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Discussion

Problem sheets?

Aside from your kardex, does anyone out ther use a "24hr sheet" or a "problem sheet" that is used as a guide to help during rounds and/or report? It is a sheet that has the events that happened in the last 24hrs but is NOT part of the pt's permanent chart and help guide with hand-off communication.

We don't have one, but I want to maybe implement this for our more complex babies where it seems communication has been challenging.

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We have preprinted report sheets. We are supposed to update the Kardex at the end of every shift with all the new orders, then make a report sheet for the oncoming shift based off the Kardex. There is an area to communicate any problems.

We have what we call SBAR sheets. It's basically a systems review with areas for meds, lines, and fluids. The back has a grid for our vitals and care rounds. Most people hate them because there's really way too much info on them - there's a little check box for just about everything, from preemie problems to ECMO. I love them, because I'm just OCD and like to give report in a very systematic way. We're supposed to hand them off at report time, but everyone pretty much just grabs a blank one and fills it out themselves while they're listening, because hello, things change over the course of a shift, and what I filled in at 0700 is probably no longer relevant at 1900. If I have time I make a new one before report, so even if the next nurse doesn't want it I don't have to think too hard while I'm talking.

We also leave them with whatever nurse is covering us during lunch, because they got a few too many complaints from parents about being told "Uhh, your nurse is on break. The baby is... fine. Can you call back in an hour?"

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