OBJECTIVES:Fall TIPS (Tailoring Interventions for Patient Safety) is an evidence-based fall prevention program that led to a 25% reduction in falls in hospitalized adults. Because it would be helpful to assess nurses' perceptions of burdens imposed on them by using Fall TIPS or other fall prevention program, we conducted a study to learn benefits and burdens.METHODS:A 3-phase mixed-method study was conducted at 3 hospitals in Massachusetts and 3 in New York: (1) initial qualitative, elicited and categorized nurses' views of time spent implementing Fall TIPS; (2) second qualitative, used nurses' quotes to develop items, research team inputs for refinement and organization, and clinical nurses' evaluation and suggestions to develop the prototype scale; and (3) quantitative, evaluated psychometric properties.RESULTS:Four "time" themes emerged: (1) efficiency, (2) inefficiency, (3) balances out, and (4) valued. A 20-item prototype Fall Prevention Efficiency Scale was developed, administered to 383 clinical nurses, and reduced to 13 items. Individual items demonstrated robust stability with Pearson correlations of 0.349 to 0.550 and paired t tests of 0.155 to 1.636. Four factors explained 74.3% variance and provided empirical support for the scale's conceptual basis. The scale achieved excellent internal consistency values (0.82-0.92) when examined with the test, validation, and paired (both test and retest) samples.CONCLUSIONS:This new scale assess nurses' perceptions of how a fall prevention program affects their efficiency, which impacts the likelihood of use. Learning nurses' beliefs about time wasted when implementing new programs allows hospitals to correct problems that squander time.

BACKGROUND:Moral distress is well-documented among civilian critical care nurses and adversely affects patient outcomes, care delivery, and retention of health care providers. Despite its recognized significance, few studies have addressed moral distress in military critical care nurses.OBJECTIVES:To refine and validate an instrument to assess moral distress in military critical care nurses.METHODS:This study examined moral distress in military critical care nurses (N = 245) using a new instrument, the Measure of Moral Distress for Healthcare Professionals-Military (MMD-HP-M). The psychometric properties of the refined scale were assessed by use of descriptive statistics, tests of reliability and validity, exploratory factor analysis, correlations, and qualitative analysis of open-ended responses.RESULTS:Initial testing showed promising evidence of instrument performance. The Cronbach α (0.94) suggested good internal consistency of the instrument for the overall sample. Scores for the MMD-HP items and the MMD-HP-M items showed a strong, significant correlation (α= 0.78, P < .001). Unique attributes of military nursing that contribute to moral distress included resource access, futile care, and austere conditions. Exploratory factor analysis established a new military-centric factor for question items associated with inadequate training for patient care, providing care in resource-limited settings, and personal exhaustion.CONCLUSIONS:These results will help guide specific, targeted interventions to reduce the negative effects of moral distress on our military health care providers, especially in terms of readiness for the next global pandemic and retention of these invaluable personnel.

BACKGROUND/OBJECTIVES:To assess nurses' opinions of the efficacy of using the FallTIPS (Tailoring Interventions for Patient Safety) fall prevention program. DESIGN:Survey research. SETTING:Seven adult acute-care hospitals in 2 hospital centers located in Boston and NYC. PARTICIPANTS:A total of 298 medical-surgical nurses on 14 randomly selected units. INTERVENTION:Three-step FallTIPS fall prevention program that had been in use as a clinical program for a minimum of 2 years in each hospital. MEASUREMENTS:Fall Prevention Efficiency Scale (FPES), range 13-52; four-factorilly derived subscales: valued, efficiency, balances out and inefficiency; and 13 psychometrically validated individual items. RESULTS:Nurses perceived the FallTIPS fall prevention program to be efficacious. The FPES mean score of 38.55 (SD = 5.05) and median of 39 were well above the lowest possible score of 13 and scale midpoint of 32.5. Most nurses (N = 270, 90.6%) scored above 33. There were no differences in FPES scores between nurses who had only used FallTIPS and nurses who had previously used a different fall prevention program. CONCLUSION:The nurses who used FallTIPS perceived that efficiencies in patient care compensated for the time spent on FallTIPS. Nurses valued the program and findings confirmed the importance of patient and family engagement with staff in the fall prevention process. Regardless of the fall prevention program used, organizations should examine staff perceptions of their fall prevention program because programs that are not perceived as being useful, efficient, and valuable will lead to nonadherence over time and then will not reduce falls and injuries. The recently developed FPES used in this study is a brief tool available for organizations to assess nurses' perceptions of the efficacy of their fall prevention program. Additional FPES research is needed with larger and more diverse samples.

Objectives This study aimed to apply implementation science tenets to guide the deployment and use of in-hospital Clinical Monitoring System Technology (CMST) and to develop a toolkit to promote optimal implementation, adoption, use, and spread of CMST. Methods Six steps were carried out to (1) establish leadership support; (2) identify, educate, and sustain champions; (3) enlist clinical staff users to learn barriers and facilitators; (4) examine initial qualitative data from 11 clinician group interviews; (5) validate barriers/facilitators to CMST use and toolkit content; and (6) propose a toolkit to promote utilization. Clinical Monitoring System Technology output before and after implementation were compared. Results The top 3 barriers to effective CMST use were as follows: (1) inadequate education/training/support, (2) clinical workflow challenges, and (3) lack of communication. Facilitators to CMST implementation and adoption included the following: (1) providing comprehensive and consistent CMST education, (2) presenting evidence early and often, (3) tailoring device and usage expectations to individual environments, and (4) providing regular feedback about progress. Empirical data drove the development of a CMST implementation toolkit covering 6 areas: (1) why, (2) readiness, (3) readiness and implementation, (4) patient/family introduction, (5) champions, (6) care team saves, and (7) troubleshooting. Clinical Monitoring System Technology positively impacted failure to rescue events. Monthly median cardiac alert responses decreased from 30 to 3.64 minutes (87.9%), and respiratory alert responses decreased from 26 to 4.85 minutes (81.4%). Conclusions Using implementation science tenets to concurrently guide deployment and study performance of 2 CMST devices and impact on workload was effective for both learning CMST efficacy at 2 hospital systems and developing a toolkit to promote optimal implementation, adoption, use, and spread.

FigurePatient falls are a common but preventable problem in hospitals. Approximately 30% of inpatient falls result in injury, and injurious falls increase patient morbidity, mortality, and healthcare costs. Patient falls are considered a nursing-sensitive outcome because their incidence has been linked to the quality of nursing care. The reasons why patients fall and fall prevention strategies in hospitals have been a focus of research for over 6 decades and the evidence has been evaluated in systematic reviews and meta-analyses. Despite decades of research and a growing body of evidence for prevention, many hospital-based fall prevention programs are locally developed, use unreliable assessment tools, and don't leverage existing evidence. This article examines the science of fall prevention in hospitals and makes recommendations for implementing and adopting a patient-centered and evidence-based fall prevention program. Literature review Over 90% of falls in hospitals are preventable. Preventable falls include accidental falls and anticipated physiologic falls. Accidental falls are caused by environmental hazards, such as spills, cluttered rooms, improper footwear, and patients unable to get help when needed. These falls can be prevented by applying universal safety precautions for all patients, including wiping up spills, maintaining a clear path to the bathroom, providing safe slippers, and ensuring patient access to the call system. Anticipated physiologic falls are caused by a patient's physical condition, and these falls are prevented by conducting a fall risk assessment, developing a personalized fall prevention plan, and communicating the plan to all key stakeholders to address patient-specific risk factors. Unanticipated physiologic falls are caused by an unknown or emergent medical condition, such as a new-onset seizure, heart attack, or stroke and may not be preventable. However, unanticipated physiologic falls account for fewer than 10% of falls in hospitals; once the cause is known, a plan can be developed so future falls can be prevented. Hospital-based fall prevention research before 2000 focused mainly on determining risk factors for falling and developing screening tools to identify patients prone to falls. As a result, the factors that place patients at risk for falls in the hospital are well established and there are many screening tools to identify fall-prone patients. The most common risk factors for falls in hospitals are a previous history of falling; gait instability; lower limb weakness; urinary incontinence or frequency and/or the need for toileting; agitation, confusion, or impaired judgment; and medications, especially sedative hypnotics. Most fall risk screening tools are comprised of a subset of these factors and were developed using varying levels of rigor. Previous studies have tested and compared the accuracy of the different screening tools, but often the methods used were flawed, contributing to uncertainty as to which fall risk screening tool should be used in hospital settings. It's important to note that risk assessment helps identify fall risk factors but doesn't prevent falls. Evidence from studies published from 2009 to the present suggests that fall prevention is a three-step process comprised of completing a fall risk assessment, developing a tailored or personalized fall prevention plan, and consistently implementing the plan. It's important to choose a fall risk screening scale that's accurate and comprehensive, which can be completed quickly at the bedside involving the patient. This will provide the information that nurses need to develop an initial fall prevention plan on admission that's tailored to patient-specific risk factors. Regular reassessment will aid in refining the fall prevention plan over the course of a patient's hospitalization as potential risks for falling may emerge. Recent evidence also suggests that patient engagement in all three steps of the fall prevention process prevents falls and related injuries. Patients who are engaged in the three-step fall prevention process are knowledgeable about their personal risks of falling and their personal fall prevention plan. Patients are then able to partner with the care team to ensure that their fall prevention plan is consistently carried out correctly. The Fall TIPS tool kit From 2007 to 2009, our team developed the Fall TIPS (Tailoring Interventions for Patient Safety) tool kit to integrate the three-step fall prevention process into practice. For step 1, assessment, we used the Morse Fall Scale (MFS) because this scale addresses all six common predictors of falls when used properly. In addition, the MFS was rigorously developed, is accurate, and can be completed quickly at the bedside with the patient. We conducted focus groups with nurses, other professional and paraprofessional providers, and patients to identify interventions to address each risk factor.Figure 1:: EHR Fall TIPS posterWe developed the Fall TIPS clinical decision support (CDS) in the electronic health record (EHR) to automatically link each MFS risk factor to evidence-based interventions that are both effective and feasible in hospital settings. As the nurse completes the MFS in the EHR, an evidence-based plan is automatically developed to address each risk factor. The plan uses icons to display patient-specific risk factors and the prevention plan at the bedside as a poster that can be easily understood by patients regardless of language or literacy level (see EHR Fall TIPS poster). We also developed a low-tech version of the poster that uses color to link the MFS risk factors to evidence-based interventions (see Fall TIPS laminated paper poster). In a series of clinical trials involving over 40,000 patients, the Fall TIPS tool kit was associated with a significant decrease in falls and fall-related injuries. The Fall TIPS tool kit includes a suite of tools to promote adoption and spread of evidence-based fall prevention best practices (see The Fall TIPS tool kit). It's used in over 200 hospitals in the US and around the world, supported by over a decade of research, and described in more than 20 peer-reviewed manuscripts (www.FallTIPS.org/resources/publications). The Fall TIPS tool kit is freely available online at www.FallTIPS.org.Figure 2:: Fall TIPS laminated paper posterCommon barriers to fall prevention and recommendations An overarching barrier to fall prevention in hospitals is the tendency to develop local fall prevention programs rather than adopt an existing evidence-based program. The following three areas are particularly problematic. Barrier: Use of fall risk assessment tools that aren't scientifically valid and don't inform interventions. The fall risk assessment is the foundation of an evidence-based fall prevention plan. Using risk assessment tools that don't address the six common reasons patients fall in hospitals will lead to gaps in the fall prevention plan. In addition, many existing tools aren't parsimonious; they include risk factors that aren't actionable. These take more time to complete but don't support the prevention plan. Recommendation: Select a fall risk assessment tool that's scientifically valid and comprehensive (includes all the common predictors of falls), doesn't include nonmodifiable risk factors, and can be completed quickly and accurately at the bedside. Some EHR vendors can prepopulate the fall risk assessment scale with EHR data, but the patient's fall risks and fall prevention plan should always be reviewed and refined based on nursing judgment to develop the tailored prevention plan with the patient. Barrier: Labeling patients as low-, medium-, or high-risk leads to generic prevention plans that don't protect the patient. For example, “high risk of falls” signs and other generic indicators of fall risk, such as yellow socks or wristbands, don't tell staff why the patient is at risk and what should be done to prevent a fall. Further, on medical units, most patients are high-risk, so these signs become “noise” in the environment. Patients at risk due to a gait disturbance require different interventions than patients with a cognitive disturbance. Applying a fall prevention bundle to all patients at high risk for falls requires a long list of interventions, many of which aren't applicable to a specific patient and may needlessly tax hospital staffing resources. Also problematic is the practice of using bed alarms for all patients at high risk for falls. Bed alarms are only appropriate for patients who can't reliably call for help. For all other patients, they create needless noise in the environment and can result in alarm fatigue. Recommendation: Don't label patients as low-, medium-, or high-risk because even low-risk patients fall. Instead, adopt practices that identify patient-specific risk factors. If a patient has just one risk factor, we're still obligated to implement a personalized intervention to prevent a fall related to that risk factor. The nurse, care team, and patient, as well as family members if available, should know the patient's risk factors and how to prevent those risk factors from causing a fall. Barrier: Lack of patient and family engagement in the three-step fall prevention process. Recommendation: Engage patients in all three steps of the fall prevention process. Patient engagement in fall risk assessment ensures that patients know their risk factors for falling and believe those risks may cause them to fall unless they follow their fall prevention plan. This is especially important for younger patients and those who aren't at risk for falling at home and don't believe they're at risk for falling while in the hospital. Patient engagement in developing the prevention plan ensures that patients understand what they should or shouldn't do and partner with the nurse and care team to accurately and consistently carry out their plan. Final thoughts Patient falls in hospitals are a persistent problem; however, falls are preventable by engaging patients and their families in the three-step fall prevention process. Evidence-based tools are available to help nurses implement an effective and sustainable fall prevention program. The Fall TIPS tool kit General resources Fall TIPS website (www.FallTIPS.org) Fall TIPS implementation protocol Fall TIPS rollout guide Laminated paper Fall TIPS template (English) Laminated paper Fall TIPS template (Spanish) Leadership resources Fall TIPS leadership talking points Fall TIPS gap analysis form Fall TIPS SWOT analysis form Fall TIPS implementation checklist Fall TIPS patient engagement monthly report template Training resources Fall prevention knowledge test Fall TIPS training slides Fall TIPS super user training slides Fall TIPS instruction sheet for nurses Fall TIPS instruction sheet for nursing assistants Fall TIPS information sheet for patients Fall TIPS quality audit and audit instructions

Introduction Falls with injury are the most prevalent hospital adverse event. The objective of this project was to refine fall risk and prevention icons for a patient-centric bedside toolkit to promote patient and nurse engagement in accurately assessing fall risks and developing a tailored fall prevention plan. Methods Eighty-eight patients and 60 nurses from 2 academic medical centers participated in 4 iterations of testing to refine 6 fall risk and 10 fall prevention icons. During individual interviews, participants rated their satisfaction with the degree to which that icon represented the concept on a 4-point Likert scale, enabling computation of a Content Validity Index (CVI), and provided comments and suggestions for improvement. After reviewing CVI scores and feedback, the research team consulted with the illustrator to revise the icons. Results Content Validity Index scores improved after icon modifications. Icons that depicted multiple concepts required further iterations to be acceptable. Discussion Using icons to depict an accurate and easy-to-interpret fall risk assessment and intervention plan for all care team members including patients and family to follow should lead to improved adherence with that plan and decreased falls. Conclusions All 16 icons were refined and used to form the basis for a bedside fall prevention toolkit.

BACKGROUND:Many hospital systems in the United States report injurious inpatient falls using the National Database of Nursing Quality Indicators categories: None, Minor, Moderate, Major, and Death. The Major category is imprecise, including injuries ranging from a wrist fracture to potentially fatal subdural hematoma. The purpose of this project was to refine the Major injury classification to derive a valid and reliable categorization of the types and severities of Major inpatient fall-related injuries. METHODS:Based on published literature and ranking of injurious fall incident reports (n = 85) from a large Academic Medical Center, we divided the National Database of Nursing Quality Indicators Major category into three subcategories: Major A-injuries that caused temporary functional impairment (eg, wrist fracture), major facial injury without internal injury (eg, nasal bone fracture), or disruption of a surgical wound; Major B-injuries that caused long-term functional impairment or had the potential risk of increased mortality (eg, multiple rib fractures); and Major C-injuries that had a well-established risk of mortality (eg, hip fracture). Based on the literature and expert opinion, our research team reached consensus on an administration manual to promote accurate classification of Major injuries into one of the three subcategories. RESULTS:The team tested and validated each of the categories which resulted in excellent interrater reliability (kappa = .96). Of the Major injuries, the distribution of Major A, B, and C was 40.3%, 16.1%, and 43.6%, respectively. CONCLUSIONS:These subcategories enhance the National Database of Nursing Quality Indicators categorization. Using the administration manual, trained personnel can classify injurious fall severity with excellent reliability.

Falls represent a persistent and costly patient safety issue. Fall TIPS (Tailored Interventions for Patient Safety) is a patient-centered and clinical decision-supported, fall prevention program that has led to fewer falls and related injuries among hospitalized patients. We aimed to identify dominant facilitators and barriers to Fall TIPS adoption. This multisite qualitative study was conducted in 11 hospitals representing three academic health systems, where Fall TIPS had been implemented for at least one year. Interviews with 50 patients and focus groups with 71 staff were analyzed using a conventional content analysis. Fall TIPS resulted in a partnership between staff and patients, in which fall prevention interventions were patient-specific and enabled by clinical decision support. We identified three facilitators to program adoption. First, staff were motivated to address falls as staff recognized fall prevention as a priority and the limitations of previous fall prevention programs. Second, patients welcomed their role in fall prevention. Third, Fall TIPS was integrated into existing staff workflows. We identified three dominant barriers to program adoption. First, poor engagement practices among staff limited patients' active participation in fall prevention. Second, the use of residual fall prevention approaches perpetuated a 'one-size fits all' approach to fall prevention. Third, patient willfulness i.e., patients' conscious deviation from fall plans challenged program fidelity. Fall TIPS changed the paradigm of fall prevention by placing an unprecedented focus on patient engagement. Actions that improve staffs' engagement of patients and patient's partnership in fall prevention will assist Fall TIPS adoption.

This article describes how nurse leaders in one organization led an interdisciplinary team to develop an evidence-based fall prevention program, Fall TIPS (Tailoring Interventions for Patient Safety), that is now used in hospitals across the country. A common barrier to fall prevention is developing new programs rather than adopting and using evidence-based approaches. The Fall TIPS program overcomes this barrier by providing a comprehensive suite of tools that nurse leaders can use to promote adoption and spread of evidence-based fall prevention best practices in their organization. This article is a call to action to inform nurse leaders about the decade of evidence behind the Fall TIPS program, how they can join the Fall TIPS Collaborative, and how they can access Fall TIPS resources to support implementation at their hospitals.

1 Poster Title Primary Author Organization 1. Developing an Intensive Care Unit Acuity Tool Laura Ritter-Cox Beth Israel Deaconess Med Center 2. Optimizing the EHR though Experience and the Agile Process Thomas Baccari Boston Children’s Hospital 3. Don’t Let PICU UP! Get You Down Alicia Gustafson Boston Children’s Hospital 4. Establishing a Process for Reducing Nursing Documentation Burden Through Discrete Data Analysis Cassandra Hunter Boston Children’s Hospital

Falls are a serious, persistent problem in hospitals. Ensuring that all hospital staff have adequate knowledge of how to prevent falls is the first step in prevention. We identified validated fall prevention knowledge tests (FPKTs) and planned to conduct a systematic literature review. When the review identified a lack of FPKTs, we developed and evaluated a FPKT, confirmed its conceptual framework, identified the content domain, drafted test items, devised the format, selected items for empirical examination, and conducted a psychometric evaluation. We randomly divided a 209‐subject data set into test and validation samples to make item reduction decisions and examine reliability and validity. The typical respondent was a white, 42‐year old female nurse with a bachelor's degree and 7 years' experience. Subjects were confident in their ability to prevent falls, rating themselves an 8 on a self‐efficacy scale of 1 (not at all) to 10 (very). The 11‐item FPKT scale (range 0–11) attained a tetrachoric coefficient of 0.73, confirming initial reliability. FPKT mean scores obtained before and after fall prevention education improved from 5.1 ± 1.8 to 6.6 ± 1.7. Statistically significant differences (paired t‐test = 12.4, p < .001) confirmed validity. A robust way to assess nurses' knowledge of fall prevention is needed to inform effective educational programs. Addressing gaps in validated FPKTs provides an opportunity to inform and evaluate effective fall prevention programs. J Am Geriatr Soc 67:133–138, 2019.

BACKGROUNDMaintaining continuity of care (CoC) in the inpatient setting is dependent on aligning goals and tasks with the plan of care (POC) during multidisciplinary rounds (MDRs). A number of locally developed rounding tools exist, yet there is a lack of standard content and functional specifications for electronic tools to support MDRs within and across settings.OBJECTIVETo identify content and functional requirements for an MDR tool to support CoC.MATERIALS AND METHODSWe collected discrete clinical data elements (CDEs) discussed during rounds for 128 acute and critical care patients. To capture CDEs, we developed and validated an iPad-based observational tool based on informatics CoC standards. We observed 19 days of rounds and conducted eight group and individual interviews. Descriptive and bivariate statistics and network visualization were conducted to understand associations between CDEs discussed during rounds with a particular focus on the POC. Qualitative data were thematically analyzed. All analyses were triangulated.RESULTSWe identified the need for universal and configurable MDR tool views across settings and users and the provision of messaging capability. Eleven empirically derived universal CDEs were identified, including four POC CDEs: problems, plan, goals, and short-term concerns. Configurable POC CDEs were: rationale, tasks/'to dos', pending results and procedures, discharge planning, patient preferences, need for urgent review, prognosis, and advice/guidance.DISCUSSIONSome requirements differed between settings; yet, there was overlap between POC CDEs.CONCLUSIONSWe recommend an initial list of 11 universal CDEs for continuity in MDRs across settings and 27 CDEs that can be configured to meet setting-specific needs.

OBJECTIVE As healthcare systems and providers move toward meaningful use of electronic health records, longitudinal care plans (LCPs) may provide a means to improve communication and coordination as patients transition across settings. The objective of this study was to determine the current state of communication of LCPs across settings and levels of care. MATERIALS AND METHODS We conducted surveys and interviews with professionals from emergency departments, acute care hospitals, skilled nursing facilities, and home health agency settings in six regions in the USA. We coded the transcripts according to the Agency for Healthcare Research and Quality (AHRQ) 'Broad Approaches' to care coordination to understand the degree to which current practice meets the definition of an LCP. RESULTS Participants (n=22) from all settings reported that LCPs do not exist in their current state. We found LCPs in practice, and none of these were shared or reconciled across settings. Moreover, we found wide variation in the types and formats of care plan information that was communicated as patients transitioned. The most common formats, even when care plan information was communicated within the same healthcare system, were paper and fax. DISCUSSION These findings have implications for data reuse, interoperability, and achieving widespread adoption of LCPs. CONCLUSIONS The use of LCPs to support care transitions is suboptimal. Strategies are needed to transform the LCP from vision to reality.

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In this article, the authors describe the development and pilot testing of an electronic bedside communication center (eBCC) prototype to improve access to health information for hospitalized adults and their family caregivers. Focus groups were used to identify improvements for the initial eBCC prototype developed by the research team. Face-to-face bedside interviews and questions were presented while patients used the eBCC for usability testing to drive further development. Qualitative methods within an iterative, participatory approach supported the development of an eBCC prototype that was considered both easy to use and helpful for accessing tailored patient information during an inpatient hospitalization to receive acute care.

Background: Nursing documentation is the record of care that is planned and given to patients, yet it is often missing or incomplete. A study of translating results from nurses' assessments of fall risk into tailored interventions using health information technology was used to examine nursing documentation of risk assessment, plans to manage those risks, and interventions to prevent falls.Objective: The aim of this study was to evaluate the effectiveness of an electronic fall prevention toolkit for promoting documentation of fall risk status and planned and completed fall prevention interventions.Methods: Nursing documentation related to fall risk and prevention was reviewed in 30% of randomly selected medical records for patients on the eight study units (four intervention units; 5,267 patients) and four usual care units (5,116 patients) during three separate study visits.Results: Patients on the intervention units were more likely to have fall risk documented (89% vs. 64%, p < .0001). There were significantly more comprehensive plans of care for the patients on the interventions documented, although no differences were found related to documentation of completed interventions compared with usual care unit patient records.Discussion: The documentation of fall risk status and planned interventions tailored to patient-specific areas of risk was significantly better on the intervention units that used the fall prevention toolkit as compared with usual care units. Improved documentation quality did not extend to the documentation of completed interventions.

Purpose: Patients and health care providers often lack real time access to information at the bedside required to provide safe patient-centered care. Both groups identified pertinent information needed at the patient's bedside. The purpose of our research was to identify the essential data elements that will be used to define requirements for a useful bedside communication tool in the acute care hospital setting.Methods: Descriptive research methods were used to identify bedside information requirements through group and individual interviews. Data from patients and health care providers were analyzed to identify common themes, compiled into a survey, and validated by both groups.Results: Thirty-seven information requirements were identified and classified under five themes: (1) plan of care, (2) patient education, (3) communication of safety alerts, (4) diet, and (5) medications. A survey completed by 30 patients and 30 health care providers confirmed 36 specific bedside information requirements (mean >= 5 on an 11-point scale). Patients and health providers each identified 24 specific information requirements that were similar in importance. When compared with nurses, significant differences were noted in the degree to which patients identified knowing the "daily routine schedule," e.g. when their doctor typically sees patients as a key requirement for the electronic bedside communication tool, t = 3.52, p = .001.Conclusion: Patients and health care providers identified information requirements at the bedside to promote self-care management of healthcare needs and an understanding of the hospital environment. Accurate, easily accessed information at the bedside is needed for providing safe patient-centered care. (C) 2011 Elsevier Ireland Ltd. All rights reserved.