clinical care processes
Developing PICOT De Pedro
Cristina De Pedro
West Coast University
NURS 350 Research in Nursing
Professor Sara Turpel
To achieve improved care quality, healthcare organizations have focused on clinical care processes such as nurses’ shift reports. And the involvements of patients in healthcare delivery. Malfait et al. (2017) report active patient participation has been critical in reducing medical errors especially during shift change and reporting among nurses. The proposition is further reiterated by Buus et al. (2017), highlighting that nurse shift reports are routine occurrences in healthcare organizations aimed at transitioning the care process. And improving care coordination among the interdisciplinary teams. Current healthcare delivery has been dominated by bedside reporting due to the one-on-one communication between the nurse and the patient. The shift report remains a viable site for studying the professional role of nurses. And has progressed to receive increased attention especially regarding quality improvement strategies and the reduction of medical errors.
Mitchell et al. (2018) argue that mandatory bedside reporting has been widely implemented in various healthcare settings to improve quality and safe care. Of note, nursing bedside report allows the interaction between the incoming and outgoing nurse to assess the patient. And examine for possible errors that may ensue. Usually, bedside reporting highlights the first time the oncoming nurse has a chance to meet the patient. And establish a rapport that sustains their therapeutic relationship. The reporting fosters specific care concerns during management and other issues that the oncoming nurse may want to prioritize.
Significance of the Topic to Nursing Practice
Currently, nursing practice has been rapidly evolving with a strong emphasis being placed on the quality and safety of care delivery. Malfait et al. (2017) state that nurse shift reporting has been essential to healthcare organizations in improving patient satisfaction and meeting their expectations of care. Specifically, the study highlights that bedside reporting has been instrumental in improving care quality, as nurses can share extensive health information between themselves and the patient. Additionally, the patients can indicate their healthcare preferences, values, and expectations which can then be aligned with the best available evidence, thereby improving their care quality (Malfait et al., 2017). By making such expectations clear to both nurses, the patient becomes more involved in the decision-making process increases the likelihood of patient-centered care. Apart from mitigating medical errors due to effective communication and handing over between the two nurses, bedside reporting also intertwines improved patient empowerment and activation.
PICOT Research Questions
Wichman (2017) argues that the patient-provider interaction during shift reporting enables the nurses to prioritize their work which ultimately enhances their accountability, medication reconciliation, and better handing over processes. In developing a PICOT question to address this topic, two key shift reporting techniques will be explored; bedside shift reporting versus nurse station shift report. As outlined in previous literature, bedside reporting has been recommended due to reduced errors as it enhances nurses to nurse and nurse-to-patient communication.
The population of interest will be patients in acute care. Due to the benefits of bedside reporting the intervention for this PICOT question will be bedside shift reporting which will be compared to nurse station shift reporting. Although several benefits have been implicated, the outcome of this PICOT question will be medication errors investigated within a timeline of 6 weeks. Thus, the PICOT will be stated as; In acute care patients (P), how does beside shift reporting (I) compare with nurse station shift reporting (C) in reducing medication errors (O) within six weeks (T)?