What are your Thoughts on Bedside Reporting?

[Phoenix16, RN, MSN]

Many studies that have shown that bedside report is beneficial to patients; mainly because patients feel involved in their plan of care and can make corrections if needed. However, I have been experiencing the downside to that. I am all for bedside reporting, but I think it should be done only in private rooms. I say this because, recently, after giving a report on a patient who had double pneumonia(PNA), the roommate overheard the diagnosis and immediately requested to change room because of her admitting condition of asthma. This time of year, if you live up north can be brutal on the respiratory system, and on that occasion, we were full. The patient then called her family and told them about the roommates PNA diagnosis, and so they came in and was noticeably irritated and loud. That resulted in other patients hearing about the roommate's condition.

Based on situations like that, giving bedside report in double occupancy rooms are no different than discussing a patient's condition in the elevator or the cafeteria. Would that not be considered a HIPPA violation? What are your thoughts?

[NightNerd, MSN, RN]

I feel like bedside report is overrated for a few reasons, but in this case it sounds like rooming patients together is also a big problem. I will usually do report in the hallway outside of the room, then go in with the next nurse to say hello/ goodbye and see if there's anything in particular the patient wants the next shift to be aware of.

[STEMIRN, BSN, RN]

I am all FOR BEDSIDE REPORT!!!! I've had a nurse tell me in report, that a pt was currently being administered 2mg of Mg+, and after report at the nurses station, I went to introduce myself to my pt. When I looked at the pump, the IV tubing was not attached to the pt, and the Mg+ was dripping all over the stretcher. The pt was also not on the cardiac monitor, and side rails were not up. We all work with that one (or two, or three) nurse, who does not exactly follow protocols. Bed side report does not have to be long and drawn out. It can be a quick introduction, and to verify any meds currently being administered. It helps with medications errors, and keeps your pt(s) up to date with the plan of care, and knowing who the next nurse is. I feel with any critical med drip (cardiac meds, etc) the next nurse coming on should perform a rate verification at the beginning of their shift anyway. Pumps malfunction, and pts disconnect themselves are just two examples that I'm sure all of us have come across.

[Phoenix16, RN, MSN]

I feel like bedside report is overrated for a few reasons, but in this case it sounds like rooming patients together is also a big problem. I will usually do report in the hallway outside of the room, then go in with the next nurse to say hello/ goodbye and see if there's anything in particular the patient wants the next shift to be aware of.

Your suggestion sounds like the reasonable thing to do; which is what I proposed to the committee. I think information about the patient's admitting diagnosis should be done away from the patient if not in a private room, and then both nurses go in to hand off and introduce the next nurse. That is when I think the oncoming nurse should check bed alarms if applicable, any med running, IV site, insertion date etc...

[STEMIRN, BSN, RN]

I feel with some pts, bedside report can be overrated. For example, in the ED with hallway pts that came in with "c/o foot pain from stepping on a cat toy" would not exactly be at the top of my pt "bedside report" turn over.

[STEMIRN, BSN, RN]

Absolutely agree with you! Other things can be discussed in a private room, BEFORE entering the room with the off-going RN, such as when their is a difficult/demanding family member, you don't exactly want to discuss in front of the pt, AND the difficult/demanding family member.

[Phoenix16, RN, MSN]

I am all FOR BEDSIDE REPORT!!!! I've had a nurse tell me in report, that a pt was currently being administered 2mg of Mg+, and after report at the nurses station, I went to introduce myself to my pt. When I looked at the pump, the IV tubing was not attached to the pt, and the Mg+ was dripping all over the stretcher. The pt was also not on the cardiac monitor, and side rails were not up. We all work with that one (or two, or three) nurse, who does not exactly follow protocols. Bed side report does not have to be long and drawn out. It can be a quick introduction, and to verify any meds currently being administered. It helps with medications errors, and keeps your pt(s) up to date with the plan of care, and knowing who the next nurse is. I feel with any critical med drip (cardiac meds, etc) the next nurse coming on should perform a rate verification at the beginning of their shift anyway. Pumps malfunction, and pts disconnect themselves are just two examples that I'm sure all of us have come across.

I agree with everything that you posted some nurses do not follow through with their duties on the shift; however, I noticed you did not comment on the possibility of HIPPA violation. I live in a small town and I would hate for someone to know what disease or ailment I had while hospitalized only because the nurse announced it during bedside report. I would appreciate your thoughts on that. I am for it, but not if it is not a private room. Thank you for responding to my post.

[Ruby Vee, BSN]

Many studies that have shown that bedside report is beneficial to patients; mainly because patients feel involved in their plan of care and can make corrections if needed. However, I have been experiencing the downside to that. I am all for bedside reporting, but I think it should be done only in private rooms. I say this because, recently, after giving a report on a patient who had double pneumonia(PNA), the roommate overheard the diagnosis and immediately requested to change room because of her admitting condition of asthma. This time of year, if you live up north can be brutal on the respiratory system, and on that occasion, we were full. The patient then called her family and told them about the roommates PNA diagnosis, and so they came in and was noticeably irritated and loud. That resulted in other patients hearing about the roommate's condition.

Based on situations like that, giving bedside report in double occupancy rooms are no different than discussing a patient's condition in the elevator or the cafeteria. Would that not be considered a HIPPA violation? What are your thoughts?

The last time I took a HIPAA class (I've NEVER taken a "HIPPA" class), the word was that we would do our best to keep patient information private. That did not preclude double rooms; it just said you would do your best in such a situation. So no, not a violation unless you're standing at the foot of Patient B's bed and discussing Patient A's information. Physicians are the worst and most frequent offenders here, not nurses giving bedside report.

In your example, however, it looks like you have two patients feeding into each other, and perhaps it would be best to separate them.

I think bedside report is overrated. Patients (and families) often slow the whole process down by trying to "correct" information that isn't incorrect and "explain" things that really don't need explanation. Plus there's that need to speak in terms that they understand rather than using professional shorthand. I think the best of all worlds is nurse to nurse report at a location other than the bedside, then the two shifts go together to introduce the oncoming nurse to the patient, check over lines, drains, wounds, etc. But what do I know? I'm only a bedside nurse.

[MunoRN, RN]

There is good evidence to support a bedside "Safety check" as part of report, however the evidence on handoff communication does not support a full report at the bedside. There is extensive research on handoff communication, and one the well established risk factors for an ineffective report or errors are distractions during the information sharing portion of report.

[Ruby Vee, BSN]

There is good evidence to support a bedside "Safety check" as part of report, however the evidence on handoff communication does not support a full report at the bedside. There is extensive research on handoff communication, and one the well established risk factors for an ineffective report or errors are distractions during the information sharing portion of report.

Distractions like patients and family members (who don't completely understand what you're saying) attempting to "correct" the information. Or discuss Grandma's gall bladder surgery while we're discussing patient's heart surgery. Or asking for directions to a nail spa.

[Have Nurse, ADN, RN]

Many studies that have shown that bedside report is beneficial to patients; mainly because patients feel involved in their plan of care and can make corrections if needed. However, I have been experiencing the downside to that. I am all for bedside reporting, but I think it should be done only in private rooms. I say this because, recently, after giving a report on a patient who had double pneumonia(PNA), the roommate overheard the diagnosis and immediately requested to change room because of her admitting condition of asthma. This time of year, if you live up north can be brutal on the respiratory system, and on that occasion, we were full. The patient then called her family and told them about the roommates PNA diagnosis, and so they came in and was noticeably irritated and loud. That resulted in other patients hearing about the roommate's condition.

Based on situations like that, giving bedside report in double occupancy rooms are no different than discussing a patient's condition in the elevator or the cafeteria. Would that not be considered a HIPPA violation? What are your thoughts?

You bet it's a HIPAA violation.

[Have Nurse, ADN, RN]

I am all FOR BEDSIDE REPORT!!!! I've had a nurse tell me in report, that a pt was currently being administered 2mg of Mg+, and after report at the nurses station, I went to introduce myself to my pt. When I looked at the pump, the IV tubing was not attached to the pt, and the Mg+ was dripping all over the stretcher. The pt was also not on the cardiac monitor, and side rails were not up. We all work with that one (or two, or three) nurse, who does not exactly follow protocols. Bed side report does not have to be long and drawn out. It can be a quick introduction, and to verify any meds currently being administered. It helps with medications errors, and keeps your pt(s) up to date with the plan of care, and knowing who the next nurse is. I feel with any critical med drip (cardiac meds, etc) the next nurse coming on should perform a rate verification at the beginning of their shift anyway. Pumps malfunction, and pts disconnect themselves are just two examples that I'm sure all of us have come across.

I must disagree with this. Your patients are to be monitored while you are in report. You can introduce yourself on rounds, and check meds beforehand. The nurses can't leave until you are on the floor anyway, so you can ask the off-going nurse to please double-check any concerns you have before you leave report

As far as things that can go wrong, and sometimes do, yes, it needs to be addressed when it happens but HIPAA is law and there are reasons for that.

If you are that worried about a co-worker who might be on duty that day, you can request the Charge RN makes sure your patients are checked on until report is over.