Bedside Report Summary

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

End of shift reports between nurses has been an important process in clinical nursing practice. Allowing nurses to exchange vital patient information to ensure continuity of care and patient safety. Therefore, the chance of potential communication gaps causing an error is high. According to the Joint Commission, communication is the primary cause of medical errors, with handoffs accounting for 80% of these errors [ (Zhani, 2012) ]. The most commonly practiced model of report takes place in the staff room, at the nurses’ station, or other locations away

Bedside reporting has the primary function of sharing patient information between nurses, as they change shifts. The nurse ending their shift would report all the changes that have occurred in the state of the patient and all measures which have been taken for the respective patient. This information would be transmitted to the nurse commencing her shift, who would then write and further transmit all patient information occurring during their shift, to the nurse coming to replace them.

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,

Bedside shift reporting, is it necessary? Baker (2010) states that is has its benefits, from patient safety, increased patient involvement and staff teamwork, ownership and accountability.” (Baker, 2010) To promote stronger engagement, Agency for Healthcare Research and Quality developed the Guide to Patient and Family Engagement in Hospital Quality and Safety for bedside reporting. (AHRQ, 2013)

The author made a problem statement that bedside nursing report is not persistence in nursing care and there is limited research to investigate. The author’s questions are specifically related to the concern of bedside clinical handover that needs to be addressed in healthcare organization, investigate patients’ opinions to help nurses become aware of patients’ needs and increase their skill in clinical bedside handover practice. Using qualitative research methodology to interview, explore, and observe patients’ experience will help the researchers to answer the research questions. Obviously, exploring the patients’ opinion of bedside nursing handover is a key to recognize patients’ perspective to provide for their needs in order to continue patient safety care and

Not everyone is open to change, and some nurses feel that bedside reporting may interfere with patient privacy and patient well-being, which could lead to non-compliance.(Joshi, Currier, & O'Brien, 2011). Nurses might feel unsure about what exactly bedside reporting is, and what it should include in terms of the nursing need-to-know versus the patient need-to-know (Joshi, Currier, & O'Brien, 2011). In situations such as this, the Nurse Bedside Shift Report: Implementation Handbook would be beneficial to any hospital considering the implementation of bedside report. It would be used as a uniform standard of care, and take the guesswork out of what is actually expected of the nursing

According to the first step of Lewin’s theory Unfreeze phase is about helping nurses to recognize the need for change and encourage them to think about what the current process of end of shift reporting, what the disadvantages are, and how it can be improved. According to Sand-Jecklin and Sherman (2014), significant percentage of a nurse’s communications occurs during end of shift handoffs, and the safety of the patient can be compromised at this time. Nurses recognized that patient handoffs as a factor regarding near miss incidents. According to the Joint Commission (2011), miscommunication is one of the factors that leading to sentinel patient events, therefore, it is a requirement of Joint Commission National Patient Safety Goals. Nursing handoff report is the time, when responsibility and accountability for the care of a patient would be transferred from one nurse to another. Ineffective handovers, such as when not all required information is provided, can be risky for patients and staffs. According to Novak and Fairchild (2012), the method for delivery of shift report varies among hospitals, units, and nurses. These handoffs occur at busy times with multiple distractions and time constraints. This makes shift-to-shift report a time with high potential for the occurrence of errors related to communication. Reports done away from bedside hinder the patient’s participation in their care, which results in a decrease in patient satisfaction scores.

Patient satisfaction is a driving force in today’s health care system. Incorporating the patient in their care will help with the patients healing process as well as encouraging the patient to be more compliant with their prescribed care. Bedside reporting is a practice that some organizations have incorporated in their standards of care. The patients care does not stop when the nurse’s shift ends. Therefore, it is important for the patient’s information to be conveyed accurately to the oncoming nurse. Conducting shift reports at the bedside allows the oncoming nurse to both visualize and interact with the patient much sooner than if the nurse had received report in another manner. Furthermore, bedside reporting allows the patient to interact with both nurses; and allows them to see that their care is being properly managed. This type of reporting also allows the oncoming nurse to ask questions, as other methods of shift reporting limits the oncoming nurse from interacting and asking questions of the off going nurse. Patient satisfaction as well as accurate transfer of information and patient safety is a crucial part in providing quality patient care.

Internal method will be the interdisciplinary team such as hospitalist, therapists, dietician, pharmacist, case managers, discharge planners and house supervisors. These stakeholders performed a thorough discussions about patient’s admission, transfer, and discharges. Upon discussing with the patient’s overall health concerns, the evidence-based practices of bedside reporting can be part of the daily discussions because this is where the basis of patient’s health outcomes can be obtained. The goal of bedside reporting is to promote safety and highest quality of care. Therefore, the input and opinions of the whole team is very essential for the successful implementation of the bedside reporting. The bedside reporting will be more stronger tools

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

Nurse knowledge Exchange (NKE) at the bedside during shift change is very important part in nursing for continuity of care. Effective communication plays great role while transferring information from one nurse to another nurse. According to studies, nursing reports at the bedside have positive results such as improved communication among nurses and patient, nurse and patient satisfaction, safety, decreased overtime and improve nurse patient relationship etc.(Maxson, Derby, Wrobleski and Foss, 2012; Tan, 2015; Sand-Jecklin, and Sherman, 2014). This paper outlines an implementation plan that describes a current issues that requires change, the method of obtaining approval and security for proposal, proposed solution and rationale, evidence from literature review to support proposed solution, and implementation logistics. In addition this paper also identifies resources required implementation.

Summary: an article written by a charge nurse from Tacoma General Hospital in Washington. She started emphasizing the advantages of utilizing the bedside reporting and the impact that brought to her unit.

The clinical practice problem that I would like to focus on is patient safety. I would like to research: Does the use of bedside reporting improve patient safety in hospitalized patients?