Student Nurse Moving Report

Pamela F. Cipriano, President of American Nurses Association was in disbelief to see how she has tried to enforce the Nightingale pledge of keeping patients free from harm was failed because medical errors are the third leading cause of death in the United States. As of now ANA has conducted yearlong campaign named “Safety 360 It Starts with You” in order to reduce and take measurable advances to protect the welfare of nurses and workers. It is one of campaign that the ANA comes with that is in support to both the nurses and patients. However, in the real-world nurses are stress and fatigue due to patient ratio. In my workplace, which is a state hospital, they have full time nurses on call where nurses work more than 70 hours a week. The nurses

The RN who is the gateway to patient care looks at the patient’s situation (current status, code status, level of uncertainty, recent changes and response to treatment…), background (comorbidities, previous episodes, current medication, family history…), assess the patient’s overall health condition and communicates vital information to all team members that are directly involved in the patient’s care during an emergency (Hood, 2014). During the course of my learning experience as a nurse, I realized that the main components in nursing profession is prioritizing information before initiating it. The use of SBAR when communicating patient’s condition to physicians, specialists, dentists, nurses and other healthcare team has improved my communication skills and has also helps physicians to determine the order of treatment for the patient thereby improving the overall patient’s

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.

Communication is very important when it comes to the information that nurses are given when treating a patient. If there is not good communication between nurses, especially between shifts and handoffs, consequences can happen, including the possibility of a sentinel event. According to Yoost and Crawford, 70% of the sentinel events that happened in 2005 were due to communication breakdown, with communication breakdowns during handoffs being the reason behind 50% of these events (p.137). There are different ways that nurses can handoff information to another nurse, with bedside report being one of the ways that is suggested to reduce the amount of communication errors. This paper will explain what makes bedside report safer for the patients

Connecting with a patients and their family leads to open communication with health care staff. Bedside reporting allows the nurse to visualize the patient and prioritize their daily care. Using bedside handoff decreases adverse events and promotes overall patient safety. This is because the patients and their family have the opportunity during report to clarify and correct any inaccuracies, so errors don’t ever have the chance to strike.

Evidence based practice has shown bedside reporting has enhanced nursing and patient satisfaction while allowing more direct time with patients. It has also helped reduce report time, increase patient satisfaction and allowed nurses to build trust with patients while involving them in their care.

Handoffs during shift change between nurses is one of the most important ways to communicate essential information related to the patients’ care and their safety. This is an evidence-based practice that improves communication among nurses and patients since the handoffs are conducted at the patients’ bedside, face-to-face, with the computer using SBAR. The patients are involved in the update of their care with the incoming nurse, enabling them to share concerns and to add valuable information, which increases patients’ satisfaction. Additionally, during the handoffs, the nurses with the patients are able to review and update the patients’ white board with the goals, activities, procedures, labs, consults, and symptom management for the incoming

Majority of medical errors occur as a result of gap in communication between health care workers. Team collaboration is very essential in the management of the patient. SBAR, a tool that helps in effective communication between staff during handoff report helps in the safety of the patient. When health care professionals miss to communicate effectively, patient safety is usually at risk for example, when information is misinterpreted or critical information are missing, unclear orders such as those over the telephone and neglect in changes in patient’s status.

Administering anticoagulants is a major problem in the healthcare field. According to Monagle, Studdert, and Newall (2012), “Heparin is one of the most commonly used drugs in tertiary pediatric centres […and] a plethora of fatal and non-fatal heparin-related errors [are] being reported ” (p. 1). A specific incident occurred in 2007 regarding a medication error that affected the two infant twin boys of Dennis and Kimberly Quaid. Shortly after birth, the twins developed a staph infection and were to be given an anticoagulant called hep-lock. According to Rick Shapiro with The Legal Examiner, “the nurses administered at least two doses of heparin”(Shapiro, 2010, p. 1). Heparin is a more potent medication than hep-lock. This mistake meant

For my change, I would like to implement the use of SBAR sheets for shift report. For my Transition to Professional Practice course, I was at Butler Memorial Hospital. My preceptor’s name is Health Alter. She has been at Butler Memorial for about seven years. She is everything I expected from a preceptor. She is knowledgeable, kind, and willing to teach me everything I need to know, plus some. When I started at Butler Memorial, they were in the transition of changing to the onset of bedside reporting from shift to shift between nurses. I noticed that nurses were forgetting to relay information from nurse to nurse at the patient’s bedside, and were having to continue the patient’s report at the nurse’s station, which is not conducive to the ideal of bedside reporting. I went to Heather about what I was noticing, and she agreed. She said that she even noticed herself forgetting information while giving report, since sometimes there may be family in the room, or the patient is asking a lot of questions, etc.. So that evening, she had me give report to the oncoming nurses using the SBAR format. The oncoming nurses did not ask for any additional information and Heather said that using the SBAR format aided in giving a thorough report. It is important for all stakeholders, being the nurses and patients, to have and give accurate information about the patient’s care.

In order to incorporate the inter-shift report change to bedside shift report, the hospital’s unit leadership, specifically the clinical nurse leader as well as the nurse manager, will play a major role in incorporating bedside shift report. Also, a specific focus committee needs to be formed, involving the director of professional development and education, nursing stuff, the director of nursing, nursing leader and manager. The committee will make a plan of how to make this change as smooth as possible. The benefits of doing so are improved communication between RN’s and other healthcare professionals about the patient’s health care plan, patients will be informed about care and who is caring for them, which in the end will lead to safer care

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.

Effective communication is critical during shift to shift report to ensure patients are receiving the highest quality care and safety (Wakefield, Ragan, Brandt, & Tregnago, 2012). There has been increasing interest in bringing shift to shift report back to the bedside to include the patient. Evidence supports bedside shift report (BSR) improves patient satisfaction, elevates accountability and increases overall communication amongst the caregivers. For years shift to shift report has taken place outside and away from the patient room leaving patients alone and unattended for long periods of time. “Research has shown that sentinel events are more likely to occur during this “alone” time" (Ofori-Atta, Binienda, & Chalupka, 2015).

Asking the patient what they have understood and encouraging them to verbalise this can help.Using communication tools such as situation–background–assessment–recommendation (SBAR) communication ensures that messages are clear and unambiguous even in stressful situations. Leonard M, et al. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care 2004;13 Suppl 1:i85–i90.

The SBAR stands for situation, background, assessment and recommendation. It is specifically suggested that nurses communicate with physicians about a patient’s condition using the SBAR format. Communication is needed between the nurse and physician in order to do what’s best for the patient. Also the SBAR format can be used as a hand-off tool during transfer of care from one person to another.