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COASTing Through Bedside Report: An Innovative Approach to Safe Transitions of Care
Kristi Webster1, Jeanne Hlebichuk, Lillian Jensen
1Author Affiliations: Advocate Health System-Chair-Midwest Nursing Practice Council, Clinical Nurse-Medical Respiratory Intensive Care Unit, Aurora St. Luke's Medical Center (Mrs Webster), Milwaukee, WI; Magnet Department, Aurora St. Luke's Medical Center (Dr Hlebichuk), Milwaukee, WI; Strategy and Innovation, Advocate Health (Mrs Jensen), Milwaukee, WI; and Patient Safety, Advocate Health (Dr Zastrow), Oak Brook, IL.
Background:
Bedside shift report improves patient satisfaction, peer accountability, communication, and decreases safety events.
Local Problem:
Clinical practice of bedside report varied prior to the pandemic. Due to limited personal protective equipment and exposure risk, bedside report was halted during the pandemic.
Approach:
The Iowa Model of Evidence-Based Practice was used to guide this project. To standardize communication during bedside report, safety data and literature were reviewed and grouped by themes. The acronym COAST was developed, consisting of code status, oxygen, access, safety, and tubes/drains. These elements were to be discussed at the bedside during handoff.
Results:
Compliance with completing elements of COAST increased during the pilot, 9- and 12-month sustainment periods. Additional safety-related outcomes of cardiopulmonary resuscitation wristband application, falls, and good catches improved. Notably, overtime declined.
Conclusions:
A bedside report with standardized communication focusing on safety elements can improve compliance with adoption and patient safety outcomes.
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