Bedside reporting
- 1. Bedside ReportingRole Development and Nursing ManagementErin Voyles, Wendi Woolley, Dan Schmit
- 2. How bedside reporting relates to nursingBedside reporting is “a strategy that includes the patient in the reporting process” during change of shift report (Caruso, 2007).Shift change is when nurses hand responsibility of patient care to another nurse andthis time period isa critical component of patient safety Detailed communication of patient status is essential to best quality nursing care
- 3. Types of shift change reportWritten reportPhone recordingTape recordingVerbal report in designated roomVerbal report at nurses’ stationVerbal report at patient’s bedside
- 4. Problems surrounding shift change reportingProviding adequate informationIncluding patient regarding plan of careCommunication deficits
- 5. The Challenge2007 National Patient Safety Goals forHospitals (Joint Commission, 2006)Implementing a standardized approach in change of shift reportingImproving communication among caregivers and reducing sentinel eventsthat resultedfrom gaps in communication (Laws & Amato, 2010)
- 6. Benefits to bedside reportingPatient empowermentPatient involvementPatient centered with emphasis on team effortPatient becoming an additional resource (Caruso, 2007)Visual learning
- 7. Disadvantage of bedside reportingTime consumingLack of privacy for patient informationInterrupting restElevated patient anxiety
- 8. What is being done?Key Practice PointsBedside communication meets the needs of both patients and nurses (Laws & Amato 2010)Bedside reporting reassures patients that the nursing staff works as a team and allows the patient to see a transfer of responsibilities
- 9. Results of Implementing Beside Reporting Protocol (Laws & Amato, 2010)Posttest survey results of implementation found that nurses believed there was:ImprovedPatient safetyPatient collaboration in plan of careAccuracy of informationPatient visualization of diagnosisStaff satisfaction including encouragement of teamwork and accountabilityImproved planning and prioritization of nursing interventions
- 10. Results continuedLaws & Amato (2010) found that the biggest challenge wasengaging patient during reportLaws & Amato suggestedutilization of champion nurses that can communicate effectively with patient regarding plan of care
- 11. Patient ParticipationTimonen & Sihvonen (2000) identified main reasons by patients for lack of participation during bedside report: tiredness, difficulties in formulating questions, lack of encouragement, difficulties with the language used, nurses concentrating more on their papers than on them, and brevity of reporting sessionsNurses reported that patients took a more active role in report than patients thought
- 12. Patient ParticipationSuggestions to nurses to improve patient participation during bedside reporting:Encouraging patient to ask questionsUsing common, everyday languageConcentrating on patientsGiving patients more time
- 13. TCAB initiativeTransforming Care at the Bedside (TCAB)This initiative implemented three changes to improve communication of patient care:Moved location of change of shift report to bedsideImplemented the safety huddle (brief meeting with all team members prior to bedside rounds)Established nurse-physician “intentional” rounds at bedside* “The current challenge in health care is to create an environment in which open and transparent communication is the norm rather than the exception.”Chapman, 2009
- 14. Positive Patient Results of Improved CommunicationPatients reports from the TCAB initiative:Enjoyment of nurses and physicians coming in room together to talk to themA different and better experience than previous hospitalizationsHigher patient satisfaction
- 15. Positive Staff Results of Improved CommunicationStaff reports from the TCAB initiative:Nurses believed that they were apart of an effective work environmentTCAB units indicated a voluntary turnover less than other units in the hospital
- 16. Improving Communication for the sake of the patients…“Multiple tests of change have produced a sustained culture of reliable, patient-centered care in which all caregivers continually strive for optimal communication.”- Chapman, 2009
- 17. SynthesisGiven the current studies supporting bedside reporting, those in the nursing profession should aim to increase communication tools that increase patient participation. According to Timonen & Sihvonen, bedside reporting gives the patient an active role in their own care. The overall goal is to provide optimal health care for the patient, and utilizing bedside reporting is a venuefor facilitate that goal.
- 18. ReferencesCaruso, E. (2007). The evolution of nurse-to-nurse bedside report on a medical-surgical cardiology unit. Medsurg Nursing, 16(1), 17-22. Chapman, K.B. (2009). Improving communication among nurses, patients, and physicians: A series of changes leads to cultural transformation at a TCAB hospital. American Journal of Nursing, 119(11), 21-25. doi: 10.1097/01.NAJ.0000362013.53342.17Laws, D. & Amato, S. (2010). Incorporating bedside reporting into change-of-shift report. Rehabilitation nursing, 35(2), 70-74. Timonen, L. & Sihvonen, M. (2000). Patient participation in bedside reporting on surgical wards. Journal of Clinical Nursing, 9, 542-548.
Editor's Notes
- #3: Effective communication increases patient safety
- #4: There are inherent problems and benefits for nurses in each type of reporting
- #6: Communication failures during shift reports are the leading cause of sentinel events in US (Joint Commission)
- #7: Patient involvement – patient feels adequately cared for due to the additional informationVisual learning – the nurse can see the lines and drains and from this visual signal may be prompt different questions
- #8: Time consuming – Nurse may have to answer additional patient questions and may require additional patient teaching - however this ensures better patient careLack of privacy – If the patient’s room is shared, lack of patient privacy could be an issueInterrupting rest – Shift change typically occurs during rest periods – 0700Elevate patient anxiety – Medical jargon or deteriorating condition may elevate anxiety and cause a stress response
- #13: Patients are a resource during change of shift report and should be included in the discussion of care