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Bedside/Face-to-Face Shift Report

Specializes in OCN certification. Has 20 years experience.

I have been told to develop a method of bedside shift report for our 34 bed medical unit. If any of you work in a unit that does this, I would appreciate any advice you can give. What are some of the problems, time considerations, benefits? This switch will be to meet JCAHO's 2006 goal of improved "hand off" communication. Thanks!!

At several facilities I go to (I'm agency), the outgoing nurse has a "cheat-sheet" with any vital info about each pt jotted down on it. The sheet is photocopied with each pt's name, room number, and MD's name on it. Accuchecks, VS, ABT status, O2 rate, appetite, labs, med changes, etc are reported on this sheet. We just walk from room to room, check alarms, and I'm made aware of each pt's status. It's really nice to put a face to a name when you're new at a facility too. Hope this helps.

BittyBabyGrower, MSN, RN

Specializes in NICU, PICU, educator.

We do it where I work on all the floors. It is very nice because you can say, okay, this is soandso, this is what the IV looked like, this is what the wound looked like, these are the fluids running,etc.

We use cheat sheets also....they have a place for treatments, O2, meds, labs, etc. All the things we need to pass on. If we know we are following the same person for a day or so, we just pass the sheet along.

Our floors found that it went faster than taped report...no stopping the tape because you couldn't understand it, or the usual jibber jab that goes on during report.

beckyboo1

Has 30 years experience.

Something we wondered about at our facility is if you do bedside report, how do you keep confidentiality in a semi-pvt room? I'm interested in suggestions.

Thx!

Becky

RGN1

Specializes in med/surg.

Something we wondered about at our facility is if you do bedside report, how do you keep confidentiality in a semi-pvt room? I'm interested in suggestions.

Thx!

Becky

Just what I was going to say.

When I trained in the "old" days I can still hear the voice of the senior nurse on handover at the bedside of the patients on our "Nightingale" wards(one long ward with at least 24 beds - UK style - though beginning to be phased out) asking in her very loud Irish accent "And Mrs Smith..... have you had your bowels open today?"

Confidentiality in anything but a single room is just not possible!

Also what about those things you don't want your patient to know yet - or the relatives have said you're not to tell???? Or is that where the "unofficial abbreviaitions" come in??

I truly think a private handover in the nurses office - NOT a tape though (what a horrible idea - do you really have taped handovers??) is the best. Personal opinion only though - of course.

beckyboo1

Has 30 years experience.

Right now, the charge nurses do face to face report with a book. It has spaces for VS, I/O, assessment, rhythm, etc. The caregivers do a face to face verbal in the station. So far, it works for us.

RGN1

Specializes in med/surg.

Sounds like the best way to me! I just can't see how a truly accurate handover can be given at the bedside - especially if it can be overheard by a room mate! Or, as in some UK hospitals virtually the WHOLE ward :rotfl:

Northwest_RN_4

Specializes in OCN certification. Has 20 years experience.

:thankya: Thanks for the input! We currently do live reports in our report room. If anyone out there is doing report at the bedside how does it work for you? Does is save time? We have a 1/2 hour report now. How are nurses getting through a face-to-face report when they may have to give more than one nurse report, depending on who's replacing them? Any info would be greatly appreciated.

:thankya: Thanks for the input! We currently do live reports in our report room. If anyone out there is doing report at the bedside how does it work for you? Does is save time? We have a 1/2 hour report now. How are nurses getting through a face-to-face report when they may have to give more than one nurse report, depending on who's replacing them? Any info would be greatly appreciated.

Not at the facility where I am but I have done these in the past. Very favorable. I prefer them. Yes they are time effecient. In fact it tends to take longer giving face to face away from the bedside because the nurse tends to talk about a lot of irrevelent stuff and rambles and even spending time on thiings that have nothing to do with the pt. If there is something that must be passed inconfidence away from earshot of the pt then it is spoken outside the room. After all you give report and then move on to the next pt's room.

As far as confidentiality with a roomate. Don't forget that room mate is there 24 hours not just when you give report. So they know things about each other already. Sometimes they know so much they could give the report. Look everyone in the hospital knows they are entitled to confidentiality and understand that things are being overheard by the room mate and visa versa. It is gererally understood that they keep each other's confidences as far as they agree among themselves.

When ever this is becomes an issue with a patient then they usually let you quietly know and they are discreetly proivided the privacy they request.

It is when visitors are present that this becomes an issue and visitors are told that your require privacy for the roomate during report and are not permitted to be there. The visitors of most concern are those who are there on a more social level rather than say an involved spouse, or adult child who is as concerned about privacy as his beloved, and understand the give and take necessar between roommates in preserving each other's privacy..

Actually it is unusual to have many visitors at the bedside at that time of day.

catlady, BSN, RN

Has 21 years experience.

Not at the facility where I am but I have done these in the past. Very favorable. I prefer them. Yes they are time effecient. In fact it tends to take longer giving face to face away from the bedside because the nurse tends to talk about a lot of irrevelent stuff and rambles and even spending time on thiings that have nothing to do with the pt.

I can't imagine it taking less time, unless your assignment exactly matches what the other shift had. Yesterday I had four patients in four different rooms and had to give report to four different nurses, who were also getting report on other patients from other nurses. Almost never does the day assignment match up with the night assignment. I think bedside report would be total chaos. It's bad enough that now we're required to listen to a group report from the charge nurse, so it's at least 20 after the hour before we start real report. That's 20 minutes of overtime for every single nurse working, and I don't learn anything I'm not going to get from the individual report that follows.

Northwest_RN_4

Specializes in OCN certification. Has 20 years experience.

Thanks again, my greatest concern is the time factor involved in having all nurses give their own report to the oncoming shift. My boss is sure this will be the perfect fix to report going over, but I still have doubts about the time factor being any shorter than it is. Any more suggestions?

TinyNurse, RN

Specializes in Emergency.

We do "bedside" report on our huge bed unit. At first I was skeptical, but now I love it. The patients love it!

We have all private rooms, so confidentiality isn't an issue. It is a good time to check iv sites, drips, the patient's mental status, pain, and room cleanliness.

We've had nothing but positive feedback from patients about our bedside report. It gives them a chance to "be in the know", and be introduced to the oncoming nurse. When my patients are happy, i'm happy.

I don't think it takes any more time than giving oral report at the nurses station.

I have found that a mix works better for me. I get report at the desk, but then ask the offgoing nurse to accompany me into the pt.s rooms for a quick check. It's a great solution, as often things like "distended", "confused", and 'lethargic" can be better defined.

cardiacRN2006, ADN, RN

Specializes in Cardiac.

I have found that a mix works better for me. I get report at the desk, but then ask the offgoing nurse to accompany me into the pt.s rooms for a quick check. It's a great solution, as often things like "distended", "confused", and 'lethargic" can be better defined.

You beat me to it. That's what we do. A sit down report in front of the chart, and then a walk in the room for the visual stuff.

Sunflowerinsc, ADN, RN

Specializes in Med/Surg. Has 46 years experience.

We have been useing a phone system, voice care, for several years now. I have went through many kinds of reporting over the years but this is by far the best. Of course it has cut out overlap between shifts alot ,miss that overtime! The shift before us prints out work sheet from the computer that comes from care plans that has interventions,ect. Includes diet, code,VS, activity, labs and xrays ect but in a very short useable sheet. Then each nurse dials in and hears report on her (his) pt.s. Charge nurse hears everyones. Of course, anyone can dial in and hear whatever ones you want if you have any questions about any pt's. The off going shift nurses go ahead and finish up charting, meds or whatever needs to be finished. The on coming staff is able to still have a face to face if any questions, ect.ER puts in report on a new pt, no waiting for a nurse to come to the phone. That and the accudose med system for controlled drugs has cut down over lap so so much. No more "who's got the keys and who's going to count, and you can't leave until someone counts! We are going to use a "good to go"sheet when pt's leaves floor for tests,ect. Another form but will be good information for when pt going to tests ,its being tested now on a med floor to see if enought (or not enough information)is on it, but we want to keep it short and simple and have it used.

We do bedside nursing at the hospital that I work at, and it isn't really bedside, its more like at the door nursing. Its pretty private, and we pull the pt. door closed during report and after report we enter into the room and the off going staff says goodbye and the new staff introduces themselves. Works fine. :monkeydance:

Just what I was going to say.

When I trained in the "old" days I can still hear the voice of the senior nurse on handover at the bedside of the patients on our "Nightingale" wards(one long ward with at least 24 beds - UK style - though beginning to be phased out) asking in her very loud Irish accent "And Mrs Smith..... have you had your bowels open today?"

Confidentiality in anything but a single room is just not possible!

Also what about those things you don't want your patient to know yet - or the relatives have said you're not to tell???? Or is that where the "unofficial abbreviaitions" come in??

I truly think a private handover in the nurses office - NOT a tape though (what a horrible idea - do you really have taped handovers??) is the best. Personal opinion only though - of course.

lsyorke, RN

Specializes in Med-Surg, Wound Care.

I think I've done every kind of reporting there is in my 22 years as a nurse. Bedside was the worst. It would take forever to get in and out of patients rooms with requests, visitors, etc.... Confidentiality went out the window, and overtime went through the roof. We discontinued it after a month.

BittyBabyGrower, MSN, RN

Specializes in NICU, PICU, educator.

In our hospital, all visitors have to go off the unit for 30 minutes when we give report, even the ICU's unless the patient is very, very critical. On the adult floors, they do report just outside the room, so that takes care of the things that the patient doesn't know about yet, but you can still go in and show them a wound, dressing, etc. Since we have gone to this hospital wide, and people have become used to it, it goes quickly and the hand off is much easier.

:monkeydance:

I think that if implemented properly, the bedside reporting would be the best for the safety of the patient and isn't that what we are all trying to acheive? The taped report on all patients seems to be a waste of time. They argument, "I need to know everything about each patient," to me is bogus. If a nurse goes on break or to lunch, a quick report should be given. Any other information about the patient like ambulation, diet, can be viewed on the Kardex or pathway. I know some of us don't like change but change simply is. If we want to go back to the way things used to be, would we want the same paycheck we got 20 years ago? We need to think out of the box.

I think I've done every kind of reporting there is in my 22 years as a nurse. Bedside was the worst. It would take forever to get in and out of patients rooms with requests, visitors, etc.... Confidentiality went out the window, and overtime went through the roof. We discontinued it after a month.

I agree. When i clock out I leave out a different hallway than my assignment, otherwise I get stopped in the hall by visitor or patients wanting this or that (me with coat and purse on)...you just can't get away.

You'll be at the bedside soon enough, no need to walk and give report. Heck, that's usually the only time in a shift where you actually get a chance to sit down and get away from it all! If you can't trust your co-workers to give accurate information in report without visually inspecting it for yourself, then THAT person needs to be addressed; you SHOULD be confident that the info you get in report is accurate without having to round with that person.

I like the poster who had the phone-in idea. Sounds like a perfect solution.

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