I work as an acute care Med-Surg float nurse and my hospital has implemented a new process where patients are being transferred to units from other units, ie. the ED to the floor, ICU to the floor, and from affiliate hospitals to our hospital without having to call and give a verbal report. I find this practice outrageous and an accident waiting to happen.
The reason behind this new policy is to expedite patient transfers and open beds faster. All I ever learned is how important patient the hand-off is, and now we are actually no longer required to give report to the next nurse who will be taking care of the patient.
Apparently now that we have the EPIC system to do our patient charting, the decision-making people feel that verbal reports are no longer needed. However, I have had several instances where EPIC contained very little patient information and virtually no history, so I literally had to ask the female patient, who was busy vomiting, why she was even admitted to the hospital. The fact that she was a stage 4 CKD patient with only one remaining kidney was nowhere to be found on EPIC. She needed pain meds, but her current medication reconciliation had not been completed, delaying her receiving any medications.
And I must also stress the last Magnet hospital I worked at did the same thing by getting rid of verbal report for patient transfers. Has anyone else been experiencing this practice, and if so, how do you deal with the huge safety risk? What happened to placing patient safety first?
In my state that would be considered patient abandonment by the BON, handoffs must include a verbal component. It's also a Joint Commission requirement.
No verbal reports from our ED to the floor. We just passed our TJC inspection with flying colors.
How does the receiving nurse ask a question of a faxed piece of paper?
Excellent question. We sign the sbar & put our extension. Before the pt is transported, we call the floor to confirm the sbar was received. If confirmed, the receiving rn can call with any questions.
This is only for stable, no tele for transport pts. Unit and/or constant monitoring still require verbal report.
As noted by several posters above, the change to faxed report was a result of throughput delays directly attributable to the ed's inability to get a floor nurse on the phone to give report.
We started the same thing at my hospital. I work in the ER. and the policy now is if the nurse on tele or med/surg doesn't take report on the first call we send transport. And it is the floors responsibility to call me when they can. It sucks bc I feel bad for the nurses upstairs. We r all busy!! The reason they put this into action is bc a lot of times it would be sometimes 2 hours after a or got a bed assigned. And people r in the waiting room. The ER wants to clear the admitted pts out so fast u don't even have time to breath anymore. It is just nuts. Then on top of it the floor nurses get mad at ME but I am just following our policy. Bc if I don't then management gets on our case if we haven't sent the pt up. It's a loose loose for all. Sorry for my fat fingers trying to type :)
Families need to be notified of things like this and explained of the bad things that can happen because of these policies. Once again, if there was adequate staffing, such issues wouldn't even happen.
Families need to be notified of things like this and explained of the bad things that can happen because of these policies. Once again, if there was adequate staffing, such issues wouldn't even happen.
I would not suggest doing this unless you want to get fired. Unless you have research, studies, and numbers to back up the "bad things" are occurring due to these policies, then you are simply spouting off opinion.
I worked at a hospital that went from verbal report to electronic report from the ER because nurses would not pick up the phone or take report - hence pat throughput was not going well. The unit coordinator gets a note saying the patient comes to the floor and the nurse has something like 45 minutes or so to read the electronic ER report. The patient hits the floor no matter what - also change of shift...
I worked in acute dialysis and one busy hospital used an SBAR form for all patients going from acute dialysis back to the floor - I filled it out and no verbal report was necessary unless something unusual happened. It is just such a busy place that nobody has time to pick up the phone all the time for reports. In a different hospital they require verbal report and it is rough to get pat out of dialysis because nurses won't take report saying it is not convenient ....
In this specific case, I would side with the acute dialysis nurses. There is no reason why a floor nurse should get a verbal report on a presumably stable floor patient who was able to leave the unit for dialysis. the only thing they need is a 15 min heads up that the patient is coming back, how much was taken off, and whether there were untoward issues.
I would not suggest doing this unless you want to get fired. Unless you have research, studies, and numbers to back up the "bad things" are occurring due to these policies, then you are simply spouting off opinion.
Well, not for anything but you don't have any evidence/research that the report-less system you're advocating is safer either.
Well, not for anything but you don't have any evidence/research that the report-less system you're advocating is safer either.
But its policy- breaking policy wil get you fired. Please don't insinuate that what I'm doing is not safe- like I said, in the years we've done it there has NEVER been compromising to a pt or the care they are receiving. Policies are in place for a reason and this is not one I'm going to fight- these policies would never have to be put into place if the floors did not show consistent delay in transfers. We don't have time for delays- people's lives depend on a bed in the ED at times- there is no reason a STABLE pt that has been worked up needs to continue to monopolize a bed in the ED bc the floor does not wish to take report.
Well, not for anything but you don't have any evidence/research that the report-less system you're advocating is safer either.
I don't think anyone said they are safer. I could argue they are, but don't have evidence. It's faster.
As for the "bad things that can happen", or as the OP said a "disaster waiting to happen", no one has yet said what those are.
I've worked where verbal reports are made, where ED reports are faxed, and where the floor nurse gets time to look at a chart before the patient comes up. I've spent most of my time on the floor, and now work in the ED.
When I was on the floor, I much preferred time to look at the chart which we did for patients from the ED over getting verbal report from the ICU and PACU. The ICU gave me way too much detail, and the PACU didn't have much to offer over what I could see in the chart. When I worked at a place where ED nurses called report, we ended up playing phone tag, and the nurse who gave report quite possibly had the one patient for a short time, many patients throughout the day, and wasn't able to provide a very good report.
Now, as a ED nurse, I can tell you that looking at the chart for a patient is likley going to give you a more accurate picture then me calling you about a patient I barely know among the few other dozen patinets I've had throughout the day.
Still, I would like to hear about all the bad things that have happened because there are not verbal reports from the ED. Anyone?
Families need to be notified of things like this and explained of the bad things that can happen because of these policies. Once again, if there was adequate staffing, such issues wouldn't even happen.
What bad things are happening because of these policies?
SC_RNDude
533 Posts
No verbal reports from our ED to the floor. We just passed our TJC inspection with flying colors.