. The World Health Organization highlights the role that patients and their family could play in the improvement of healthcare. Active patient participation reduces communication errors, increases patient empowerment and is associated with positive health and psychosocial outcomes. A possible strategy to improve patient participation through communication can be bedside shift report (BSR).

Bedside shift report is a process where shift-to-shift report between nurses is, if approved by the patient, executed at the patient's bedside in order to improve the patient's involvement. Bedside shift report has the potential to result in more patient satisfaction, better clinical outcomes, improvement of health education and enhanced team coherence. Preliminary research indicates that BSR decreases safety incidents and adverse events and readmissions, positively influences staff satisfaction, offers beneficial financial effects by reducing nurses' overtime, and allows direct patient care to start earlier.

Despite of these effects, rigorous and large-scale scientific research on this topic is lacking. Currently, the available evidence is scarce and mostly consists of single case or small-scale studies. Longitudinal results on effectiveness and sustainability of BSR are also unknown or inconclusive. There is a need for an increased number of controlled studies to evaluate the impact of BSR on patient, staff and economic outcomes and its longitudinal results.

The aim of this study is four-folded:

1. The development and fine-tuning of a BSR-intervention and implementation protocol by using diagnostic interviews, co-design, and pilot studies.
2. A quantitative evaluation of BSR in comparison with care as usual on patient-related, clinical, and nurse-related outcomes.
3. A qualitative evaluation of the feasibility, appropriateness and meaningfulness of BSR as a method to improve communication and patient participation with a particular interest in the experience of benefits and disadvantages by healthcare professionals and patients.
4. A process evaluation of BSR to determine the intervention fidelity and to assess the evolution of BSR over the period of the study (e.g. adaptations, consistent practice).

The study design was based on the Medical Research Council-framework for developing and evaluating complex interventions. Power calculation indicates a minimum of 5 experimental wards with 35 patients should be included in the study. The hospital, the specialization of the ward and the nurse-patient ratio will be used for the matched controlled assignment.

Enrollment: 750 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Patients

Inclusion Criteria:

• Admitted on a participating hospital ward
• Be conscious
• Speak Dutch
• Participated in at least 3 bedside shift reports

Exclusion Criteria

• Dementia or other severe cognitive/mental disorders

Nurses

Inclusion Criteria:

• Work on a participating hospital ward
• Have at least six months of experience on the ward
• Have participated in 10 bedside shift reports or more

Exclusion Criteria:

• No hands-on patient contact
• Internship

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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750 participants in 2 patient groups

Bedside shift report

Experimental group

Description:

The experimental group (nurses and patients) will: * develop a tailored BSR-intervention by use of co-design, diagnostic interviews, and pilot testing * use the tailored BSR-intervention, with participation of the patient, instead of the regular nurse shift report

Treatment:

Behavioral: Bedside shift report

No bedside shift report

No Intervention group

Description:

The control group will not use bedside shift report, but will use the regular nurse shift report without participation of the patient