[A project to improve the completeness of nursing shift reports in the surgical ward]

The authors found that surgical ward shift reports were not being adequately completed, with 29.4% of content items on shift reports not reaching 80% completeness. After an analysis of the situation, we found that the problems were caused by factors that included lack of understanding of shift report contents, inappropriate shift reporting standards, lack of specialty-related knowledge and guidance in the shift report, and discontinuities in patient care allocation. Based on these findings, the researchers revised shift-reporting standards, redesigned the report format, conducted relevant training, and changed the shift assignment methodology. A survey conducted following implementation of researcher-directed changes found that 100% shift report items had reached 80% completeness and achieved improvement goals. At the same time, the author found full staff participation and lack of confidence to be, respectively, the principal strength and weakness in accomplishing this project. A limitation of this project is that it cannot be applied to non-surgical wards. Project methods have already been applied to new staff training in the hospital at which this study was conducted. Based on project findings and experience, the author also makes the following additional suggestions: (1) shift report-related content, skills and principles should be incorporated into school curricula; (2) shift report should be monitored and updated regularly; and (3) follow-on research may explore the factors that affect shift report content completeness.