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Contemporary Alternative Medication

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Bedside Shift Repot
Gina Siebdrath
College of the Desert

Change-of-shift report is the time when responsibility and accountability for the care of a patient is transferred from one nurse to another. The communication that ensues during this process is linked to both patient safety and continuity of care giving. While many nurses already recognize the value of bringing report to the patient's bedside and have practiced in this manner, this remains relatively uncommon. Typically, nurse change-of-shift report has occurred at a nurses' station, conference room, or hallway. When report is given away from the bedside, the opportunity to visualize the patient and include the patient and family in an exchange of information and care planning is lost. I interviewed a few different nurses at Eisenhower Medical Center about bedside shift report and patient handoff. All of the nurses had the same response when I asked them about giving a bedside shift report. They really like the beside patient hand off, where they can point out needs for the patient, medications for the patient, status of IV’s, and continuum plan of care. While, they all agreed that giving a verbal report in front of the patient can lead to a HIPPA violation. Most common patients are not in private rooms and their neighbor will hear all of the patient’s issues. Also, there are times when a patient was agitated and combative during their shift and that is something that you do not want to say in front of the patient or their family. The best plan of action is to give report away from the patient and then do a face to face hand off in front of the patient so that they are informed and know who their new nurse is for the next twelve hours. The nurses on the unit four south at Eisenhower have recently switched to bedside shift reporting. There is an outline that nurses are to follow for bedside report. The outline does not state that all medical issues are discussed at bedside, but they are to ask the patient for five minutes for introduction of the new nurse and plan of care for the day. During this time they are to talk about any tests or procedures for the day, their IVs or drains, and activity level. Although, this conversation could lead to a HIPPA violation as well, the nurses must be cautious. The goal of bedside shift report is to improve patient satisfaction and safety. The implementation of bedside shift report has had a positive impact in patient satisfaction according to the Press Ganey survey. According to the research article I found, patients who actively participate in bedside nurse to nurse handoffs are more likely to provide input to the plans of their care. Also the researchers found staff nurses found satisfaction in bedside report through interpersonal relationships, receipt of information and accountability. Also, the nurses felt more prepared for to discuss patient care issues with physicians. (Maxon) The joint commission also did a study on beside patient handoff. During the study the nurses had to go through several training sessions and meetings to learn the transition to bedside patient handoff. The end results were positive in patient satisfaction. (Joint) The staff nurses on four south at Eisenhower also had to attend meetings, make an educational poster board and make a video tape production demonstrating a bedside patient shift report. The Institute of Healthcare Improvement uses a quality improvement model. The first thing to do for quality improvement is to act. ACT: Schedule a group meeting involving staff members and implement the plan of bedside shift report. Second is to plan. Plan: Educate the nurses regarding the policies and procedures of bedside reporting. Help empower patients by informing them of the purpose of bedside reporting. Third is to do. Do: Implement the plan into a department. Schedule times for re-education about bedside reporting. Lastly is to Check. Check: Evaluate effectiveness of implementation of floors and make refinements if adequate improvement has not taken place. (Cherry) By implementing bed side report we are trying to accomplish increased patient satisfaction and involvement in their plan of care. Utilizing patient surveys will allow the facility to see a change in improvement in quality of care. Clinical managers making patient rounds is one change that we can make that will result in improvement. Also, weekly meetings with the staff to work on ways to improve patient satisfaction. Goal 2 of the National Patient Safety goals is to improve the effectiveness of communication amongst caregivers. (Joint) This goal is directed at giving results of critical tests or diagnostic procedures in a timely manner. During a bedside report is the time to communicate these important results, because it will allow the patient to be involved in their plan of care.

References
Cherry, B., & Jacob, S. R. (2011). Chapter 8. In Contemporary nursing: Issues, trends & management. St. Louis, MO: Mosby/Elsevier.
Joint Commission. (n.d.). Retrieved from http://www.jointcommission.org/standards_information/npsgs.aspx
Maxon, P. M., Wrobleski,, D. M., & Moss, D. M. (2012). Bedside Nurse-to-Nurse Handoff promotes patient safety. MEDSURG Nursing, 21(3). Retrieved December 7, 2014.

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Bedside Shift Repot
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