title: Transforming Care at the Bedside (TCAB): enhancing direct care and value-added care.
abstract: OBJECTIVE
  The purpose of this study was to examine the effectiveness of a Transforming Care at the Bedside initiative from a unit perspective.
  
  
  BACKGROUND
  Improving patient outcomes and nurses' work environments are the goals of Transforming Care at the Bedside. Transforming Care at the Bedside creates programs of change originating at the point of care and directly promoting engagement of nurses to transform work processes and quality of care on medical-surgical units.
  
  
  METHODS
  This descriptive comparative study draws on multiple data sources from two nursing units: a Transforming Care at the Bedside unit where staff tested, adopted and implemented improvement ideas, and a control unit where staff continued traditional practices. Change theory provided the framework for the study.
  
  
  RESULTS
  Direct care and value-added care increased on Transforming Care at the Bedside unit compared with the control unit. Transforming Care at the Bedside unit decreased in incidental overtime. Nurses reported that the process challenged old ways of thinking and increased nursing innovations. Hourly rounding, bedside reporting and the use of pain boards were seen as positive innovations.
  
  
  CONCLUSIONS
  Evidence supported the value-added dimension of the Transforming Care at the Bedside process at the unit level.
  
  
  CONCLUSIONS
  Nurses recognized the significance of their input into processes of change. Transformational leadership and frontline projects provide a vehicle for innovation through application of human capital.
authors: USA College of Nursing, Mobile, AL 36688-0002, USA. vdearmon@usouthal.edu
authors: Valorie
authors: V
authors: Dearmon
authors: Linda
authors: L
authors: Roussel
authors: Ellen B
authors: EB
authors: Buckner
authors: Madhuri
authors: M
authors: Mulekar
authors: Becky
authors: B
authors: Pomrenke
authors: Sheri
authors: S
authors: Salas
authors: Aimee
authors: A
authors: Mosley
authors: Stephanie
authors: S
authors: Brown
authors: Ann
authors: A
authors: Brown
mesh_terms: D040421:Cell Phone / Q000191:economics; D015400:Clinical Nursing Research; D017046:Cost Savings; D006801:Humans; D017146:Models, Organizational; D009732:Nursing Care / Q000458:organization & administration* / Q000592:standards; D015279:Organizational Culture; D010043:Outcome and Process Assessment, Health Care; D010147:Pain Measurement; D005791:Patient Care / Q000191:economics / Q000379:methods / Q000592:standards*; D017060:Patient Satisfaction