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Bedside shift-to-shift Report

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by Alison Dunlap on 9 February 2014

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Transcript of Bedside shift-to-shift Report

Introduction
Currently, the majority of report is given at the desk
The oncoming nurse is delayed at seeing their patient for the first time their shift
Safety checks are being delayed
Points of care are being missed
Parents don't meet the oncoming nurse right away
Today:
See what has happened with other institutions that have changed to bed-side report
Data to support it
Ways to implement it
Patient Safety
visualize patient, prevent error/sentinel event, safety checks
80% of serious medical errors involve miscommunication (Reinbeck, 2013, p. 16)
Patient Satisfaction
increase communication with patients/family, feel a part of care
A hospital had a HCAHPS score for "nursing always communicated well" increase from 75%-86.7% in just 3 months, following implementation of bedside report (Radtke, 2013, p.19)
Conclusion
Bedside report has been shown to empower staff, improve patient involvement, and allow for a safe transition of care between providers. It establishes and promotes trusting relationships between patients and staff members, which serve as a foundation for teamwork
(Reinbeck, 2013, p. 16).
Image by Tom Mooring
Significance of Bedside Report
Bedside shift-to-shift Report




Significance Cont.
Nursing Satisfaction
increase nurse cohesion, decrease report time, see their patients faster
"Bedside report cultivates an environment for mentoring relationships to develop among nursing staff and create relationships of mutual respect. Nurses are able to visualize patient and implement safety checks at the start of their shift, reducing the length of time they spend at the nurses' stations and away from the bedside" (Reinbeck, 2013, p. 17)
Significance Cont.
Joint Commission
Bedside report is a Joint Commission initiative
The Joint Commission, Healthcare Reform and the Institute of Medicine are expecting that patients and their loved ones are involved in their care
According to Reinbeck (2013), "the Joint Commission advocates for healthcare facilities to create organization cultures of safety and quality that value patient-centered communications as an integral component of delivering patient-centered care. (p. 16)"
How to Integrate
How to Integrate
Make sure staff knows why bedside report is important
this will help with the "buy-in"
Give examples of how to give bedside report
SBAR, handouts, examples
Make sure people are following protocol
Management's presence, evaluations
Unfreezing, Movement & Freezing

A facility that used this model had an increase in their HCAHP score on "nurses kept you well informed" from 68.3% to 87.4%
Unfreezing-Undoing the current process
Movement-Getting people to move into the new process
Freezing-once the process is in place, making it stick.
(Olson-Sitki, et al, 2013, p. 28)
SBAR
Should explain what is happening now
Should take 8-12 sec.
State patient name, why they are on the unit, and introduce the nurse to the patient/family
Situation
SBAR

Discuss concerns and/or goals of patient/parents, discharge planning information, information to pass on to doctor or care team.
SBAR

Report the current condition
Look at medications, check IV sites, IV rates, dressings, orders
SBAR


Background information specific to the patient
health history, diagnosis, procedures
Background
Assessment
Recommendations
References
Carlson, S.A. (2013). Make it a habit: 2 weeks to bedside report. Nursing Management, 44(3), 52-54. doi: 10.1097/01.NUMA.0000427193.45066.44

Evans, D., Grunawalt, J., McClish, D., Wood, W., Friese, C.R. (2012). Bedside shift-to-shift nursing report: Implementation and outcomes. MEDSURG Nursing, 21(5), 281-292.

Olson-Sitki, K., Weitzel, T., Glisson, D. (2013). Freezing the process: Implementing bedside report. Nursing Management, 44(7), 25-28. doi: 10.1097/01.NUMA.0000431431.39008.af

Radtke, K. (2013). Improving patient satisfaction with nursing communication using bedside shift report. Clinical Nurse Specialist, 27(1) 19-25. doi: 10.1097/NUR.0b013e3182777011

Reinbeck, D.M., Fitzsimons, V. (2013). Imporving the patient experience through bedside shift report. Nursing Management, 44(2), 16-17. doi: 10.1097/01.NUMA.0000426141.68409.00

Schroeder, M.J. (2011). Looking to improve your bedside report? Try SBAR. Nursing Made Incredibly Easy, 9(5), 53-54. doi: 10.1097/01.NME.0000403196.52921.2a.

Nursing Satisfaction
before after
Average Report time 45m 29m
Nurses Satisfied w/Report 37% 78%
White Board Adherence 25% 98%

(Evan et al, 2012, p. 284)
PICO: How does the staff’s end of shift report affect patient satisfaction?
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