Advantages Of Bedside Reporting

In every profession there are changes that propel how tasks are done; nursing is no stranger to this. One of the biggest changes that have come into nursing’s daily events is how report hand-offs are being done. Gone are the days of taped report that each off going nurse must tape about each patient and the oncoming nurse must listen to. Nurses are now being encouraged to move their report to the bedside, in front of the patient (Trossman, 2007). It is very important to know how this can affect the patient and even the nurse’s schedule. With every change, there are positives and negatives that can finalize the decision to keep or forego

Nurses prefer working in an environment where they feel appreciated in both their actions and decisions. In the event that they are ignored, they tend to experience subjection and they are likely to resist. At one time, our healthcare facility sought to implement the bedside shift reporting (BSR). This process would have required that nurses be informed and trained on the use of the documentation. However, this did not happen, on the start of the month each nurse received a formal letter form the chief nursing officer informing us that we would be reporting to a newly hired nurse educator who would evaluate our performance in implementing the BSR. This was met with anger and most of the nurses seemed to have decided that they would not accomplish

The emphasis on improving bedside reporting is crucial today, when it is more than ever necessary for the health care institutions to operate at higher efficiency levels. In the absence of bedside reporting, nurses are frustrated as they spend 40 minutes reviewing patient data; patients also get frustrated (Ostermeier and Clair, 2008). Bedside reporting has the ability to improve nurse and patient satisfaction and support the overall quality of the medical act.

The hand over process of communication between nurses to nurses is done with the intention of transferring essential information for safe, and patient centered care. Traditionally, this shift report has been done away from the patient’s bedside, at the nurse’s station, or other place like staff’s room. In addition, the shift report used to be delivered through audio recording of the patient’s information. These reporting mechanisms did not include face-to-face reporting of the patient information, nor involvement of patient. Therefore, information regarding the patient’s care was not shared with the patient, leaving them out of his/her own care plan. Recent studies and development of Patient Centered Care Philosophy have challenged this belief of giving a report away from the patient. Tan (2015) said, “Shift report must not only be restricted in nurse to nurse communication, but it must involve patients as the recipients of care” (p. 1). Incorporating the patient into the end of shift report is essential for providing patient centered care and patient satisfaction. Nurses at the St Jude Medical center in the acute in-patient rehabilitation unit are not exceptional. Most of the end of the shift report between nurses are still done away from the patient. Aim of this paper is to make a change in the work place, which is the process of giving end of shift report at the bedside incorporating patient and families in the acute in-patient rehabilitation unit at St Jude Medical

Currently at the hospital I work in does not require bedside reporting in high acuity areas such as the emergency department. The current practice is to first identify the nurse for the assignment you are relieving, which often times can be multiple nurses. This often leads to very brief exchange of patient information so that each nurse can get to the next person and start care or leave for the day. Due to the nature of an emergency department, patient population is extremely diverse yielding reports regarding patients of different ages, diagnoses, and acuity. Couple the diverse nature of clients with the brief interactions between nurses to communicate what is presumed important regarding patient care while attempting to maintain privacy all with the distractions of a busy nursing station and it is likely some piece of information may be missed or overlooked.

Traditionally, nursing shift-to-shift reports were organized methods of communication between only the oncoming and leaving nurse, designated to a location such as the central nursing station or nook of a hallway. Shift reports can be considered the foundation of how the day is going to plan out because it introduces the patient, diagnoses, complications, medications, consults, upcoming test and the entire plan of care. These reports are full of complicated and vital information and while set in certain locations that are vulnerable to interruptions, such as the nursing station, medical errors and miscommunication are more likely to be made. The Joint Commission’s 2009 and 2010 National Patient Safety Goals (Joint Commission, 2015) included two patient safety standards, first to encourage patients to be involved in their health care plan and second, to implement a standardized communication process for handoff reports between providers. Soon after in 2013, The Agency for Healthcare Research and Quality under the United States Department of Health and Human Services introduced a set of strategies to improve patient engagement along with safety and quality in patient care. Within these strategies the new method of nurse bedside shift report was developed, which suggests nurses to conduct shift-to-shift reports at bedside in the room of each patient, rather than out of the room. The benefits of this new method were

Bedside reporting involves giving information or a report to the oncoming nurse in the presence of a patient. This method gives the patient an opportunity to ask questions and get clarification regarding his or her care. Bedside reporting increases patient satisfaction, quality of healthcare and nurse-to-nurse responsibility. Hospitals need to design a better handoff process that can easily reduce patient risks and increase patients’ involvement in their care. Emergency rooms shift reports usually take place at the nursing station of every patient care area. The departing nurse gives information verbally to the oncoming shift. Therefore,

Meanwhile, elsewhere in Habersham County, Tom was feeling slightly nervous as he exited the staff lounge and entered the hustle and bustle of County Hospital’s ER to begin his first shift as an RN. The first few hours of his shift passed slowly as Tom mostly checked vital signs and listened to patients complain about various aches, pains, coughs, and sniffles. He realized that the attending physician, Dr. Greene, who was rather “old school” in general about how he interacted with nursing staff, wanted to start him out slowly. Tom knew, though, that the paramedics could bring in a trauma patient at any time.

Communication between nurses at report change is essential. The next nurse needs the most important information whether it is as Situation-Background-Assessment-Recommendation (SBAR) that the Institute for Healthcare Improvement (n.d.) outlines to use or in another form. The case of Rio Grande Regional Hospital Inc v. Villarreal discusses how one nurse breached the standard of care because the record reflects that from the time Hermes was given the double-edged razor until he died neither Nurse Bergado nor any other nurse checked to see how Hermes was doing in the bathroom” (Find Law for Legal Professionals, 2016). At Baylor Scott & White at All Saints, we have a policy that each patient is rounded on physically every hour.

Nursing theorist, Imogene King’s theory of goal attainment can be applied to bedside reporting. One major concept of King’s theory listed by McEwen & Wills (2011) is nursing; a process of action, reaction, and interaction whereby nurse and client share information about their perceptions in the nursing situation. The nurse and client share specific goals, problems, and concerns and explore means to achieve a goal (p. 163). When mutual goals have been identified, means have been explored, and nurse and client agree on means to achieve goals, transactions will be made, and goals achieved (Lane-Tillerson, 2007). Once the patient’s goal(s) are achieved then

Two types of data were collected through surveys, both before and after implementation of the combined approach (Sand-Jecklin and Sherman,2014). The first data was on nurses’ point of view with regards reporting process, and the second on patients view regrading nursing care. The baseline survey included 233 patients and 148 nurses, while the survey three months into the implementation period included 157 patients and 98 nurses. The final survey, 13 months into the impanation, was completed by 154 patients and 54 nurses. The patient survey also included responses from patient families. These were 70, 72, and 53 responses for baseline survey, three-month postimplementation surveys, and 13-month postimplementation surveys.

The impact of report on practice particularly in primary care is very huge. Over the past decades, we have realized, with every passing decade, nursing has become an increasingly integral part of the healthcare services, so that a future without large numbers of nurses is highly impossible to envision. We have also witnessed the drastic changes and advancement that have happened in the field of nursing over the past decades. Nurses have to change their current health care practice in order to meet the growth and also the goals of the IOM report.

Scottsdale Healthcare is an organization of magnet status and is continuously striving to find ways in which to improve patient satisfaction and quality of care. As of October 2011, Scottsdale Healthcare implemented bedside report in order increase patient satisfaction providing the patient and family knowledge in regards to their condition and plan of care in order to set goals for the patients recovery and gives them the ability to ask questions. Prior to bedside report taking effect, management gathered all employees from the unit going over what is to be expected and how bedside report was not only taking effect on our unit alone, but hospital wide. Nursing leaders knew that they had a situation at hand due to the fact that nursing staff was so comfortable in giving report at the nurses station and did not want to wake the patient or deal with a family member, but they remained positive and encouraged staff that this would dramatically change our satisfaction scores. In maintaining patient satisfaction scores, the hospital would qualify for reimbursement from Medicare. The nurse

The authors recommend that the findings originating from this study can be used as a basis to initiate protocols for implementation of bedside nursing

By focusing on overall patient care and satisfaction many areas patients are surveyed on can be improved. Once a performance standard is selected staff must develop a plan for improvement. The first step would be to research as many sources as possible to find the best evidence based practices that would work for the specific facility. This can be divided into two the two categories of direct nursing care and indirect nursing care. Direct nursing care would include implementing hourly rounding, adequate nursing staff and SBAR communication. Indirect nursing care includes availability of technology such as wireless communication, real time locating, wireless monitoring, and electronic medical records. The second step would contain education of the staff on what is to be implemented and why. The why is important for nurses to overcome any barriers that might be encountered. While nursing practice has grown based on evidence Vanhook (2009) explains the greatest barriers to evidence based practice, such as difficulty interpreting findings, limited time, and misunderstanding of research itself, and how to overcome these barriers. With phase one and two completed facilities can move forward with implementation and evaluation.