Bedside shift report. - page 3

I was just wondering if your facility utilizes bedside shift reporting. Is it working well? What do you feel are the pros and cons with it? Our facility is going to start to use this method of... Read More

  1. Visit  tokebi profile page
    0
    This is a quick update to my above post. After spending some time on the floor, I came to conclusion that it is IMPOSSIBLE to work without a cheat sheet! I wonder if educators have been away from the bedside for too long.

    I still believe that bedside report can work without taking too long. But I can't try this for real because no one really does it. I can't just drag an unwilling nurse away from her comfy seat.
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  3. Visit  RNJill profile page
    0
    Actually, although I initially hated bedside report when our unit first started doing it, I've come to (generally) like it and see its value. For me, like others have said, the benefit really is that you *see* the patient, can quickly assess for safety issues, and notice things that remind you to ask questions to the previous nurse. I also feel that it makes me at least see every patient quickly at the start of the shift so that if things get crazy quickly in the morning, there is not that one patient that I'm like, "Oh shoot, I haven't even seen yet."

    I have to say also that I think bedside report usually takes too long when 1) the next shift is late and thus you "lose" 5-10 mins immediately or 2) the person giving report is not following any sort of SBAR-ish pattern in what they say and going down rabbit trails/saying "ummm" constantly/asking the patient to "refresh their memory" etc.
  4. Visit  musicgal profile page
    1
    Research suggests bedside report has positives, and definitely it's negatives. It would be wrong to wake up a patient who is suffering delirium from sleep deprivation, or any patient who is confused. It would be wrong to talk about family conflict, pathology that the doctor has not shared with the patient yet, etc, in front of the patient. It is also in conflict with management demands that nurses clock out by 7.30 as many patients are understandable nervous in hospital and want to tell you their entire health/ sleep/ pain history hoping it will improve their care. Another example (happened last night) is that one patient just wanted to talk about every member of staff who had ever been good to her (a long list!). HOW ARE WE SUPPOSED TO CLOCK OUT ON TIME?!?!? Positives include an increase in patient safety on one hand, as they can correct misinformation etc, but I have also heard nurses say that patients interrupt so much that they have been unable to stick to an SBAR format or forgotten to pass on key information. In my experience, it works extremely well with patients who like to participate in their own health care, particularly educated patients - but not so much with those who refuse to participate, which is unfortunately a large proportion of patients as that is why they are in hospital in the first place. It would be wrong to say that checking drips and dressings etc is a benefit of bedside reporting, because all nurses at our hospital practice this at the bedside no matter where they give report. Overall, I believe nurses are very educated individuals who should have a little more autonomy in their decision making. It is a shame that large institutions inflict blanket policies that do not allow for this. There will always be lazy nurses, resistant to change despite heaps of robust research that proves they are wrong, and no blanket policy enforcement will change their attitudes. But most of us want to give the best care we can and are intelligent enough to familiarize ourselves with research then make good judgment calls.
    Wise Woman RN likes this.
  5. Visit  musicgal profile page
    0
    On my unit we go into every patient room to check dressings/ drips etc - the question is, where do we go through the SBAR report? If you do that outside, then go in to check drips etc, it is not bedside report. I agree that going into every room is essential - but should you go through SBAR at EVERY bedside too? It's a good question, research says 'YES", I have posted some more LONG WINDED thoughts below :-)
  6. Visit  jrwest profile page
    1
    I think it stinks. The concept is a great idea, but 80 percent of the time , yep " i have to go to the bathroom, or since you're here, get me some fresh water. Now you have to explain yourself as to why you want to have the tech help them; they don't understand why, since you are right there, that you cant help them. They don't care that you have to get report on another person- they've all been led to believe they are the only pt that you have.

    I also find that stuff gets missed, as , of course, we want to have the ptt hear the "good report", not the " she's a manipulative, borderline personality who has already told previous nurse that she doesnt care if she has other pt's, I want<fill in the blank> NOW!. Or, hmm pt has a 20 year etoh hx, and now his ef is 5. Pt asks, what's that mean? Now we have to tell him,despite that the dr is the one who should have told him in the first place.

    For simple cases, sure, the BS report (lol) is great- ms. m had a lap chole, her pain meds are due at such and such, her incisions look like this, vss. any questions? the the bs report works well.
    Last edit by jrwest on Aug 22, '13 : Reason: fat fingers
    jadelpn likes this.
  7. Visit  Been there,done that profile page
    1
    Bedside report is administration's response to HCAHPS.
    Customer service equals ... Medicare payment... equals maximum reimbursement.

    Administration has deemed bedside report improves customer satisfaction.

    Get used to, get around it .. whatever.. it's not going away.
    jadelpn likes this.
  8. Visit  chare profile page
    0
    Quote from musicgal
    I agree that going into every room is essential - but should you go through SBAR at EVERY bedside too? It's a good question, research says 'YES", I have posted some more LONG WINDED thoughts below :-)
    Please provide references for this research.
  9. Visit  dudette10 profile page
    0
    We now do a hallway report and take a look at the patient together to see what we're getting. Sometimes it's half and half...talk and look at the same time. We're supposed to do a full bedside report to meet the customer satisfaction stuff, but we look at the patient together for nursing continuity more than anything. I've gone back and forth about whether I like the idea of bedside report or not, and now I'm firmly in the camp that it should be nursing related, not customer service related, if you know what I mean. I want to be able to talk the lingo without having to explain myself when the patient/family is listening in.
  10. Visit  MunoRN profile page
    2
    "Safety checks" are a great idea, full report at the bedside is ineffective at best, dangerous at worst. A universal complaint about doing a full report at the bedside is lack of access to the chart and other patient data, which means Nursing feels less informed by report, which isn't acceptable (then there's also the issue of interruptions, self censoring, etc. As Nurses we work under our own license, others are free to make suggestions, but if you feel a bedside report impairs communication about the patient's plan of care, then stand up for your patients (and your license) and don't do it.
    jrwest and chare like this.
  11. Visit  MunoRN profile page
    1
    Quote from musicgal
    On my unit we go into every patient room to check dressings/ drips etc - the question is, where do we go through the SBAR report? If you do that outside, then go in to check drips etc, it is not bedside report. I agree that going into every room is essential - but should you go through SBAR at EVERY bedside too? It's a good question, research says 'YES", I have posted some more LONG WINDED thoughts below :-)
    For the sake of the basic premises of Nursing, please stop using SBAR for report, that's what the Nursing process is for. SBAR is for communicating a single change in status, not for communicating an overall Nursing care plan, we have enough trouble with remembering the "evaluation" portion of the Nursing process without adopting an inappropriate format that does away with it all together.
    chare likes this.


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