[rdhdnrs]

Hey all,
I really need help. How do you do nurse shift change report?
We have recently gone to group report and it has led to everyone staying late on the offgoing shift every day. We need to streamline report or think of a new way to do it altogether.
Our manager is concerned about Hippa violations when we do bedside report.
Please let me know how you do report. Thanks
Lisa

[SmilingBluEyes]

Group report.....we have always done this, so we basically have it "down". Some suggestions:

Everyone gets a report sheet with pertinent and very basic facts on it.

When talkiong, just the important facts. Stick to what is pertinent to your direct care of the patient. I usually only cover exceptions or what is unusual, esp when it comes to labs etc.

WHen I am giving report, PLEASE Don't interrupt me ....wait til I am done with a given patient....and I THEN am happy to answer questions on that person/.couplet. I can give report on quite a few patients in 10-15 minutes' time. If I only have a few couplets or a labor patient, it's 5 minutes or less.

I am always out by 7:30 this way. I give quick bullets and move on. NO playing around or gossiping. This is on MY time now and I don't like hanging around.

Once you get used to it, it's not bad, but everyone has to be on the same page. It may be tough at first. Some places used TAPED shift reports. You could consider that if people can't seem to get it together. It may be a difficult transition at first, esp if you have a lot of nurses at report at once.

Bedside report CAN violate HIPAA rules---- IF there are other people in the room (including family members in a private room) ---that can hear you, so your manager has a REALLY good point.

Good luck.

[L&D_RN_OH]

Assignments are made at shift change. The offgoing nurse gives report to the oncoming nurse on her pts, in the nurses station. No bedside report, no group report.

[rdhdnrs]

We used to do one-on-one report. Our manager, besides the HIPPA concerns, also thinks that all the nurses on the floor need to have a general idea what's going on with the patients, so that coverage can be provided if needed.
It's not practical for us to do report at the nurses' station; not enough room.
Thanks for the input--anyone else?

[SmilingBluEyes]

Originally posted by rdhdnrs
We used to do one-on-one report. Our manager, besides the HIPPA concerns, also thinks that all the nurses on the floor need to have a general idea what's going on with the patients, so that coverage can be provided if needed.
It's not practical for us to do report at the nurses' station; not enough room.
Thanks for the input--anyone else?

she is RIGHT, being clueless as to what is going on with the rest of the floor is NOT a good thing. There are times when our assignments change or we have to cover each other's patients for one reason or the other. New admits make this happen more often than I would like to see.

And there is not always time when things are happening fast (e.g. an urgent or crash csection) to get report THEN, where you have to take the floor or at LEAST a couple other patients for a while. It's a fact. So yes, having report for the FLOOR is a good thing IMO, to make you aware of what is going with other patients in general. I know it's helped me time and again.....

good luck. Sounds as if you are going this way like it or not; it will be an adjustment but you will do ok.

[L&D_RN_OH]

I guess I should rephrase that. At the beginning of the shift, we go over the census sheet with a mini report "Jane Smith, G3P2, active labor, epidural, 5/90/-1, etc." for all the pts. That is howwe choose assignments. Then we get individual, indepth reports for the pts we are assigned. And continually through out the shift, we update each other on what our pts are doing. We are never clueless.

There are only 4 of us on each shift, so it's easy to share info, and fit in the nurse's station.

[rdhdnrs]

Deb,
I love your "George Dubya" quote!!!
I do think we will have to adapt to group report. I read an article online about how to streamline group report. They said have the charge nurses do a detailed report in front of the oncoming shift, then just have any changes reported on by the bedside nurse.
What do you think about this?
Lisa

[at your cervix]

We have gone to taping report and it works great. Most nurses hated it and complained about it, but when the recorder broke and we went back to live group report, they realized how much they acutally liked it. Here's how we do it: The off going shift tapes report sometime in the last 1 or 2 hours of the shift, if something changes with the patient after report is taped, we add it on the at the end. The oncoming shift then goes into the lounge and listens to the taped report and the oncoming charge nurse then makes assignments. This way, time is not wasted on the unimportant stuff, people actually listen to report because it is harder to rewind to hear things again whereas with live report, you always have 2 nurses that sit and talk the whole time you are giving report and then they ask you all of the questions again! It also allows everyone to hear report on eveyone in case there comes a need to change patient assignments during the shift. The other plus is that the off-going shift is still avaliable to answer call lights, round with docs etc while report is being given. We love it!!!!!

[OBRN03]

We used to give group report and too much time was wasted on nothing. A few seasoned nurses would question other nurses interventions etc. A lot of wasted time. So our manager decided to go to tape report and it goes much quicker!
We have a check list to go by so we don't miss anything. I tend to stick to exception reporting since there is a sheet that gives you the "stats" of the patient.
Hope that helps

[rdhdnrs]

Thanks everybody.
Our compromise so far is that the offgoing charge nurse gives report to the oncoming charge nurse in front of the oncoming shift, then the offgoing nurses come in two at a time and give a quiet report to the nurses who are taking over their patients.
It is working well so far, because when someone gets report then she can come out and count narcotics, watch the monitors, etc.
Thanks for all your input.
Lisa