transforming our staff report: need input

[moodwaffle]

A "two-unit floor": med-surg on one side 19 beds, and oncology on the other with 15 beds (it's a hallway floor layout, not podded) Currently our report is as follows:

1: Look at the staffing board to see what side of the floor you'r assigned. The breakroom has a moveable partition and the med-surg group is on one side, the oncology on the other. (Usually staffed 3/3 on med-surg and 2/2 on onc).

2: the nurses and CNAs listen to report on ALL the patients, and then divide up the floor. Sometimes, report takes 45 minutes.

The reasoning for this type of report: having all the nurses get report on everyone on the floor allows for improved teamwork. Our staff "mileau" is very teamwork oriented, and we watch each others back and help each other a lot, though you're ultimately responsible for your group. I find the most important thing I need to know about other people's patient's is their code status and contact precautions-- everything else can change throughout the day and it's best to look at the chart. With that reasoning, administration wants to move to a patient assignment type of report, and another coordinator and myself have been assigned to change the way the floor has done report for the past several millenia.

Our plan:

1: assign patient groups to RNs and CNAs

2: have RN and CNA teams listen to report on their patients, and then start the day. When another person is getting report, the RN is to start looking up labs, meds etc on their patients.

Our problems:

1: NOC RNs giving report will have to split up their report (2 NOC RNs passing on report to 3 dayshift RNs).

2: The oncology side is hectic, and involves much more skilled chemo knowledge, and most chemo nurses such as myself prefer to hear report on everybody.

I want to get a feel of what other hospitals and units similar to ours do. Any suggestions? Personally, if people didn't use report of personal decompression time and just gave the facts, report time would be a lot quicker. On the other hand, I'd like to know my patient group ahead of time, so I pay more attention during report on my patients.

[mamiekay]

We do written reports, in our computerized charts, in our hospital. Then each RN gets report on his/her own patients. When a podmate or work buddy goes on break, the RN taking over gets a short report on each of the other patients--dx, relevant hx, code status, meds given & what they can have, how they get up & any other pertinent info. The CNA's take report on their own patients from the CNA from the prior shift & then get updates from the RN. I did clinicals in units where every RN & CNA took/heard report on every patient. It seems like a waste of time to me. As you cover for each other & help each other out during the shifts, you do tend to get to know each patient anyway, without having to keep all that information straight. At night, 2 RN's & 1 CNA will give report to 3-4 RN's & 2 CNA's on day shift. It works well for us. Of course, no matter how you change it, there will an adjustment period with people wanting to go back to the old way, simply because it's familiar. But give it time & try to be patient.