The healthcare world is very complex and fast-paced, and efficient communication during shift handoffs is critical to prevent patient safety risks and guarantee continual care. Nevertheless, the traditional system of shift handoff in our medical ward does not have a structure. It does not involve the patients and their families in their care, which leads to an incomplete transfer of information from nurses to nurses and patients and makes them feel left out. To resolve this problem, our medical unit suggests using the ISHAPED tool as a framework for bedside shift reporting.
Proposed solution
The solution applies the ISHAPED Tool (Introduction, Story, History, Assessment, Plan, Evidence, Discussion) as a structured framework for bedside shift reporting. Stimpson et al. (2020) state that it enhances effective communication between all parties by ensuring the exchange of comprehensive information, including the patient in the process, making it transparent and educating users on ISHAPED, making provision for contextual (sociocultural and linguistic) competencies aimed at building communication inclusive of all. Visuals, tapes, or interpreters will be used to translate and transmit the information. The effect of that on nursing practice will be a standardized approach for teams to collaborate, the continuity of care, and patients being the prime focus during care delivery.
Implementation steps
The implementation of ISHAPED in our bedside reporting practices involves a multidisciplinary approach. To begin with, we will get the management team’s support and put together a multidisciplinary group to oversee the project, recruiting from different teams, for example, representing the nursing staff, medical doctors, and patient advocates. Together, this team will create educational materials, staff training sessions or workshops, and some supplements such as flashcards or visual aids for better reinforcement of the ISHAPED framework.
Once these groundwork milestones are completed, the pilot phase will be initiated, during which we will implement ISHAPED for shift reporting at the bedside on some selected units. Creating nurse champions who will show outstanding practices and guide frontline staff in a virtual space will be done. Audits will be carried out simultaneously to assess the compliance of the ISHAPED process and get feedback from the nurses and patients. This feedback will be beneficial in pointing out the possible challenges, adjusting the implementation strategy, and considering any sociocultural or language issues that might arise. We will be tracking the market performance indicators, including patients’ satisfaction based on their communication with our nursing staff, adherence to our ISHAPED framework, and the quantity of preventable adverse cases associated with the incomplete handover. With these metrics, we measure the intervention’s success and use it to identify any adjustments that may ensure the project’s long-term adoption and success.
Objectives
The goal of implementing ISHAPED is to increase patient satisfaction scores related to nurse communication by 20% within ten weeks. Since patients in the medical ward have been complaining about how nurses do not involve them during handoff, instead they talk to themselves, pointing at the patients without involvement, we hope the introduction of this tool will improve nurse communication with patients, and they will be satisfied by the end of 10 weeks. Another goal is to achieve 90% compliance in using ISHAPED for bedside shift reporting by week 8. We hope that all nurses in the medical ward will embrace the use of the ISHAPED tool and that there will be less or no resistance to use by the nurses. Another goal is to reduce preventable adverse events linked to incomplete handoffs by 30% over ten weeks. Preventable adverse events, such as miscommunication of patient information and improper patient management, will occur over ten weeks if all the nurses adopt the ISHAPED tool in the wards. Another goal is to ensure 100% of bedside handoffs involve translation services when needed by week 6. Even patients who speak different languages or are of diverse cultures and may need help understanding the information being passed will be given translated messages for them to understand and feel included.
Measurable outcomes
To measure the progress of the implemented tool, we will use measures like patient satisfaction survey scores. This will be done by asking the patients questions and recording their responses to see the percentage of their satisfaction levels as time passes. We will also audit results on staff compliance with ISHAPED use. If some staff are resistant at first, we expect them to adopt the ISHAPED tool as time goes on to ensure 90% compliance by week 8. We will also review the incidents and adverse events happening during the implementation and compare them to the period before implementation, as we expect a decline in incidences and adverse events like patient falls and medication errors resulting from miscommunication, among others. We will also utilize the rates of translation services given to culturally diverse patients in the medical ward, as we expect an increase in the rates.
The rationale for respecting autonomy
Implementation of the ISHAPED tool empowers patients by actively involving them in handoff discussions through the ISHAPED framework. As the nurses aim to improve their communication with the patient, the patients will be empowered as they will get a chance to give their views and ask questions concerning their health progress and how soon they can get well and go back home. Transparency within the nursing staff, by giving the patient all the information available regarding their care, will allow patients to clarify information that may have been recorded wrongly, voice concerns regarding their treatment plans, and make informed decisions about their care, upholding self-determination and autonomy for the patients, which empowers them (Olejarczyk & Young, 2022). It also respects nurses’ professional autonomy by providing a flexible tool to guide comprehensive handoffs while allowing personalization based on patient needs. Also, nurses demonstrate respect for individual and population diversity by addressing sociocultural and linguistic factors through inclusive communication strategies.
Conclusion
This implementation plan details a structured approach to introducing the ISHAPED Tool for bedside shift reporting. It outlines clear objectives, measurable outcomes, and steps to improve patient engagement, satisfaction, and safety while respecting autonomy through enhanced communication and inclusive practices. The proposed solution aligns with evidence-based practices and aims to drive positive changes in nursing workflow, teamwork, and patient-centered care delivery.
References
Olejarczyk, J., & Young, M. (2022, November 28). Patient rights and ethics. National Library of Medicine; Stat Pearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538279/.
Stimpson, M., Carlin, K., & Ridling, D. (2020). Implementation of the m-ISHAPED tool for nursing interdepartmental handoffs. Journal of Nursing Care Quality, Publish Ahead of Print (4). https://doi.org/10.1097/ncq.0000000000000451.
write