View Full Version : Bedside Shift Change Reports


Jaime
02-28-2008, 06:20 PM
Recently, I listened to a teleconference (www.nrcpicker.com) on Bedside Shift Change Reports. The presenter described bedside shift report as “a process where nurses provide shift-to-shift report at the patient’s bedside so the patient can be more involved in his or her care.”

During the bedside shift report, the oncoming nurse and nursing assistant or an unlicensed assistive personnel obtain the information about their patient assignments from the patient record. Along with the off-going nurse for each patient, the oncoming nurse, assistant or assistive personnel conduct the shift report at the patient’s bedside using a standardized pocket guide. The pocket guide was developed using the Institute for Healthcare Improvement-recommended SBAR method to reporting: Situation-Background-Assessment-Recommendation.

The patient is encouraged to participate in the shift report so that all parties are knowledgeable about the patient’s plan of care. Each individualized report takes about 2 to 3 minutes per patient, according to Anderson and Mangino (2006).

After receiving report the nurse identifies each patient’s priorities, the team priorities, and communicates appropriately to the team members. In addition to the bedside report, team “huddles” are encouraged to take place every 3 to 4 hours to exchange any new and updated information between the nurse. At the end of the shift, the assistive personnel reports back to the nurse to communicate any additional information as necessary (e.g. bath not completed).

Who out there have units that use bedside shift reports? How have they been received by patients? by staff? How did the implementation process go?

Mr Ian
02-29-2008, 08:16 AM
They were a great idea - until it was realised that bed side handover on a 4-bedded unit was breaching confidentiality.
Single rooms are great for this type but for communal dormitories - not practicable

geenaRN
02-29-2008, 11:13 PM
How do you address psychosocial aspects of a patient's case? We had a patient once that was suspected to be abused by their children - neglected, not taken care of, etc.

We discussed it quite a bit in our shift reports - where the case workers were with the situation, etc. I can't imagine talking about it right in front of the patient. It obviously concerned the patient, but... still.. would have been awkward.

P/J
03-01-2008, 06:18 AM
I have experience this. A quick general handover is given as a group covering all patients on the ward to all nurses, this was where confidential material was covered. The nurses then met up with the leaving shift and did a bedside update introducing the new nurses, an update of medication usage et al. The patients felt more involved in their care and more looked after, even if they didn't see much of the nurse for the rest of the shift.

MelJayne
03-21-2008, 10:55 AM
This isn't going over so well at my work. Most nurses refuse to do it. But, we work in a crammed ER. Usually at 7pm on my shift I am giving report to the nightshift nurse the rooms are all full as well as all of the hallways. So, giving a bedside report isn't very practical considering all the people around. I agree with the majority and think it's far better for the patient's privacy to stick to report at the nursing station. Now, I don't think it's a big deal to round and introduce the new shift though. That would be a nice compromise.

Polaris
03-21-2008, 01:29 PM
We use it at our critical access hospital and it's going very well. The patient's absolutely love it and it's actually helped us catch quite a few mistakes - such as wrong meds, the doc told the patient something different than us regarding tests or plan of care, etc.

We have had multiple comments from patients about how it's nice to be more involved in their own medical care now.

I don't have any problem reporting stuff in front of my patient. Some things are best left outside the room - but you can always find a way to do that at the station or in a separate room or some such.

I think it's great and would hate to go back to the old way.

angelbev
03-23-2008, 12:33 PM
I don;t think it works for 100% of my pateints but it does work for quite a few. It works for the ones who want to know...when will things be done, what will happen next, who is taking care of me. It allows me to introduce them to the new nurse and update both the pt and the nurse on where we are and what we are waiting for. Everybody is then on the same page. I love that. Then again, there are some pt's where you just can't do that with. It's why we have critical thinking skills.