Nurse Champions as Change Agents for Bedside Handover Compliance: A Case Study
DOI:
https://doi.org/10.33755/jkk.v12i3.1036Keywords:
Bedside Handover, Change Agent, Kurt Lewin Change Model, Nurse Champion, Nurse ComplianceAbstract
Background: Bedside handover is an essential element of effective nurse-to-nurse communication to ensure patient safety. A preliminary assessment at Hospital X, supported by previous literature, identified limited knowledge, heavy workloads, and the absence of evaluation and appreciation systems as key barriers to optimal bedside handover implementation.
Objective: This study aimed to identify the implementation of the Nurse Champion role in improving nurses' compliance with bedside handover at Hospital X using Kurt Lewin's Three-Step Change Model (Unfreeze–Move–Refreeze).
Methods: This case study was conducted in the medical-surgical inpatient unit of Hospital X from 8 September to 1 October 2025 using Kurt Lewin's Three-Step Change Model. Baseline observations were conducted from 8–14 September 2025, followed by semi-structured interviews with four Primary Nurses on 19 September 2025. The intervention included bedside handover socialization (24 and 26 September), appointment of a Nurse Champion (24 September), checklist-based monitoring integrated into the shift workflow (24–30 September), implementation of reminder stickers, and a reward program (1 October). Nurses' compliance with bedside handover was evaluated at the end of the intervention.
Results: Following the intervention, compliance across the 9P bedside handover components varied. The highest compliance was observed for Plan and Partnership (98.76%) and Patient Comfort (92.28%), whereas Personal Hygiene and Environment showed the lowest compliance (26.44%), indicating that these aspects were less consistently addressed during bedside handover.
Conclusion: Therefore, the implementation of Nurse Champions based on Kurt Lewin’s Change Model was associated to improved compliance with 9P bedside handover and fostered sustainable behavioural change through enhanced motivation, appreciation, and a collaborative work culture in nursing practice
References
1. Rifai A, Afandi AT, Hasanah A. Bedside Nursing Handover: Patient’s Perspective. NurseLine J. 2020;4(2):120–30. doi:https://doi.org/10.19184/nlj.v4i2.15422
2. Malfait S, Eeckloo K, Van Biesen W, Deryckere M, Lust E, Van Hecke A. Compliance with a structured bedside handover protocol: An observational, multicentred study. Int J Nurs Stud. 2018 Aug;84:12–8. doi:10.1016/j.ijnurstu.2018.04.011
3. Bruton J, Norton C, Smyth N, Ward H, Day S. Nurse handover: patient and staff experiences. Br J Nurs. 2016 Apr 14;25(7):386–93. doi:10.12968/bjon.2016.25.7.386
4. Daicampi C, Veronese M, Cesaro E. Impact of Bedside Handover on Patient Perceptions and Hospital Organizational Outcomes: A Systematic Review. Krishnamoorthy B, editor. J Nurs Manag. 2025 Jan;2025(1):3803491. doi:10.1155/jonm/3803491
5. Ghosh M, O’Connell B, Nguyen HT, Coventry L, Towell-Barnard A, Gallagher O, et al. Patient and Family Involvement in Nursing Bedside Handover: A Qualitative Descriptive Study of Consumer Perceptions of Nursing Care. Nurs Rep. 2025 Feb 3;15(2):51. doi:10.3390/nursrep15020051
6. Karmila R, Maula H. FAKTOR YANG MEMPENGARUHI KEPUASAN PASIEN TERHADAP KOMUNIKASI SAAT BEDSIDE HANDOVER. J Keperawatan AKIMBA JUKA. 2024;8(1). doi:doi.org/10.63404/juka.v8i1.146
7. Maurissa A, Yuswardi. PELAKSANAAN BEDSIDE HANDOVER OLEH PERAWAT DI RUANG RAWAT RUMAH SAKIT BANDA ACEH. Idea Nurs Journa. 2019;10(1):63–8.
8. Afshar PJ, Karbasi BJ, Moghadam MN. The relationship between patient safety culture with patient satisfaction and hospital performance in Shafa Hospital of Kerman in 2020. J Educ Health Promot. 2021 Dec;10(1). doi:10.4103/jehp.jehp_1650_20
9. Damayanti M, Afriani, T, Erwin, Suminarti T. SUPERVISI DAN SOSIALISASI SEBAGAI UPAYA OPTIMALISASI PELAKSANAAN SERAH TERIMA PASIEN ANTAR SHIFT DENGAN METODE SBAR: PILOT STUDY. Dunia Keperawatan J Keperawatan Dan Kesehat. 2021 Jul 29;9(2):257. doi:10.20527/dk.v9i2.7769
10. Herikurniawan. PATIENT SAFETY AND INTERNATIONAL PATIENT SAFETY GOALS (IPSGS) IN THE FIELD OF RESPIROLOGY. Indones J Chest. 2020;7(1). doi:https://www.indonesiajournalchest.com/index.php/IJC/issue/view/160
11. Ismuntania, Kartika, Mualim A, Nurlela, Idawati. Essensial Bedside Handover Dalam Menunjang Keselamatan Pasien Di Rumah Sakit Umum Ibnu Sina Kabupaten Pidie. Lebah. 2023 Sep 11;17(1):22–7. doi:10.35335/lebah.v17i1.165
12. Jaber S, Fawaz M, Rayan A, Alhroub N, Suliman M, ALBashtawy M, et al. Relationship between Nurses’ Attitudes and Satisfaction with Bedside Shift Reports and Patient Safety Culture. Nurse Media J Nurs. 2022 Dec 28;12(3):414–22. doi:10.14710/nmjn.v12i3.47811
13. Korwa DL, Wardani R, Prasetyo J. PENERAPAN BEDSIDE HANDOVER DAN WALKING ROUND DENGAN PENDEKATAN SBAR TERHADAP KETEPATAN ASUHAN KEPERAWATAN DAN MUTU KESELAMATAN PASIEN DI UNIT RAWAT INAP RUMAH SAKIT UMUM DAERAH MERAUKE. SENTRI J Ris Ilm. 2024;3(11):4927–33. doi:ejournal.nusantaraglobal.or.id/index.php/sentri
14. Goedken CC, Livorsi DJ, Sauder M, Vander Weg MW, Chasco EE, Chang NC, et al. “The role as a champion is to not only monitor but to speak out and to educate”: the contradictory roles of hand hygiene champions. Implement Sci. 2019 Dec;14(1):110. doi:10.1186/s13012-019-0943-x
15. Santos WJ, Graham ID, Lalonde M, Demery Varin M, Squires JE. The effectiveness of champions in implementing innovations in health care: a systematic review. Implement Sci Commun. 2022 Jul 22;3(1):80. doi:10.1186/s43058-022-00315-0
16. Universidad Industrial de Santander, Bucaramanga, Colombia, Quiroga-Pico LN, Aceros-Lora AM, Fundación Cardiovascular de Colombia, Floridablanca, Colombia, Díaz-Castañeda TM, Fundación Cardiovascular de Colombia, Floridablanca, Colombia, et al. Nurse Champions: Transforming Evidence-Based Practice. Rev Cuid. 2024. doi:10.15649/cuidarte.3745
17. Boshart B, Knowlton M, Whichello R. Reimplementing bedside shift report at a community hospital. Nurs Manag (Harrow). 2016 Dec;47(12):52–5. doi:10.1097/01.NUMA.0000508265.42099.cc
18. Ting G. Kurt Lewin’s Change Model: Trends and Issues in Human Resources Management & Development. J Innov Knowl. 2021;3. doi:10.13140/RG.2.2.24442.21449
19. Magdalena H, Handiyani H, Pujasari H, Hariyati RTS, Sari EP. Pengembangan pedoman handover di ruang rawat inap rumah sakit Universitas Indonesia. Holistik J Kesehat. 2025 May 3;19(2):403–9. doi:10.33024/hjk.v19i2.848
20. Kaasalainen S, Ploeg J, Donald F, Coker E, Brazil K, Martin-Misener R, et al. Positioning Clinical Nurse Specialists and Nurse Practitioners as Change Champions to Implement a Pain Protocol in Long-Term Care. Pain Manag Nurs. 2015 Apr;16(2):78–88. doi:10.1016/j.pmn.2014.04.002
21. Clark A, Wolgast KA, Mazur N, Mekis A. Leading Change in Nurse Bedside Shift Report. Nurs Clin North Am. 2020 Mar;55(1):21–8. doi:10.1016/j.cnur.2019.10.002
22. Purssell E, Drey N, Chudleigh J, Creedon S, Gould DJ. The Hawthorne effect on adherence to hand hygiene in patient care. J Hosp Infect. 2020 Oct;106(2):311–7. doi:10.1016/j.jhin.2020.07.028
23. Nguyen VN, Miller C, Sunderland J, McGuiness W. Understanding the Hawthorne effect in wound research—A scoping review. Int Wound J. 2018 Dec;15(6):1010–24. doi:10.1111/iwj.12968
24. Sultan, Yuly Peristiowati. The Influence of Reward, Work Motivation on Nurse Performance in Inpatient Rooms. Str J Ilm Kesehat. 2023 Nov 30;12(2):177–85. doi:10.30994/sjik.v12i2.1009
25. Novita W, Wahidi KR, Jus’at I. Working Motivation and Reward System Influenced Nurses’ Perception of Performance Mediated by Organizational Commitment. Int J Nurs Health Serv IJNHS. 2022;5(4). doi:10.35654/ijnhs.v5i4.63
