Bedside nursing report is a shift-handoff method in which information is transferred in the patient’s presence rather than only at a nurses’ station or through a recorded report. The practice is intended to improve continuity, patient involvement, accountability, and safety by allowing the outgoing nurse, incoming nurse, and patient to review relevant information together. Its effects, however, depend on how consistently it is implemented, what information is discussed at the bedside, how privacy is protected, and whether nurses are trained to use the process efficiently (Sherman & Sand-Jecklin, 2013).
The study by Sand-Jecklin and Sherman (2014), A Quantitative Assessment of Patient and Nurse Outcomes of Bedside Nursing Report Implementation, remains an important early evaluation because it examined multiple outcomes before and after a practice change rather than relying only on staff impressions. The original version of this paper incorrectly described the sample as ten nurses and ten patients. The published study was substantially larger: seven medical-surgical units at a large university hospital implemented a blended shift-report model, and data were collected from patients, family members, and nurses at baseline and after implementation (Sand-Jecklin & Sherman, 2014).
Study Design
The investigators used a quasi-experimental pre- and postimplementation design. This design is appropriate for a hospital-wide practice change because nurses and patients cannot easily be randomized to receive one handoff method or another while routine operations continue. The trade-off is that other changes occurring during the study period may influence outcomes, so the design is weaker for causal inference than a randomized controlled trial.
The intervention was a blended nursing report. Rather than replacing all existing communication with one bedside conversation, the model combined recorded report with bedside exchange. This distinction matters because the study did not test a pure bedside-only handoff. Its findings apply most directly to the blended system used in those medical-surgical units.
The hospital collected data at three points: baseline, approximately three months after implementation, and approximately thirteen months after implementation. The Patient Views on Nursing Care survey was completed by 233 patients at baseline, 157 patients at the three-month postimplementation point, and 154 patients at thirteen months. Family members completed 70 surveys at baseline, 72 at three months, and 53 at thirteen months. Family responses were later excluded from some statistical comparisons because family members might not have been present during the shift report itself (Sand-Jecklin & Sherman, 2014).
Nurse survey participation also varied over time. The baseline nurse perception survey was completed by 148 nurses, compared with 98 at three months and 54 at thirteen months. Nurses came from all seven participating medical-surgical units and represented different work shifts. This declining response rate is important when interpreting later nurse-perception results because the individuals responding at each point were not necessarily the same.
The main outcomes were patient satisfaction, nurse perceptions of the handoff process, patient falls, nursing overtime, and medication errors. This multi-outcome approach was a strength because bedside report was expected to influence both experience and safety. At the same time, not every outcome could be interpreted equally well because some measures were survey-based while others came from operational hospital data.
Patient Outcomes
Patient satisfaction was already high at baseline, which created a ceiling effect. Most survey-item means were above four on a five-point scale even before implementation. Despite this high starting point, four items specifically related to bedside report improved significantly or showed statistically significant differences across measurement periods.
Patients were more positive about knowing who their nurse was and being encouraged to participate in care by the final postimplementation period. Responses also improved for being included in shift-report discussion and for nurses passing important information from one shift to another. These findings support the idea that bedside report can make the handoff process more visible to patients rather than leaving them outside a conversation about their own care.
Narrative comments were mostly positive, but they also revealed an implementation problem. At both postimplementation data collections, a noticeable proportion of patients reported that bedside report was not used consistently or amounted only to introducing the oncoming nurse. This is important because it suggests that the intervention’s effectiveness depended partly on fidelity. A bedside-handoff policy cannot improve communication if staff do not actually perform the intended components.
Privacy concerns were less prominent in this study than might be expected, but that does not eliminate the issue. More recent evidence continues to identify confidentiality as a major barrier. A 2024 qualitative meta-synthesis of thirteen studies involving 383 nurses and 89 patients found that both groups generally valued the partnership and individualized care associated with bedside handover, while also identifying privacy and confidentiality as recurring concerns (Anshasi & Almayasi, 2024).
Patient preference should therefore shape how sensitive information is handled. Diagnoses, family conflict, behavioral health information, substance use, sexual health, safeguarding concerns, or information unknown to visitors may need to be discussed away from the bedside. Bedside handover should increase patient participation without assuming that every clinical detail belongs in a shared room or in front of family members.
Nurse Outcomes
Nurse perceptions changed in a more complicated pattern. After bedside report was introduced, nurses reported stronger perceptions of accountability and patient involvement in care. These findings fit the intervention’s purpose because the incoming nurse directly observes the patient and the outgoing nurse becomes accountable for presenting the patient’s condition in real time.
Some efficiency measures initially worsened. At the three-month point, nurses were less positive about whether the report system was efficient, effective, or relatively stress-free. By thirteen months, however, these perceptions had rebounded toward baseline. The pattern suggests an implementation curve: a new handoff process may initially feel slower or more difficult while staff are learning it, then become more acceptable as routines improve.
Importantly, nurses’ perception that bedside report took longer was not matched by a significant increase in overtime. This is a valuable distinction between perceived workload and measured overtime. A practice may feel cumbersome while staff are adapting even when total paid time does not materially increase.
Implementation support also changed after the first postimplementation period. The research team introduced tip sheets, posters, manager and preceptor observation, one-to-one feedback, and documentation changes designed to improve consistency. These additional interventions make the study more realistic because organizations often refine a new process after seeing early problems. They also complicate causal interpretation because the thirteen-month outcome reflects bedside report plus these implementation supports rather than the original rollout alone.
Recent evidence supports this emphasis on implementation. The 2024 meta-synthesis found that nurses identified both facilitators and barriers to bedside handover, including communication quality, patient involvement, privacy, time concerns, and consistency. A separate 2024 systematic review of educational interventions for nursing handovers concluded that training can improve handover knowledge, skills, and performance, reinforcing the idea that a handoff method should be treated as a learned clinical process rather than a simple policy instruction (Choi et al., 2024).
Safety Findings
Patient falls at shift change decreased substantially after bedside report implementation. This is clinically plausible because both nurses are briefly present with the patient, creating an opportunity to verify mobility status, bed position, call-bell access, alarms, lines, and other immediate safety concerns. However, the quasi-experimental design means that the decline cannot be attributed with complete certainty to bedside report alone.
The medication-error outcome requires even greater caution. The original paper summarized the study as showing fewer medication errors, but Sand-Jecklin and Sherman explicitly reported that an intervening variable during the study period invalidated the pre- versus postimplementation medication-error comparison. Medication-error reduction should therefore not be presented as a confirmed finding from this study.
This correction is important because research appraisal should distinguish what investigators intended to measure from what their data actually support. The study provides stronger evidence for changes in patient and nurse perceptions, the lack of significant overtime increase, and the observed reduction in falls at shift change than for medication errors.
Handoff safety also depends on the content of communication. Bedside report can support visual verification of intravenous lines, wounds, drains, oxygen, patient identity, fall precautions, and other immediate concerns. Yet information can still be omitted if the report lacks structure. Many organizations use standardized formats such as SBAR or locally designed checklists to make critical elements less dependent on memory.
Study Appraisal
The study has several strengths. It examined a real practice change across seven medical-surgical units, used repeated measurement over thirteen months, included both patient and nurse perspectives, and incorporated operational safety outcomes. The long follow-up is especially useful because nurse attitudes changed between the early and later postimplementation periods.
The design also has limitations. There was no randomized control group, so secular trends and other hospital changes may have influenced the results. Survey participation declined substantially among nurses, creating possible response bias. Bedside-report adherence was inconsistent, meaning not every participant received the same intervention. Baseline patient satisfaction was already high, limiting the amount of measurable improvement possible.
The study also took place in one university hospital. Medical-surgical units may differ from critical care, pediatrics, maternity, psychiatric care, emergency departments, or long-term care, where privacy, patient capacity, family participation, acuity, and workflow create different handoff requirements.
Another limitation is that some outcomes depended on perception. Patient and nurse satisfaction are important but do not necessarily prove that clinical information was more accurate. Future studies can combine satisfaction measures with direct observation, handoff-content audits, adverse events, omissions, interruptions, and patient understanding.
Practice Implications
The evidence supports bedside report as a potentially useful handoff strategy rather than a universally superior ritual. Successful implementation requires staff involvement, a defined structure, clear privacy rules, leadership feedback, and adaptation to the clinical setting. Patients should be invited to participate without being forced into a conversation they would prefer to keep private.
Organizations should also monitor fidelity. A policy that says “conduct report at the bedside” can gradually become a quick introduction while the meaningful exchange still occurs elsewhere. Audits and patient feedback can determine whether the intended elements are actually occurring.
Privacy procedures should be explicit. Nurses need guidance on what can be discussed openly, when visitors should be asked to leave, how to manage shared rooms, and when sensitive information should be transferred separately. The patient’s preferences should be considered whenever possible.
Outcome monitoring should extend beyond satisfaction. Falls, handoff-related errors, overtime, interruptions, escalation events, patient understanding, nurse workload, and privacy concerns can all help determine whether the process is functioning as intended. Units should expect an adaptation period and provide coaching rather than treating early inefficiency as proof that bedside report has failed.
Sand-Jecklin and Sherman’s study remains useful because it demonstrates both the potential and the complexity of bedside nursing report. The intervention improved several patient and nurse perceptions, did not significantly increase overtime, and was associated with a substantial reduction in falls at shift change. It did not provide valid evidence of a medication-error reduction, and inconsistent implementation remained a concern. Later research reinforces the same conclusion: bedside handover can support partnership, safety, and individualized care, but its benefits depend on communication quality, privacy, training, and consistent implementation.
References
Anshasi, H., & Almayasi, Z. A. (2024). Perceptions of patients and nurses about bedside nursing handover: A qualitative systematic review and meta-synthesis. Nursing Research and Practice, 2024, 3208747.
Choi, J. Y., Byun, M., & Kim, E. J. (2024). Educational interventions for improving nursing shift handovers: A systematic review. Nurse Education in Practice, 74, 103846.
Sand-Jecklin, K., & Sherman, J. (2014). A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation. Journal of Clinical Nursing, 23(19–20), 2854–2863. https://doi.org/10.1111/jocn.12575
Sherman, J., Sand-Jecklin, K., & Johnson, J. (2013). Investigating bedside report: A synthesis of the literature. MEDSURG Nursing, 22(5), 308–312.
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