Published Jan 18, 2002
Due to my position in nurse administration I often have to float nurses to other units. I am often approached with the problem of diff. areas using diff. type change of shift reports. would anyone have research info. on comparison of types. I need to write a proposal to uniform the reports.
I would be interested in any information on this topic too. Our unit used to tape record report, but recently changed to a one-on-one format. One quick result has been that nurses are on the floor caring for patients at least 1/2 hour sooner.
Trying to make a uniform shift report format is very difficult if not impossible. There are too many variables between units. Both within the patient population and the skill mix and expirience level of the nursing staff involved. It needs to be tailored to the individual unit to be the most efficient.
Question as to why you have to float staff so much that this is a problem?
I think that walking rounds work best when staff are floated -- it's much easier for the "floatee." Also a good time to get a quick view of the patient, etc. Walking rounds have always fizzled out on my floor -- every so often management mandates them -- but haven't really done them in years. I think they truly work best.
I agree with Susanmary. Walking rounds report gives the oncoming nurse the opportunity to see what she is dealing with. (I would not accept a unit/hall without actually taking a walk thru it to make sure it was not a mess, IVs needing changed, etc.). It also helps to eliminate the on-coming shifts complaints about how the unit was left "from the previous shift" because they can address things right then. When I was DON- I required that a half hour before the end of the shift- the nurse on the unit did a walking rounds report with the CNAs. This gave the nurse the opportunity to question the aides about BMs, behaviors, etc. It also ensured the hall was in good shape for the oncoming nurse. Any problems identified could be addressed by the aides before they left to go home. Then the nurses did "walking report" when the next shift came in with each other. Actually seeing the pt. also helps to jog the memory of something that you may have forgotten to write down.
It doesn't solve all the problems- but it sure helped.
As the educator in a long term care faciltiy (aka nursing home) I am co-ordinating a committee looking to solve our communication problems. We are focussing on the poor transfer of information during shift report. We have 102 residents on 2 floors, HCAs, RPNs and RNs all attend report, so a "walk-around" is not going to work for us. We want to reduce redundancy in our paperwork, so huge forms won't work. What are others doing? Thanks. Wendy
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