shift to shift report/staff assignments

[catskillrn]

At our facility, everyone (aides and nurses) listen to a verbal report from the out-going shift charge nurse. Sometimes, this can be time consuming. How do other facilities handle report time? Also, the process of CNA assignments seems very time consuming. We do primary care ( senior aides have the same group of residents each day) However, the lists are constantly adjusted, showers assigned, cathartics, vitals etc etc. Does anyone have an faster way?

[SYDNEY]

How do other facilities handle report time?

Report time used to take up too much of our time until the DON decided to invest in cassette recorders. Now the off going nurse merely has to record report whenever is convenient for her, count off with the oncoming shift, and clock out. The oncoming nurse, after counting, gets to hear a concise report of the past 8 hours without the added story telling and/or venting. Less personal, yes, but sure saves a lot of time in that first work hour.

Also, the process of CNA assignments seems very time consuming. We do primary care ( senior aides have the same group of residents each day) However, the lists are constantly adjusted, showers assigned, cathartics, vitals etc etc. Does anyone have an faster way?

Our assignment sheets are are room oriented and the CNA has the same assignment every day. The assignment sheet is easily updated on the computer to allow for quick patient updates. The CNA's do walk through reports at shift change time, so they find out immediate information about their assignments from each other rather than listening to the nurse's report. After each has had their respective report, then the nurse fills the CNA in on any extra information she might need. CNA's don't do vitals at our facility, however this can be accomodated on the assignment sheet, i.e. a column for who's medicare charting on which shift and when those vitals need to be taken. New patients and change of condition are charted on for 72 hours.

The shower list is based on room assignment rather than resident, so thats never changing

[P_RN, ADN, RN]

We did a written/verbal report by teams. The teams always included the same group of rooms, no more no less. Admissions were by team, you had empty rooms you got admissions.

The offgoing shift printed a worksheet for each team member with new orders, all treatments etc. The team leader then reported to the oncoming team (all of them) and handed out the sheets.

That way there was no gossip and no saying "nobody told me about that." All 3 teams could do report at the same time and it took a little less than 10 minutes. A copy of each team report was also left with the oncoming charge nurse.

Quick and to the point.

[bigred]

Like Sydney, we too have cassette tape recorders for report. We have had that for 5 years or more. When we had the verbal report, it was very time consumming. When I gave report to the staff comming on, there were be chitter chatter amongst themselves. If I mentioned something that got their attention, someone would interrupt with "who was that?". That still occurs today. When it does, the tape keeps on going and I tell them afterwards that they can rewind it and have a listen to what they missed. Also, the staff member leaving usually gets out sooner. Any place I have worked at previously had taped reports.

To answer your other question, we have assignment sheets for each shift. They are typically filled out the day before except for nights. That assingment sheet is shorter, and the RN/RPN fills it out when he/she begins the shift. The assgnments rotate because of part time staff and full time staff rotate shifts q 2 weeks. For the most part the assignment sheets work well...we sure keep the paper companies in business!

Hope that helps.

[tinkertoys]

At our Center, we use cassette recorders, too. Each nurse tapes for their relief, and the Team coordinators tape a comprehensive report for the nurse following them. The TC listens to that tape, and the individual reports, and so has a good idea of what is going on and what she needs to accomplish for her shift. CNT's get report from their charge nurse at the beginning of the shift.

As for assignments, our patients are divided into set groups for patient care. Each CNT gets a worksheet daily with the list of pts for her group, which includes V/S , I&O, meal %, shower schedule, and any special needs/concerns each patient may have. They then can add day to day concerns during report.

These worksheets are updated twice weekly, and have improved our continuity of care. We also have a set schedule for showers, straightening of drawers, cleaning IV and GT pumps,etc. so that the work is spread over the week and no one shift or work group gets "dumped on".