Exploring the process of implementing nursing bedside shift report

Patient-and-family-centred care is at the forefront of today’s health care. Conducting shift report at the bedside is one patient-and-family-centred nursing practice being implemented at health care institutions. A review of the literature revealed that few studies have explored the process of implementing bedside shift report (BSR) at various health care institutions; most reports focus on the experiences of single units or single institutions. The purpose of this study is to explore what can be learned about optimizing the implementation of bedside shift report from the perspective of nurses who have implemented it. An interpretive description methodology guided semi-structured interviews with nine nurses recruited from four Canadian hospitals. The analytic process revealed two main themes and corresponding sub-themes (a) Strategies for implementation (creating a BSR implementation working group, group member preparation, creating staff awareness, staff education sessions and the initiation of BSR) and (b) BSR implementation challenges (attitudes and beliefs about BSR, dissemination of patient information and confidentiality concerns, the impact of changing practice to BSR, and nurses’ negative influence on BSR). Nurses resisted the implementation of BSR because it interfered with the communication style of current handover practices, the social time that occurs with current practices and the valuable time to debrief with colleagues. Furthermore, nurses opposed BSR due to the need to report objectively, be more accountable and portray professionalism. In addition, practicing BSR is impeded by naysayers, bullying, peer pressure and the presence of stymied culture. The findings suggest the need to determine the appropriate methods for implementing BSR as well as including education on communication and bullying. Further research exploring the meaning of nursing handover, nursing perspectives on relational dynamics in nursing and the impact on practice environments may provide information to assist with the implementation of BSR.Applied Science, Faculty ofNursing, School ofGraduat