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Changing to the Bedside
      for Report
     BY JENNIFER PEREZ, RN, BSN
What is Bedside Reporting?




 When the off-going nurse hands off report to the on-

 coming nurse at the patient’s bedside.
Why change to the bedside for hand off
               report?
Can you think of a reason?



 Research

 Provides safer care for patients.

 Increases patient satisfaction.

 More patient centered than the traditional hand off
 report.
 Meets three National Patient Safety Goals(NPSG).
Joint Commission’s NPSG’s



1.   Improve the accuracy of patient identification.

2. Improve the effectiveness of communication

     among caregivers.

3. Encourage patient’s active involvement in their

     own care.
Advantages of Bedside Report


 Builds teamwork

 Ownership and accountability

 Brief assessment/Environmental check

 Allows one to view other’s work

 Patient involvement
Advantages for Patients



 Able to voice concerns and ask questions.

 Plan interventions and set goals with their

 caregivers.

 Able to meet caregiver at the beginning of each shift.
Obstacles of Beside Report


 Patient’s status and condition

 High acuity

 Confidentiality

 Time management

 Effective communication
How can we overcome the obstacles of

          bedside report?
Overcoming Obstacles


 Patient’s role and rights during report


 Fair patient load


 Role play


 Trial run


 Shared techniques
Use of SBAR(T)

1. Situation:

    Off-going nurse – say goodbye to patient.

    On-coming nurse – introduction with AIDET.
2. Background:

    Off-going nurse – brief update of patient’s plan
    of care.

    Oncoming nurse – answer patient’s questions.
SBAR(T)

3. Assessment:

    Off-going nurse – explain and inform.
    On-coming nurse – quick physical and
    environmental assessment.
4. Recommendation:

    Off-going nurse – review the plan of care.
    On-coming nurse – validate the plan of care and
    ask questions.
SBAR(T)

5. Thank the Patient:

    Off-going and On-coming nurse – before
    leaving the room ask the patient questions.


  Use Closing Key Words:
  “ Ms. X will take good care of you.”

  “Is there anything you need right now?”
References

Baker, S. (2010). Bedside shift report improves
   patient safety and nurse accountability. JEN:
   Journal of Emergency Nursing, 36(4), 355-358.
Caruso, E. (2007). The Evolution of nurse-to-nurse
   bedside report on a medical-surgical cardiology
   unit. MEDSURG Nursing, 16(1), 17-22.
McGovern, W. , & Rodgers, J. (1986). Change theory. The
   American Journal of Nursing, 86(5), 566-567.
Trossman, S. (2009). Shifting to the bedside for
   report. American Nurse, 41(2), 7.

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Bedside report

  • 1. Changing to the Bedside for Report BY JENNIFER PEREZ, RN, BSN
  • 2. What is Bedside Reporting?  When the off-going nurse hands off report to the on- coming nurse at the patient’s bedside.
  • 3. Why change to the bedside for hand off report?
  • 4. Can you think of a reason?  Research  Provides safer care for patients.  Increases patient satisfaction.  More patient centered than the traditional hand off report.  Meets three National Patient Safety Goals(NPSG).
  • 5. Joint Commission’s NPSG’s 1. Improve the accuracy of patient identification. 2. Improve the effectiveness of communication among caregivers. 3. Encourage patient’s active involvement in their own care.
  • 6. Advantages of Bedside Report  Builds teamwork  Ownership and accountability  Brief assessment/Environmental check  Allows one to view other’s work  Patient involvement
  • 7. Advantages for Patients  Able to voice concerns and ask questions.  Plan interventions and set goals with their caregivers.  Able to meet caregiver at the beginning of each shift.
  • 8. Obstacles of Beside Report  Patient’s status and condition  High acuity  Confidentiality  Time management  Effective communication
  • 9. How can we overcome the obstacles of bedside report?
  • 10. Overcoming Obstacles  Patient’s role and rights during report  Fair patient load  Role play  Trial run  Shared techniques
  • 11. Use of SBAR(T) 1. Situation: Off-going nurse – say goodbye to patient. On-coming nurse – introduction with AIDET. 2. Background: Off-going nurse – brief update of patient’s plan of care. Oncoming nurse – answer patient’s questions.
  • 12. SBAR(T) 3. Assessment: Off-going nurse – explain and inform. On-coming nurse – quick physical and environmental assessment. 4. Recommendation: Off-going nurse – review the plan of care. On-coming nurse – validate the plan of care and ask questions.
  • 13. SBAR(T) 5. Thank the Patient: Off-going and On-coming nurse – before leaving the room ask the patient questions. Use Closing Key Words: “ Ms. X will take good care of you.” “Is there anything you need right now?”
  • 14. References Baker, S. (2010). Bedside shift report improves patient safety and nurse accountability. JEN: Journal of Emergency Nursing, 36(4), 355-358. Caruso, E. (2007). The Evolution of nurse-to-nurse bedside report on a medical-surgical cardiology unit. MEDSURG Nursing, 16(1), 17-22. McGovern, W. , & Rodgers, J. (1986). Change theory. The American Journal of Nursing, 86(5), 566-567. Trossman, S. (2009). Shifting to the bedside for report. American Nurse, 41(2), 7.

Notas del editor

  1. Report is handed off to the next nurse at the bedside in front of the patient. Family members, friends, or other team members may be present. Ask patient if they would like the report to be private.
  2. Wait for a reply from the class.
  3. Communication is improved which has been shown to decrease errors. Patient satisfaction has been shown to improve because patient’s feel like they know what is going on. Patient’s and families are involved in the POC.
  4. Both nurses can check the patient’s identification, along with the PCA settings per policy. Verify information with nurse in front of the patient, chart. Empower patients to become involved in the care.
  5. Nurses work together to provide the best care possible. Off-going nurse becomes responsible and accountable for the patient’s POC, pending tasks. On-coming nurse is able to do a brief assessment during report, including checking IVF, drains, tubes, dressings, etc.On-coming nurse can ask about overdue tasks, duties.
  6. Tell class the story about when I received a bedside report and the wrong information was given to me by the nurse according to the family.
  7. Wait for replies from the class.
  8. Explain to the patient what bedside report is and their role. Ask questions after report is finished.Lead nurses should divide heavy loads between all nurses.Practice!Trial run will be done with a group of day and night nurses. Share communication techniques and good “catch” stories.
  9. Situation: manage up; update white board; check patient identification. Background: patient’s chief complaint; treatments; medications; pending tests; special needs; involve patient.
  10. Assessment: inform about your assessment; tasks; follow-up care; check patient; IV sites; IV pumps; pain level/comfort. Recommendation: Review orders, POC, relevant info like medications, other support departments involved; patient questions.
  11. Thank you: Ask the patient about their comfort level, understanding the POC, any concerns? Off-going nurse: thank the patient.On-coming nurse: Let the patient know that you will return at a later time.