Nursing report ED to Floor

[TRAUMARN05]

I am curious to get some feedback on some processes that work well for those in nursing in regards to report from the ED. What processes work well in your facility? Does the ED call you, do you call them, do they send an SBAR?

[anna722]

Several months ago, in unit council meetings, we brought up the issues with the ER not calling report (they would just send the patient up whenever) and our whole procedure was changed after several more meetings. We now get a page (from a PAGER, yea my hospital still uses those) with the patient's name, medical record number, admitting dx, and attending physician. The ER then calls and gives a (imo) very basic report, sometimes they are able to answer questions, sometimes not. The patient is then transported up sometimes within 20 minutes, sometimes closer to an hour or two. The transporter calls up to the desk when they get there, someone from the unit has to lay eyes on the patient before the transporter leaves.

If the assigned RN is not available to immediately take report, another RN is supposed to take the report. Sometimes, they call immediately after the page is sent, sometimes there's a 20 minute or so delay, and, for me, personally, I try and look up the patient to figure out what's going on before they call. I also try and figure out some of their orders,(if they need an IV pump, SCD machine, bed alarm, etc.)

The system is definitely not flawless but an improvement from previous methods. The only problem is that they can (and oftentimes do) send the patient during shift change hours, which I have found to be unsafe.

[FlyingScot, RN]

If you do a search on this topic there are tons of threads asking this same question. I'm not chiding you for not doing a search just letting you know the info is already here. It has been discussed and discussed and generally turns into a slugfest. The first salvo has already been sent out with the first reply. This will get heated pretty fast.

[emmy27]

The only problem is that they can (and oftentimes do) send the patient during shift change hours, which I have found to be unsafe.

It's funny, we keep telling patients it's unsafe to walk in the door during shift change, but they just keep coming.

[FlyingScot, RN]

And so it begins.

[icuRNmaggie, BSN, RN]

https://allnurses.com/general-nursing-discussion/why-dont-you-996960.html

July 2015 thread on ED report.

[icuRNmaggie, BSN, RN]

https://allnurses.com/general-nursing-discussion/admissions-1004945.html

August 2015 thread on report from ED.

One suggestion was to build a nursing transfer summary into the EMR that would import abnormal results VS tx and meds. That would solve the change of shift issue.

[weirdscience]

Assume you're getting minimal to no report and figure out the hot spots of your computer charting to dive in and read quickly (h&p, labs, recent vitals, then MAR is what I speed-read if I get crummy report.)

[Dranger]

I have much to say on this but I don't feel like opening a can of worms...haha