Shift-to-shift report in front of patient and family

Nurses Safety

Published

New rule at work. I think it was created by someone who has never provided patient care.

I'm finding it extremely difficult to implement. I find it hard to organize my thoughts when I don't have the chart in front of me, and to say everything in a way that doesn't overload and possibly scare the patient, but still adequately informs the incoming nurse. I also have trouble feeling I am adequately informed when I take report that way. Not at all sure it's a good idea. Doesn't matter what I think, though, I have to learn to do it.

Thoughts? Tips?

I don't like performing for the family either.

Specializes in ICU.

If I were the patient, I would be uncomfortable having report on me given in front of visitors. Especially if they were pulling back covers, exposing stuff like a colostomy, drains, etc., that visitors don't need to see or even know about! Seems like it would be awkward regarding HIPAA. Once when I was in the hospital, I was embarrassed just having visitors see my foley bag hanging with my urine in it, but that's just me. Right now, we give report to all oncoming nurses in the report room, and every nurse has to get report on every patient. That includes the ICU's and the floors~ if there are 26 patients on that floor, you get report on all of them, not just the ones you are taking. There isn't much "social" yakking, because if you are the one giving report, you just keep on talking, giving report, and if someone isn't listening, that is their problem. We manage to give report within a 30 min time-frame. I have worked at places where we did bedside reports, and it worked ok in the ICU because there were no visitors allowed during report, due to HIPAA, but it is hard to do that on the "floor" because invariably the patient or family member starts questioning meds, etc., and it ends up taking forever.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
we are supposed to do bedside as well, but i insist on giving and getting a real report at the desk, with access to labs, orders etc. only have to sign onto the computer once, and it goes quickly. then we "round", do pt handoff and introductions at bedside, check the iv etc. having to sign in on each bedside computer and then try to whisper or talk low enough not be heard is rather rude in my opinion, people really don't like be "talked over".

report this way takes maybe 5 minutes longer than it used to (no bedside), as we have gotten pretty good at it.

this....this...this!:redlight:

the purpose of bedside report is to prevent errors. the "bedside" part is to check iv's for drip rate, patency accuracy of fluids... drug, assessment, pulses etc. care specific item to prevent error and confusion. the bulk of the report is usually given else where.

it isn't all customer satisfaction driven it's a joint commission (amongst others) thing.

errors may occur because communication is faulty.

two joint commission national patient safety goals are to address......

patient safety issues that may be encountered during change-of-shift report. first, patient involvement in care is encouraged as a patient safety strategy and it is also recommended that a family member or trusted friend should be an advocate when the patient is unable to speak for himself or herself.

these national patient safety goals can be applied during the process of change-of-shift report. patients and their families, if desired by the adult patient, should be involved in the communication processes related to their care planning. in addition to the patient and family's need for information, partnering with patients or families at the bedside during report is a patient safety strategy.

bringing change-of-shift report to the bedside: a patient- and family-centered approach

roser said it best from the families perspective.....

roser13

during my brother's recent hospitalization, both nurses came into the room at shift change. outgoing nurse introduces patient to new nurse, then gives a quick synopsis of reason for admit. then both step to the side and they continue their report in quiet tones. i felt that at any time i could ask a question of one or both. i also (surprisingly) felt comforted that nurse a handed off to nurse b in front of us. i had never understood the rationale behind beside report, and now i kind of do.

Thanks, Esme12.

We ask visitors to step out during report, of course.

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