Patient care gets revamped
Staff learns from studies on care practices and bedside reporting
article-down-arrow
By Jonathan Bilyk
EDITOR'S NOTE: Jonathan Bilyk is a freelance writer.
As a nurse manager at Cancer Treatment Centers of America Eastern Regional Medical Center in Philadelphia, Marie Decker sometimes feels the last thing her patients want to hear is “nursespeak.”
But based on surveys she’s seen, patients actually often times enjoy when nurses speak about their care, particularly when that discussion takes place at their bedside. In 2015, Decker, MSN, RN, AOCN, NE-BC, HN-BC, presented to the annual Oncology Nursing Society Congress the results of a recent pilot study she helped coordinate at CTCA. The study examined what might happen if nurses took the shift change reporting from the unit nurses’ station to the patients’ rooms. Decker’s pilot study bolstered new evidence-based literature about the potential benefits of bedside reporting. “We realized the noise level (at the nurse’s station) at change of shift was high,” Decker said. “There were 10 nurses giving reports at one time, so we asked our nurses the questions: ‘Did you have difficulty hearing?’ ‘Did you have difficulty completing your report?’ The answer was, ‘Yes, we need to change.’” From there, the pilot expanded and grew, “one nurse, one patient at a time,” Decker said.
Beginning first with practice rounds, Decker said the nurses eventually took the program into the rooms of consenting patients, introducing the oncoming nurses and discussing that particular patient’s status, care and condition, and the plan for the coming hours. “We try to avoid getting extremely clinical, and save any required technical ‘nursespeak’ for outside the room,” Decker said. “We don’t want to overwhelm the patients.”

The painstaking efforts bore positive results, she said, as surveys following the month-long pilot demonstrated strong patient support for the change. Decker said 99% of the patients surveyed said they liked the new bedside reporting method. “They said it was very comforting for them,” she said. Decker said most liked “being included in the conversation — unless they wanted to sleep. They enjoyed being able to say goodbye to the nurse whose shift was ending, and meeting the oncoming nurse before they begin actually providing care.” Nurses surveyed about the program also said they wished the program to continue, with 44% of them adding they believed the bedside reporting program increased the “professionalism of their practice.” A year later, the program was standard practice in one unit of the hospital and was expanding to other units. “The handoff has become pivotal to ensuring the continuity of care,” Decker said.
Check out our digital editions
We try to avoid getting extremely clinical, and save any required technical ‘nursespeak’ for outside the room. We don’t want to overwhelm the patients.”
— Marie Decker, RN
Survey care plans study
Mary Ellen Galiczynski, BSN, RN, OCN, transplant coordinator at CTCA Philadelphia, shared the promising results of her survey of primary care physicians continuing the care of stem cell transplant recipients who had been discharged following successful transplant at CTCA. Those physicians, she said, were enthusiastic about the “survivor care plans” sent home with transplant recipients. She said the care plans discuss possible long-term side effects from the transplant and intensive chemotherapy for oncology patients, including potential cardiac, pulmonary, dermatological and ophthalmological issues. The plan, she said, helps the patient’s hometown physician know what a newly developed odd rash may mean, or when and what dose of a vaccine to give to a transplant recipient whose immune system has been rebooted. “This way, they’re more apt to get the patient treated there than to send them back to us unnecessarily,” Galiczynski said. About 63% of the physicians surveyed said the care plans were “vital” elements of the transition, and all surveyed found the plans helpful, she said.
Patient empowered care study
In another study, nurse practitioner Deborah Selm-Orr, MSN, RN, CRNP, AOCN, examined the effects of the CTCA patient-empowered care model on symptoms of chemotherapy-induced nausea and vomiting, comparing that to the more standard chronic care model. “As an oncology nurse, I’m looking at ways to help patients deal with the nausea and vomiting,” Selm-Orr said. “That is one of the most feared side-effects of chemo.” While the CTCA model showed some promise for further study, she said the results were largely inconclusive, as both groups of patients — those who had experienced both care models — reported little difference in symptoms. Further, the comparison was complicated by differences in the strength of chemotherapy drugs used and differences in cancer types.
share-dots-shadow
hamburguer-icon-shadow
MENU
toc-image-nurse-1X
Contents
LP-500235791-_1_
Be a driving force behind EBP
Learn why evidence is a must when it comes to quality patient care.
arrow-TOC
evidence-based practice
Nurses cross into research
Nurses are doing the digging to find answers to their practice questions.
arrow-TOC
ThinkstockPhotos-477866850
Get to the root of it
Master the basics of EBP and learn how to start your own project.
arrow-TOC
ThinkstockPhotos-510228138
Research feeds good practice
Turn a patient care idea into practice by starting with solid research.
arrow-TOC
LP-629779480
You hold the power
Bedside nurses have the ability to make significant practice changes.
arrow-TOC
LP-512224162
Making the grade
Evidence is a moving target. Be ready to adjust EBP policies.
arrow-TOC
ThinkstockPhotos-538346404
Protect the children
Pain management is a big deal when it comes to the littlest patients.
arrow-TOC
evidence-based practice
Meet a wound care expert
RN Nancy Morgan tells you what really works wound care.
arrow-TOC
evidence-based practice
FREE CE: What's new in EBP?
Learn the latest about ICU sedation, CLABSIs, and more.
arrow-TOC
LP-95838760
EBP blasts make an impact
A nurse successfully expands healthcare access for her patients.
arrow-TOC
LP-465046266
Fuel career satisfaction
Use new evidence to transform your old practices.
arrow-TOC
image7
CE Catalog
Boost your knowledge of EBP with these education modules.
arrow-TOC
LP-101185412
Follow the evidence
You know EBP is important; now grasp the strategies behind it.
arrow-TOC
LP-171579618
The journey continues
Driving interest in EBP is not always easy, but it’s worth the effort.
arrow-TOC
LP-636524952
An unacceptable risk
Periop nurses are striving to decrease pressure ulcers.
arrow-TOC
LP-510968064
Training days
Patient-centered care plus team science equals dazzling results.
arrow-TOC
LP-477475021
Pregame practice
Nursing students are being to appreciate the value of EBP.
arrow-TOC
LP-485934274
Poor self-care is a safety issue
Nurses who do not address fatigue can jeopardize patients.
arrow-TOC
LP-465326271
Create a dream team
A children's hospital shows how interdisciplinary care pays off.
arrow-TOC
LP-483629308
It's all about the team
Learn how the TeamSTEPPS strategy took shape.
arrow-TOC
LP-512545687
Patient care gets revamped
A cancer center reboots bedside reporting and improves care.
arrow-TOC
© 2018 OnCourse Learning Corp. All rights reserved
20225 Water Tower Blvd. Brookfield, WI 53045
left-arrowright-arrow
How to Navigate
Nurse-logo
Subscribe
X
How to Navigate
BROWSE
FIND
right-arrowleft-arrow
hamburguer-icon-shadow
MENU
Move forward or backward between articles by clicking the arrows.
Click or tap to bring up the Table of Contents.
READ
share-dots-shadow
facebooktwitterLinkedingoogle-pluspinterest
SHARE
scroll
Share articles by clicking on one of the social media icons in the upper right corner of the page.
Use your mouse wheel, keyboard arrow keys, or scroll bar to move up and down in an article.
Don't miss our next edition!
Get free tips and nursing content delivered right to your inbox