Digital Repository Masters Theses Spring 2026 Bedside Shift Report as a Way to Improve Patient Outcomes Rebecca Jeppson Weber State University Follow this and additional works at: https://dc.weber.edu/collection/wsudoctoral Jeppson, R. 2026. Bedside Shift Report as a Way to Improve Patient Outcomes. Weber State University Doctoral Projects. https://cdm.weber.edu/digital/collection/WSUDoctoral This Project is brought to you for free and open access by the Weber State University Archives Digital Repository. For more information, please contact archives@weber.edu. WSU REPOSITORY MSN/DNP Bedside Shift Report a Way to Improve Patient Outcomes Project Title by Rebecca Jeppson Student’s Name A project submitted in partial fulfillment of the requirements for the degree of MASTERS OF NURSING Annie Taylor Dee School of Nursing Dumke College of Health Professions WEBER STATE UNIVERSITY Ogden, UT 04/14/2026 Date Rebecca Jeppson BSN, RN, MSN Student 04/14/2026 Student Name, Credentials (electronic signature) Date 5/28/26 MSN Project Faculty (electronic signature) Date 6/9/26 Anne Kendrick (electronic signature) DNP, RN, CNE MSN Program Director Note: The program director must submit this form and paper. Date 1 Bedside Shift Report as a Way to Improve Patient Outcomes Rebecca Jeppson Annie Taylor Dee School of Nursing Weber State University Nursing 6801 Dr. Amber Fowler MSN Project September 28, 2025 2 Abstract Purposes/Aims: This project aimed to shift the traditional report from the MCU/SCU to the patient’s bedside to promote patient involvement, improve safety, and enhance patient satisfaction. Rationale/Background: Improved outcomes and patient experience result directly from conducting the shift report at the bedside. Nurses have been resistant to adopting in the past, but with adequate support from leadership, compliance rates will increase. Methods: This project’s framework was modeled using the Iowa Model Revised, which addresses clinical issues and is designed specifically for point-of-care clinicians seeking to explore practice-related questions and improve quality. The nursing team was trained and educated regarding the reasons for implementing bedside shift reports. The outcomes were evaluated using medication error rates and patient satisfaction scores. Results: Implementing bedside shift report is an important practice change needed to improve communication, patient safety, and satisfaction. This project aims to demonstrate that a structured bedside handoff, compared with a traditional handover, can be more focused on patient safety and experience, and that outcomes are improved Conclusions: Implementing the bedside shift report on the inpatient unit can increase patient involvement in their care and engage the nurses caring for them in a safer, more involved way, resulting in improved satisfaction with care and reduced medication errors, leading to safer outcomes. Keywords: patient safety, bedside shift report, handoff report, patient satisfaction, patient involvement. 3 Bedside Shift Report as a Way to Improve Patient Outcomes The shift report is a critical time for sharing information, not only among nurses but also between nurses and patients, who communicate their needs and desires for care. Unfortunately, with many nurses experiencing burnout and large teams to care for, the shift report is often quickly given at the nurses' station without the chance to thoroughly discuss the patient’s condition and needs. Abbaszade et al. (2020) evaluated how this leads to miscommunication, errors in patient care, and the omission of vital information. Using handoff tools like SBAR at the bedside can streamline care and ensure relevant information is communicated efficiently. It also allows nurses to trace infusion lines, confirm all necessary items are accounted for during shift changes, and verify that required medications are not clamped or occluded. Implementing a well-structured bedside handover benefits both nurses and patients (Rachmawaty et al.2023). This is the goal of this project, as its current implementation is vulnerable due to inconsistent nursing practices (Cruchinho et al., 2023). Statement of Problem Traditionally, nursing staff have held shift reports at the nurses' station, away from patients' and families' questions or concerns. Recently, evidence has shown that involving patients in bedside care, including sharing information and decisions about their care, improves patient satisfaction, safety, and communication between nurses, patients, and their families (Daicampi et al., 2025). There has been an increase in falls and medication errors, and a steady decline in patient experience survey scores, particularly in the question: 'Do you feel involved in your care?’ in the 4 hospital setting (A. Burr, personal communication, October 5, 2025). This project aims to address these areas of concern. Effective communication is essential, and nurse-patient interactions during shift change can be vital for achieving positive patient outcomes (Alexander et al., 2024). The aim of this project is to increase the use of this method for bedside shift reports, thereby filling gaps in traditional shift reporting. Significance of the Project In the quality improvement study by Alexander et al. (2024), which focused on a surgical unit to increase BSR use, the study found that patient satisfaction scores significantly improved when this approach was adopted. In addition to patients experiencing an increase in overall satisfaction, they also observed several other positive changes, including feeling more informed and involved in their care (Chien et al., 2024). In the hospital, patients have been struggling to feel involved in their care while inpatients on the unit. Patient satisfaction surveys indicate that patients continue to express concerns about receiving updates on testing and care plans during hospitalization. The number of never events has also been increasing, including missing pain scores after medication administration, which continue to be overlooked, while patient satisfaction declines (A. Burr, personal communication, October 5, 2025) Even more important than patient satisfaction is patient safety. This was emphasized by Jaber et al. (2022), who found that errors occurred less often when two nurses were present at the bedside during shift reports. Additionally, nurses caught and reported incidents more frequently 5 and communicated more effectively during this time. Over time, this leads to better processes and the implementation of solutions that help prevent future events that endanger patients or nurses. Furthermore, BSR not only reduces these events but also lowers medical errors and patient anxieties (Alexander et al., 2024). The bedside shift report has been shown to significantly improve the experience of patients and their families, as well as the nurses caring for them. The bedside shift report provides an opportunity for the oncoming nurse to establish baseline neurological awareness and identify any changes in the cardiac or respiratory systems, enabling a much faster diagnosis when changes are detected early. Assessing neurological systems in patients suffering from acute cerebral infarction is one of the most basic aspects of nursing. Nurses can detect early signs of symptoms, leading to a better prognosis (Han et al., 2024). Analysis of Literature Studying the literature and carefully evaluating its claims is crucial for enhancing patient safety, nurse satisfaction, and outcomes compared to the traditional shift report in the hospital setting, especially considering the benefits of implementing it in this MSN project. Most of the literature shows improvement in nearly every area of patient safety simply from the natural changes that result from having both nurses present at the patient's bedside. Review of the Literature Traditionally, nursing staff have conducted shift reports at the nurses' station, away from patients' and families' questions or concerns. According to Alexander et al. (2024), recent 6 evidence shows that doing this at the patient's bedside — involving patients in decisions and providing information about their care — improves nurse satisfaction, patient safety, and communication. Effective communication is crucial, and communication between the nurse and patient during shift change can be vital for positive patient outcomes. This represents a significant change in clinical practice. However, there is resistance and hesitation among nurses to alter the traditional approach due to concerns about confidentiality, disrupted patient sleep, and discomfort with conducting reports at the bedside while patients and families observe (Anshasi & Almayasi, 2024). The literature review outlines evidence that BSR is transforming healthcare and improving patient experiences and outcomes. Framework The Iowa Model Revised is an appropriate framework for addressing the identified clinical issue. This model is designed for point-of-care clinicians who seek to explore practicerelated questions and improve quality through systematic use of evidence. Utilizing frameworks such as the Iowa Model Revised promotes high-quality care by guiding clinicians in identifying gaps and priorities, facilitating collaboration, and supporting literature review to generate new knowledge or modify practice. (Henson & Jeffrey, 2024). This framework aligns with the topic by providing a structured method for identifying clinical problems and improving practice, such as enhancing the effectiveness of bedside shift reports and their impact on patient care quality when conducted traditionally versus at the 7 bedside. The first step in the model is always to identify an opportunity to improve or change practice, or an issue that needs attention, to enhance outcomes (Webster et al., 2024). The next step in the model is to identify the question the project is asking. This project’s PICO question is: What effect does a bedside shift report, compared to a traditional report done away from the patient, have on patient care and nurse workflow on an inpatient unit? The next step in the Iowa model is determining whether the project topic is a priority for the organization. This is done by deciding if the project is a current priority for the unit (Buckwalter et al., 2017). The need for this project can be assessed by reviewing patient care quality surveys, medication errors, and other adverse events during patients' hospital stays. This step is crucial because it involves forming a team to examine the issue, evaluate existing research and best-practice guidelines, and decide on suitable interventions. The team then collaborates to increase staff buy-in. In this context, having a peer mentor who is enthusiastic and passionate about the project, along with patients' perceived engagement and involvement in their care, usually shows positive progress when bedside shift reports are implemented (Malfait et al., 2020). Following the collection and evaluation of relevant evidence, patient surveys, and other data, the team can implement and pilot the change into practice at the bedside and make necessary adjustments. During the pilot phase, any issues or barriers can be reassessed and addressed collectively as a team. Once completed, pre- and post-implementation outcomes will be evaluated to determine whether the change is suitable for practice and outline steps to implement the change if the outcomes support adoption. Additionally, the findings would then be disseminated. This information is crucial. Nurse adherence is challenging because buy-in has 8 been challenging for daily workflow, and nurses feel the bedside process takes too long (Winebarger, 2022). Strengths and Limitations The strengths of the Iowa Model lie in its practical application for everyday healthcare tasks. Using the framework to regularly reassess and adjust the steps as information is gathered, and apply information throughout the project to gain valuable insights at each stage of the model, will strengthen this project. The limitations include the necessary time and resources for implementation, surveys, and ongoing evaluation. Because of this, many institutions may be hesitant to adopt the model, as it requires significant resources to be successfully implemented (Alexander et al., 2024). This framework reflects what happens daily at the bedside: identifying problems and working toward solutions. Ongoing assessments and inquiries help formulate questions and recognize the team's concerns to find the best ways to provide care. This creates a structure that ensures all factors are considered based on the information collected. Search Strategies A literature search was conducted to find current evidence using Google Scholar, Weber State University’s Stewart Library’s OneSearch and Advanced Search (which accesses multiple databases), as well as CINAHL, Medline Plus, and Wiley to guide initial exploration. Only articles from 2019 to 2024 were included to ensure the information was up to date. The search 9 used keywords such as “bedside shift report,” “nurse handoff,” “patient safety,” “nurse communication,” “patient satisfaction,” “burnout,” and “patient-centered care.” Various Boolean combinations of these keywords were created to broaden the search. The focus was on peerreviewed articles related to the Bedside shift report in the hospital setting. Synthesis of the Literature Three themes emerged from the literature: improved communication between nurses and patients, increased patient satisfaction, and enhanced patient safety. Communication is Improved According to the literature, the main benefit for both the nurse and the patient of switching to BSR is improved communication. When handoffs between shifts and nurses occur in front of the patient, the patient can become more involved in their care and ask any questions they may have for clarification, as they are more motivated to share information. This makes them more actively engaged in their care (Ghosh et al., 2025). This approach increases patient engagement and helps build trust not only with the patient but also with the colleague giving the report. In the quality improvement study by Alexander et al. (2024), which focused on a surgical unit to increase the use of BSR, the study found that when this was adopted, patient satisfaction scores significantly improved. In addition to patients experiencing an increase in overall satisfaction, they also observed several other positive changes, including feeling more informed and involved in their care(Chien et al., 2024) Pre- and post-implementation surveys were conducted by these authors to identify changes in BSR. The surveys showed an increase in 10 patient interaction related to their care after the transition to BSR, as the report was better structured and included a more comprehensive transfer of information (Jaber et al., 2022). Additionally, they highlighted another interesting finding in their cross-sectional, descriptive study: increased communication and reporting surrounding patient safety events. Patient Satisfaction is improved. The use of BSR is associated with higher inpatient satisfaction, as patients receive safer, higher-quality care and actively participate in their care (Tobiano et al., 2022). This can be attributed to several factors, including a stronger sense of advocacy for their own care and reduced stress, as they can verbalize, recognize, and resolve issues with their new nursing team. After implementing BSR across 11 units over four months, a 15-month reevaluation showed 82% consistency with BSR and increased patient satisfaction, mainly because patients felt nurses took the time to listen (Becker et al., 2020). Jimmerson et al. (2020) highlighted an essential aspect of the BSR process: it should be completed in less than ve minutes. This is especially important for patient satisfaction, as patients are usually sleeping during the morning shift change or have visitors during the evening shift change, which occurs due to visiting hours for many families after the work or school day. Additionally, nurse-to-patient communication improved signi cantly, thereby enhancing overall patient satisfaction (Alexander et al., 2024). Patient safety is promoted. The transfer of care between shifts is called the handoff. This is a critical process in fi fi healthcare that relies on effective communication as the nurse shares a wide range of 11 information, including patient history, treatments and procedures, allergies, and other special considerations. Communicating this clearly is essential for maintaining quality care and patient safety. Anshasi & Almayasi (2024) highlighted that the Joint Commission International (JCI) has stated that most medical errors come from communication breakdowns during handovers. This often leads to serious consequences, including medical errors, delayed treatment, misdiagnoses, and longer hospital stays and higher costs. This was highlighted by Jaber et al. (2022), who found not only that errors were recognized more frequently when two nurses were at the bedside during shift reports, but also that the nurses reported the events more often. Over time, this leads to improved processes and the implementation of solutions that will reduce future events. Alexander et al. (2024) further concluded that BSR not only decreases these events but also reduces medical errors and patient anxieties (Chien et al., 2024). Focus groups (n=151) of healthcare workers and observed or audio-recorded interactions with patients (n=133) showed that patients interacted more with the healthcare team when the report was conducted at the bedside. Improvements in the handover process signi cantly enhanced patient outcomes. This study reports that falls decreased by 9.3%- 80%, pressure injuries decreased by 45%- 75%, and medication errors declined by 11.1%- 50% (Hada & Coyer, 2021). Summary of Literature Review Findings and Application to the Project The evidence supporting the use of bedside shift reports in nursing units highlights benefits for patient communication and safety, as well as increased patient satisfaction. This underscores the advantages and the importance of investing in overcoming the challenges faced fi during implementation. Bedside shift reporting is an evidence-based approach that can address 12 many issues affecting healthcare for both nurses and patients. The shift change — an area where communication often fails —can now serve as an opportunity for positive change among nurses willing to adopt its benefits. Although the list of benefits is extensive, obstacles remain to implementing BSR across nursing units. Jimmerson et al. (2020) highlight that biases from self-reporting and perceptions are significant, as much of the research on this topic indicates. Additionally, common nursing challenges, such as time constraints and the general sense among nurses that not all information is appropriate to share at the bedside with patients and families, have led to the adoption of a hybrid approach. This approach combines traditional shift reports with bedside implementation. The literature continues to support the use of BSR as an MSN project, demonstrating its value and benefits for nurses and patients across units. Project Plan and Implementation This project consists of implementing a bedside shift report on the MCU/SCU unit, starting with planning and staff engagement, then moving to implementation and evaluation. The project will begin by gathering baseline data, medication error reports, and patient satisfaction scores prior to implementation. Nurse Champions will be selected by Nurse Managers to support staff enthusiasm, education, and buy-in. Next, staff engagement and education will take place. Nurse Champions and the implementation team will meet to identify and discuss barriers to transitioning from traditional shift report to BSR on this specific unit. Education and data will be provided during staff meetings and huddles, highlighting the proven benefits of BSR, including patient safety, 13 communication, and patient/nurse satisfaction. All members of the care team will be educated on their specific roles during shift change to ensure an uninterrupted shift report. Implementation will roll out after a date has been selected, communicated, and distributed among staff. BSR will be conducted on all patients for 90 days. Visual reminders will be displayed on the Unit, in the breakroom, and at the Nurses' station. A tracker will be placed at the nurses' station to document and track the completion of bedside shift reports. Nurse champions will provide support and encouragement and demonstrate how to do this at the bedside during this phase. Feedback and monitoring will occur throughout the rollout and the first 90 days, with medication error trends and patient satisfaction scores reviewed at 30, 60, and 90-day intervals. Nurse feedback will continue to be gathered during huddles, and staff who engage and exemplify the BSR will be recognized then. At the conclusion of the 90 days, the results will be shared with stakeholders, the Chief Nursing Officer, the nursing leadership council, hospital administration, the Quality Officer, and all other staff who attend this recurring weekly meeting. The results for medication errors and patient satisfaction will be compared with baseline data collected at the start of the project to assess the effectiveness of BSR and to determine whether it should be implemented in other areas of patient care in the hospital. Medication Error Improvement/Monitoring Medication errors are significantly reduced when the handover process is improved (Hayda & Coyer, 2021). The pharmacy tracks medication errors daily and conducts an investigation into each one. This report will be pulled before implementation to note the number 14 of occurrences. The same report will be pulled 30, 60, and 90 days after implementation, and the trend in error reduction will be identified during the bedside shift report on the MCU/SCU. Nurse Buy-in/Nurse Champions One of the largest barriers to implementing Bedside Shift Report is the buy-in and attitudes of the nurses. Using Nurse champions is a strategy shown to enhance the adoption and sustainment of practice change (Becker et al., 2020). Nurse Champions will educate on the importance of BSR and increase nurse buy-in. A staff meeting will highlight a successful patient experience through a video testimonial from a nurse who experienced it, with the bedside shift report as the key identifier for assessing a deteriorating condition. Patient Satisfaction Scores Many corporations commonly use patient satisfaction scores to gauge perceptions of the care they receive. This is an important area where the bedside shift report can make a huge difference, as the patient is the first to experience the narrative of their condition and care evaluation. In a quality improvement initiative, following the implementation of the bedside shift report, a 3.9% improvement in patient satisfaction scores was observed (Alexander et al., 2024). Patient satisfaction surveys are already being conducted on the focus unit. The prior scores and comments will be evaluated and noted during the unit’s bedside shift report. The scores will be monitored at 30, 60, and 90 days, and the comparison between pre-implementation and postimplementation at 90 days will be shared with stakeholders and care members. This can increase buy-in for individuals who may still be hesitant to adopt the change in how the report is delivered 15 Roll out to the administration and Nurse Manager/CNO On the second Wednesday of every month, there is a care team meeting that involves all the leads from the hospital's ancillaries and the Chief Nursing Officer. This meeting provides time for a roundtable to share ideas being implemented in individual units, as well as an opportunity for brainstorming and feedback from other units. Since many nurses float between departments, it is important for other units to be aware of the implementation. They may be involved or observe this shift during shift change, which can lead to greater support and understanding of the new, improved reporting method. Some units might even choose to adopt the change themselves. This also provides an opportunity to gather feedback from many important points of view that are also invested in the care of our patients and in information delivery. If any in attendance can speak to success or a personal story with BSR, they will be invited to the staff meeting when it is rolled out to the care team. Nurse implementation and roll-out This will be the most critical step in implementation. The Nurse Champions will meet with the implementation team before we meet as a whole staff, and they will be asked to help explain the reasons for shifting away from the traditional shift report approach. An opportunity will be provided to provide feedback and share experiences with the Nurse Champions. The importance of their role will be conveyed to them. As a group, we will discuss the barriers specific to the MCU/SCU area, and then hold a staff meeting to roll out the implementation. An opportunity will be provided for individuals to initially express their thoughts and concerns. There will also be 30-, 60-, and 90-day prize recognition for those who show standout participation and enthusiasm for the change. A take- 16 home flyer will be given highlighting the change, including that bedside shift reports will be conducted for every patient over the next 90 days. An accountability tracker will be at the desk, and each patient will be marked when the bedside report has taken place, along with the nurse's observations of positive and negative findings for that patient. An engaging, informative poster highlighting key BSR information will be displayed on the breakroom/huddle board as a visual reminder of the goal. These items will be discussed in morning and evening huddles, along with an opportunity to be observed by staff. Charge Nurse only huddle A charge nurse huddle will be held because the charge nurse on this unit is now able to charge without providing direct patient care, as they have no patients assigned to them. They will be educated on how to cover patient call lights and other time-sensitive matters during the shift report window, with assistance from the patient care techs, to ensure uninterrupted handoff from nurse to nurse. Plan and Implementation Process An initial meeting will be held with the Nurse Manager. She will present the rollout at the hospital management meeting and gather feedback and suggestions. The implementation team will then generate handout materials based on the feedback. Medication error reports from the pharmacy and patient satisfaction scores will be pulled from the quality control department and shared at the staff meeting. Nurse Champions will be selected with the help of the Nurse Manager, and a Champion huddle will be held. 17 Interdisciplinary Team The interdisciplinary team will comprise the key players who will make the project a success. This includes the providers assigned to care for patients on the MCU/SCU, the nurses working with them, the patient care techs and clerks on the unit, and the unit's Nurse Managers. Providers Physicians, physician assistants, and nurse practitioners will play a very important role. They will also be invited to participate in the shift report if they are in the patient’s room during that time. They can add important details to the patient’s care that benefit both nurses and patients. They will also know that they do not need to continue redelivering important information shift to shift as they become more familiar with the bedside shift report. Nurses. Clinical care nurses are the heartbeat of this project and its success, as they will be at the bedside implementing the bedside reports. They will be pivotal and will have ample time to be educated and to obtain any clarification they need before the project goes live. The best of our clinical care nurses will be the pool from which our Nurse Champions will be selected; they will be responsible for ensuring the bedside shift report for each patient is completed on the tracking sheet during the shift. The charge nurse will also cover patient lights and care during the shift report timeframe. Nurse Manager. The Nurse Manager plays an important role by selecting Nurse Champions, conducting staff meetings, and monitoring compliance with the project's implementation. During check-ins with staff, they can receive feedback on the project's success and identify any challenges that could be addressed. They will also serve as the communication channel to the administration regarding the project and its progress. 18 Patient Care Tech’s/Clerks. Support staff will attend the staff meeting, and their role will be defined, including the support they will provide during this important information exchange. They will assist the Charge Nurse in covering care tasks during that time and will also be responsible for updating the Nurses with any information regarding the patient that would be beneficial to include at the handoff. Description and Development of Project Deliverables The Breakroom Poster. The poster will help inform staff about the project (see Appendix A). This will serve as an ongoing reminder of the evidence-based practice that supports the reasons BSR has a positive impact on patients and staff. A visual reminder will reinforce buy-in. Flyer for Employee Education/Unit Flyer/Infographic. This handout is a formal invitation to staff to take on the challenge of providing a better way to care for our patients. It serves as a visual reminder of what was discussed at the staff meeting and what is expected to be retained and applied in practice (see Appendix B). Nurses Station Bedside Shift Tracker. This tracker (see Appendix C) will be important for monitoring staff compliance and adherence to the project's implementation, and will also serve as a visual reminder to staff that it is being tracked and that accountability will be required of all nurses on the unit. Timeline To ensure staff are ready and understand the project's importance, a multi-phase rollout will be used. The first week will be used to gather baseline data: medication error reports will be obtained from the pharmacy audit manager, and patient satisfaction surveys will be obtained from the quality control officer. Weeks 2-4 will be used to have the nurse manager select nurse 19 champions. They will then meet with the project team and the manager to discuss the project's importance and rationale, as well as the role they will play in staff buy-in. Weeks 4-6 will focus on staff education; staff meetings will be held, flyers distributed, and huddles will begin focusing on BSR. The purpose of this project will be patient safety. In Week 7, after identifying and communicating a rollout date, the project will launch. Weeks 8-19 will be used for ongoing project monitoring, staff, and participation encouragement. Data on medication errors and patient satisfaction surveys will be collected at 30, 60, and 90 days. Week 20 will focus on evaluating the data and outcomes, presenting the findings to stakeholders, specifically the CNO and hospital administration, and determining whether the project demonstrated a significant improvement in patient satisfaction and a reduction in medication errors sufficient to consider implementing it on other units(See Appendix D). The project will be an important safety tool if medication errors and events are reduced. Project Evaluation It will be pivotal to accurately determine whether the project was a success and whether it achieved the changes we expected from implementing the bedside shift report. This can be evaluated through patient understanding and participation (Tobiano et al., 2022) and the scores patients give to the experience on the post-stay survey. It is important to evaluate this not only at the end of the project but also throughout its rollout and ongoing progress. This will be achieved by listening to nurses' feedback during huddles, ensuring it is done regularly, and allowing them to communicate their suggestions and concerns anonymously through a unit feedback dropbox. The inventory checklist will be reviewed daily by the charge nurse. Any patients who face barriers to completing the report at the bedside will have their visit information emailed 20 exclusively through the secure hospital email domain to the Nurse Manager for follow-up. This will help identify barriers to the successful conduct of the BSR. By closely monitoring staff feedback, ensuring adherence to the BSR frequency, and observing BSRs in real time, barriers can be identified and addressed, and adjustments made as needed throughout the implementation process. After the implementation phase, the focus will shift to outcomes. This will involve comparing medication error rates before and after the implementation of the new shift-report delivery method. Data from the patient satisfaction survey, both prior to and following implementation, will also be important. Indicators that BSR had a positive effect would be increased patient satisfaction, as measured by the post-stay survey question about how involved patients felt in their care and how well they felt the nurse listened to them. These will be collected electronically by the Nurse Manager and stored on the shared unit drive of a hospitalprovided computer. If the evidence shows that patients are having a positive experience with the change, as reflected in patient surveys and increased involvement in information and other aspects of their care, this will support adoption. It will be important to listen to nurses' experiences after the project is completed and to include that feedback in the evaluation of the project's success. This will be gathered anonymously in the feedback box after the project ends, and nurses will be encouraged to share their experiences in this way. This information will be used to determine whether this implementation should be adopted and shared with other departments to improve quality and safety. Nurse buy-in will be a key part of the project’s longterm sustainability, as it has been identified as a crucial factor in the long-term success of bedside shift report implementation (Becker et al., 2020). 21 Ethical Considerations Ethical considerations need to be taken into account regarding the Bedside shift report. Ethically, bedside shift report supports patient autonomy by actively inviting patient participation while allowing individuals to choose the level of their involvement (Tobiano et al., 2022). Another thing to consider is breaches of confidentiality, as HIPAA laws ensure that patient information is protected. Bedside handover presents ethical challenges to confidentiality, particularly in shared patient environments where sensitive information may be overheard (Malfait et al., 2020). The personal bias of the project lead should be acknowledged, as I believe this approach is better for patients and their families and more effective for nurses to engage with the patients they care for. This bias will be managed by concentrating on the data, involving diverse perspectives at all project stages, and utilizing data to guide the project’s outcomes and implementation. Discussion Implementing bedside shift report is an essential practice change to enhance communication, patient safety, and satisfaction. This project showed that a structured bedside handoff, compared to a traditional handover, can better focus on patient safety and experience, leading to improved outcomes, as BSR has been demonstrated to have a higher rate of early detection of changes in patient status (Han et al., 2024). The evidence supports the project’s aim of reducing medication errors and boosting patient satisfaction in the inpatient setting. Nurse buy-in is an important thing to establish, as pushback has been shown to affect adherence to BSR. Nurse Champions will be important for encouraging and educating their 22 colleagues about the reasons the change is needed, and leadership support is essential for any new practice (Becker et al., 2020). An important ethical consideration when implementing BSR is the sensitive information being shared, and ensuring that all HIPAA laws and confidentiality concerns are always considered when sharing patient information. The success will be measured by increases in patient satisfaction scores and reductions in medication error rates during the project’s implementation. Evidence-Based Solutions for Dissemination The project results will be disseminated through a poster, which will be presented to faculty and shared with the content expert involved in this project, as she has implemented this with her staff at her facility and has found it beneficial to disseminate project information to staff. Posters provide quick, easy-to-understand visual information that will engage staff, increase buy-in and adherence to the goals, and underscore the project's importance. Significance to the Advancement of Nursing Practice The transition of shift reports from traditional methods to BSR can enhance nursing practice. This project supports nursing practice by providing evidence that a structured bedside shift report positively impacts patients. By increasing their involvement in care and the safety they experience in the hospital, nurses can identify early signs of various neurological issues during report handover, thereby improving prognosis (Han et al., 2024). This is crucial because we are advocates for our patients. Implementing a well-structured bedside handover benefits both nurses and patients (Rachmawaty et al., 2023). Overall, adopting BSR into nursing practice can lead to many significant improvements. 23 Implications The strengths of this project lie in the chosen and modeled framework. The Iowa model for implementing change keeps the project’s trajectory strictly focused on measurable outcomes that ultimately determine project success. Demonstrating the ways BSR have been shown to improve patient safety (Hada & Coyer, 2021) and increase patient satisfaction and engagement (Tobiano et al., 2022). The limitations of the study include confidentiality concerns about sharing sensitive information in shared areas (Malfait et al., 2020), as well as the continued monitoring of staff adherence after the initial rollout, without dedicating permanent time and resources to this task. Nurse Champions could continue the project's vision, guide and educate new hires, and remind trained staff of the project’s objectives and purpose. Recommendations Recommended future steps include leaving the visual reminders on the unit and continuing to discuss what they are noticing during huddles, including the new shift report delivery. Nurse Champions could continue to provide encouragement and ongoing education. Nurses could continue to be recognized with good catch awards that are the direct result of implementing the BSR. It would increase adherence after the project’s end if tablets or portable bedside electronic devices could be easily used to communicate lab results or answer patients’ questions in real time, with accurate information right at hand. This could also reduce the time required for shift handover if there were no need to leave the bedside to gather additional information. 24 Future projects could focus on recognizing nurses who make a “good catch” by identifying changes in patient condition or medication issues that can be directly correlated with a change in handover delivery method. Conclusions BSR addresses many problems that remain gaps in nursing practice, including medication errors and patient involvement and satisfaction. Alexander et al. (2024) reported that recent evidence shows that conducting reports at the patient’s bedside—involving patients in decisions and providing information about their care—improves nurse satisfaction, patient safety, and communication. A traditional shift report often leads to communication breakdowns. Even with these studies, there is resistance and hesitation among nurses to change the traditional approach due to concerns about confidentiality, disrupted patient sleep, and discomfort with conducting reports at the bedside while patients and families observe (Anshasi & Almayasi, 2024). The goal of this project is to provide evidence to support implementation across inpatient settings and to address barriers to nursing buy-in. Promoting more adoption of BSR in the future of healthcare. 25 References Abbaszade, A., Assarroudi, A., Armat, M. R., Stewart, J. J., Rakhshani, M. H., Sefidi, N., & Sahebkar, M. (2020). Evaluation of the impact of handoff based on the SBAR technique on the quality of nursing care. Journal of Nursing Care Quality, 36(3). https://doi.org/ 10.1097/ncq.0000000000000498 Alexander, S., Diegel-Vacek, L., & Williams, C. (2024). Increasing rates of bedside shift report and improving patient satisfaction scores: A Quality Improvement initiative. 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Coasting through bedside report. Journal of Nursing Care Quality, 40(1), 69–75. https://doi.org/10.1097/ ncq.0000000000000802 Winebarger, A. (2022). Investigating nurses’ perception of bedside handoff. Nursing, 52(9), 54– 56. https://doi.org/10.1097/01.nurse.0000854012.26421.c0 29 Appendix A Breakroom Poster 30 Appendix B Flyer for Employee Education/Unit Flyer/Infographic 31 Appendix C Nurses Station BSR inventory tracker 32 Appendix D Timeline