Clinical Problem and Research Problem

Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project
Use the critical appraisal guide template for answering questions for qualitative or
quantitative study appraisal. Use References page in APA format. 6th edition Each
question should be answered with at least 2-3 sentences and be thorough with critiquing
key elements. Provide APA reference page with DOI/ website link and a PDF of the
article itself with assignment submission.
Can you let me know if it is QUALITATIVE OR QUANTITATIVE so I can email you
the questions to answer?

Bedside Shift Report: Article Critique
Problem Statement

  1. Clinical Problem and Research Problem
    The article “On the same page: Nurse, patient, and family perceptions of change-of-
    shift bedside report”, by Bigani and Correia (2018) outlines the research statement as the
    perception of the nurses, patient s, and their families on the change of shift and how it
    adversely affects the safety of the patients in a pediatricsetting. The clinical problem
    addressed by the study was in reference to the safety of the pediatric patients and how t is
    affected by the handoffs during the change in a shift among the nurses. The studyexplores the
    various perceptions by the different involved parties and how the concerns have been
    addressed to prevent mishaps and accidents after or duringchange of shift, which endangers
    the patients.
  2. Significance of the Study
    The authors have established the significance of the study by basing their argument
    that during shift changer there is the need for proper communication among the incoming and

ARTICLE CRITIQUE 2
the outgoing nursing teams during handover to ensure that there is little or no room for errors
which may result in adverse effects or fatality of a patient in hospital care. As such, the
precedence set by the article and report is that there is need to ensure that the various
stakeholders are involved in the process to minimize the risks involved and to ensure that the
transition is smooth.Furthermore, the importance of effective communication, collaboration
with family members, and its role in patient safety through bedside shift change havebeen
elaborated in the study.

Purpose and Research Questions

  1. Purpose of the Study
    The purpose of the study was to establish the perception of the patients, nurse,
    family members, and other stakeholders on the bedside change of shift. The article also
    explores how it affects patient safety. Additionally, it also describes the safety concerns and
    the role of effective communication and collaboration with family members in improving the
    outcomes and prevention of errors during the handover process.
  2. Research Questions
    The research questions were incorporated in the questionnaires administered to the
    participating nurses and the family members of the patients. The questions revolve around the
    competency of the nurses, which include: “Have you been adequately trained and oriented in
    conducting a change of shift properly?”. Secondly, what are the safety concerns that may
    arise during the handover and shift change? In addition, the parents and relatives were on a
    separate questionnaire were asked their perception and knowledge of the bedside change of
    shift report.
  3. The relevance of Purpose and Research Question

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The purpose of the study is relevant in the study as the aim is to understand the
perception of the nurses, and the patient family members in regards to change of shift bedside
report. The study also raises the patient safety concerns which may arise from the handover.
Also, it helps understand the depth and scope of knowledge for the patient’s family and
relations, and the nurse’scompetencies on the change of shift bedside report.

  1. The relevance of Qualitative Methods
    Qualitative methods used in the study were relevant as they were aimed at gathering
    information on the different pertinent research questions raised. The questionnaires
    administered were simple enough to respond to while providing the relevant information
    from nurses and the patient’s families. Moreover, they were in a position to create the link
    and relationship between the patient safety outcomes on the quality and effectiveness of the
    change of shift bedside report communication.
    Literature Review
  2. The relevance of Qualitative and Quantitative Studies Cited
    The quantitative and qualitative studied cited by the authors were relevant and
    included other works and research conducted on the same. The use of administered
    questionnaires also led to first-hand account and data which was relevant to the investigation
    and provided insight into the effectiveness of the communication and knowledge
    dissemination on change of shift bedside report. It was also instrumental in the provision of
    relevant information from other authors and reports done on the same topic, which aided in
    the understanding of the importance of its implementation and execution to patient safety.
  3. Current References

ARTICLE CRITIQUE 4
The references used in the study were current. The older article used by the authors
was published in 2006, with the majority being five to six years after being published.
However, the articles which were older (2006, 2007, and 2009) were also relevant and
provided competent information in regards to change in shift bedside report. Furthermore, the
information provided by the article augmented the findings of the exploratory- descriptive
qualitative study.

  1. Disciplines of the Authors Cited and Databases Searched
    Authors of various studies and research conducted on the bedside report and cited by
    Bigani and Correia (2018), included joint commission reports composed of nursing
    practitioners and administrators. They included investigative studies conducted by the
    collaborative effort of physicians and nurses. Different areas of nursing specialization other
    than pediatricswere also considered in the studies. The search criteria for the references are,
    however, not indicated and hence, the databases used are unknown to the reader.
  2. Evidence Provision
    The study was adequately supported y the various evidence in the form of citations
    of other articles on the need and necessity of the study. It incorporated other views on bedside
    change of shift and the evidence that it affectspatient safety. Moreover, critical aspects such
    as effective communication were also highlighted and supported with relevant citations and
    evidence-based practices.

Frame of reference

  1. Development of a Framework
    A frame of reference from the study findings was developed and was noted to be
    aligned with other studies. It developed the essence and role of effective communication in

ARTICLE CRITIQUE 5
handover processes during shift change. Moreover, it outlined the role of the various players
in the process, which included nurses and family members. As such, the framework
developed also aided in answering the various research questions raised earlier and the
possibility of further studies on the topic.

Sampling and Samples

  1. Selection Criterion
    Participants of the study were selectedvoluntarily in a Southern California children’s
    hospital. The nurses were from both day and night shift and were handed informational
    material before selection and were also required to have a minimum two years’ experience
    while parents and families were selected from the various patients admitted in the facility and
    information provided before their participation with a minimum of one-day admission
    required. Nonverbal patients, patients without a guardian of parent consent, patients under ten
    and those with developmental problems were excluded.
  2. Inclusion and exclusion criteria
    Inclusion criteria for nurses were that one had to be a willing participant, two
    years,or more experience. Moreover, they were to have worked for at least 12 months in
    either the surgical or the medical units of the hospital. The inclusion criteria for the
    parents and families was that they had to be willing and also were required to have a
    patient admitted at the hospital for at least a day the participation was voluntary.
  3. The relevance of Selected Subjects
    The subjects were in a position and provided the required information through the
    questionnaires. The nurses provided information on their competencies and communication
    in a change of shift bedside report. The participating families, on the other hand, provide

ARTICLE CRITIQUE 6
information on their perception of the hand over the process and how they felt the process
was conducted and its effects on the safety of the patients.

  1. Participants
    A total of 40 participants were involved in the study. Participation was voluntary
    with the request for participation having been sent to 120 nurses and 25 participating. The
    number of families interviewed in the study was 15. It was voluntarily,and some of the
    families and nurses declined or rather did not a volunteerof the study.

Data Collection

  1. Process of Data Collection
    Data was collected using semi-structured questionnaires with the responses being
    recorded both in English and Spanish. The interviews were recorded and later transcribed
    using the software Verbal Ink.Moreover, Spanish translator was also provided to aid in the
    interviews for non-English speakers. Furthermore, the transcribed data werereviewed by the
    investigators and nurse colleagues for the commonality of the themes under investigation.
  2. Timeline
    The timeline for the study was approximately sixmonths. The study started with the
    requests for participation among the nurses, which was conducted between April and
    September 2015. Before the selection, there had been a training conducted on change of shift
    bedside report in 2012. Information was also gathered after the selection within the same six
    months period.

Protection of Human participants

  1. Benefits or Risks of Participation

ARTICLE CRITIQUE 7
The benefits of participation included the provision of information that would
improve patient safety and consequently, the quality of care provided. The participants were
also gifted with five US dollar vouchers. The risk not identified would have been the
incentivization of the patients and their families and the participating nurses due to the gift
vouchers. However, the amount was too little to be of significant effect.

  1. Adjustment of Recruitment Techniques
    There was little if any adjustment is done to the recruiting techniques with the only
    noteworthy change being the provision of an interpreter to aid in the interviews of the
    Spanish speaking patients and their relatives as they are also part of the Southern California
    demographic. Furthermore, nonverbal and developmental issues patients were included if
    their guardianswereinterviewed for the study.
  2. Data Collection and Management Techniques
    The collection of data acknowledged the participant’s sensitivity and vulnerably
    through the exclusion of patients without consent, patients less than ten years of age, patients
    with developmental issues,and language barrier. The exclusion criteria were to protect the
    vulnerable groups. The language barrier was overcome through the use of an interpreter.

Data management and Analysis

  1. Data management and analysis
    The data management and analysis in the study was through the correct labeling of
    the various tapes recorded during interviews. The transcription process was also done using
    Verbal Ink to reduce the occurrence of errors. Additionally, the data was vetted by the
    investigators and their colleagues’ nurses to ensure relevance and preservation of the study
    theme.

ARTICLE CRITIQUE 8

  1. Biases
    The biases that may have occurred include the researcher bias, which may be due to
    the investigators going through the transcriptions looking for the themes of the study. As
    such, they may impose their bias by selection of the thematic relevant areas and ignoring the
    rest. Furthermore, the interpretation and transcription process may lead to the loss of
    authenticity of statements leading to loss of information.
  2. MinimizingResearcher Bias
    Incorporation of other nursing colleagues to aid the investigators in counterchecking
    the transcriptions was to minimize the researcher bias. They were to ensure that the process
    was optimized and hence no occurrence of the bias. Response biases would have occurred
    due to poor reliability and validity testing of the responses in the interviews.

Findings

  1. Addressing the Purpose
    The findings of the study addressed the purpose under investigation. It established
    the link between the change of shift bedside report, quality of healthcare provided, and the
    patient safety. Moreover, the study was essential in outlining the role of effective
    communication and the impact and implication on the quality of healthcare and patient safety.
  2. Data interpretation
    The interpretation of the data was congruent with the data collected. The
    investigators also involved nursing colleagues to ensure that the data was reflective of the
    interviews conducted after transcription form audio recordings to writing. They also ensured
    that the themes of the study were captured in the interviews conducted.

Discussion

ARTICLE CRITIQUE 9

  1. Links to Other Studies
    There was the establishment of links to other studies conducted previously. The data
    collected was augmented by the various articles referenced and cited in the study. Moreover,
    the link was also established to the barriers of bedside report, quality of healthcare, the
    perception of the changeover report among the patients and guardians, and the impact on
    patient safety.
  2. Clinical, Theoretical and Policy Significance
    The authors of the study have explored the various implications in their findings.
    Clinically, there is the use of evidence-based care and hand over with effective
    communication to improve the quality of healthcare and outcomes. Theoretically, there is the
    establishment and implementation of the nursing theories that support the change of shift
    bedside report while the policies have been explored by outlining required competencies from
    the nurses in handing over.
  3. Future Studies
    Future studies have not to need expressly mentioned but insinuated in the findings.
    They should be based on the need for the reinforcement of the bedside report. Moreover,
    there is a need to increase the scope of the study to establish the various efforts to sustain the
    practice in hospitals.

Logic and Form of Findings

  1. Ease of Finding information
    The study was well organized with the various sections clearly labeled and outlined.
    Information was easy to find and included addition references and citations of relevant works.
    Moreover, the authors used easily to understand and colligable language.

ARTICLE CRITIQUE 10

  1. Coherent logic
    There was coherent logic to the finings which was categorized broadly into themes.
    The themes were them broken down into the topics which addressed various issues and
    research questions. The logicwas also supported by references and citation of other relevant
    works.

Evaluation Summary

  1. Application in Nursing Practice
    Application in the nursing practice of the findings is important in overcoming the
    barriers that may hinder change in shift bedside report. Moreover, the families are
    encouraged to play an active role as collaborates with the nursed ad health professionals it
    also can be used as n assessment measure of the quality of healthcare provided by an
    institution and a test of nursing competencies in improving patient safety.
  2. Addition of Findings to Body of Knowledge
    The findings of the study are useful in creating a link on the importance of the
    collaborative measure among the patients, families, and nurses in ensuring effective
    communication in a change of shift. The handing over processes should be exhaustive to aid
    the incoming medical personnel adequate information to prevent the occurrence of errors.
    The importance and knowledge of bedside reports is also emphasized
  3. Conclusion
    In conclusion, the appraisal of the study revealed various relevance of the bedside
    report. It also highlighted the role of the variousstakeholders, including nurses, patients, and
    their families in the improvement of the communication and provision of quality healthcare.
    The link to patient safety and nursing competencies was also established from the study.

ARTICLE CRITIQUE 11

Reference

Bogani, D. K., & Correia, A. M. (2018). On the same page: Nurse, patient, and family
perceptions of change-of-shift bedside report. Journal of Pediatric Nursing, 41(2018),
84-89.

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