bedside report patient turnover

BSR is defined as “the change-of-shift report between the offgoing nurse and the oncoming nurse that takes place at the bedside. This makes patients a part of the process in the delivery of care.” Although BSR is a relatively new concept, there have been facilities who have performed BSR for almost 40 years.

Full Answer

Can bedside shift report improve patient outcomes?

Most importantly, research indicates that bedside shift report, or BSR, can improve patient outcomes. What is Bedside Shift Report? BSR is defined as “the change-of-shift report between the offgoing nurse and the oncoming nurse that takes place at the bedside. This makes patients a part of the process in the delivery of care.”

Is bedside reporting becoming more and more common?

These days, with the goal of increasing patient’s involvement in their own care, bedside reporting is becoming more common. What are the advantages and disadvantages of receiving the report at the patient’s bedside? We are all familiar with the end-of-shift “report”, in which patient care is handed off from the departing to the oncoming shift.

How do you write a bedside report on a patient?

It should start outside of the patient's room covering the general information history what's occurred, then kind of go through a head‐to‐toe assessment of what's going on. Then you go into the room and you can finish the bedside report at the bed, looking at all of the things that you might have noted.

Where can I find nurse-to-nurse bedside shift report implementation handbook?

Nurse bedside shift report implementation handbook. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy3/Strat3_Implement_Hndbook_508.pdf. 26. Caruso EM. The evolution of nurse-to-nurse bedside report on a medical-surgical cardiology unit. . 2007;16(1):17–22.

What is a nurse bedside shift report?

Nurse bedside shift report, or handoff, has been defined in the literature as a process of exchanging vital patient information, responsibility, and accountability between the off-going and oncoming nurses in an effort to ensure safe continuity of care and the delivery of best clinical practices.2 -6There are different types of nursing reports described in the literature, but the four main types are: a written report, a tape-recorded report, a verbal face-to-face report conducted in a private setting, and face-to-face bedside handoff.3,4,7,8

How does a bedside shift report help?

Systematic literature review studies point out that implementing nurse bedside shift report can improve the patient experience with care as related to nurse communication.8,9 ,11For example, Mardis and colleagues conducted a systematic literature review of 41 articles related to the use of bedside shift report and concluded that 49% of the reviewed literature identified an increase in patient experience with care as a self-reported outcome, whereas only 2% of the reviewed studies identified patient complaints with this practice.11Sherman and associates also found patient advantages in relation to nurse bedside shift report, such as patients being more informed about and engaged in their care, improved nurse-patient relationship, and improvement in overall patient satisfaction.8

What is the knowledge phase in nursing?

The knowledge phase is defined as the time when bedside handoff is introduced to the nursing unit(s) and organization, and the following interventions take place: leadership support and commitment, relationship building, staff meetings, and nursing education.4,15,17,18-20,27Providing education can take the form of a journal club, formal training in bedside shift report practice through written and video materials, educational sessions that offer case scenarios based on nursing feedback, staff communication skill development training, and mandatory continuing education and annual performance competencies.2,9,11,16-18,20,27

What is a nurse bedside handoff?

The only nursing report method that involves patients, their family members, and both the off-going and the oncoming nurses is face-to-face bedside handoff.3This type of nursing report is conducted at the patient's bedside and has different variations. In broad terms, nurse bedside shift report can be classified into two categories: “blended” and face-to-face bedside handoffs.8,10The “blended” bedside shift report can be defined as a nursing handoff composed of two parts: Half of the report is written or conducted in a face-to-face approach in a private setting and the other half of the report is conducted face-to-face at the patient's bedside. The face-to-face nurse bedside shift report is solely conducted at the patient's bedside.8

What are the five steps of Everett Rogers' bedside shift report?

The concepts that have been used in the literature for achieving acceptance and sustainability of nurse bedside shift report follow Everett Rogers' five-step approach to adoption of innovations: knowledge, persuasion, decision, implementation, and confirmation. 28

What are the disadvantages of bedside shift?

These included difficulties understanding the report and medical jargon, tiredness as a result of information being repeated multiple times, lack of privacy, anxiety over incorrect information or too much information, and inconsistency with how the nurse bedside shift report was conducted.8,22,23

Why don't nurses do bedside shifts?

Studies also reported a number of reasons why some nurses don't prefer bedside shift report, including that they may have little awareness of and skills with engaging in a patient-centered approach to care, and that they may feel uncomfortable talking in front of patients and intimidated if patients ask questions for which they don't have answers. 7,24They may also be afraid to unintentionally disclose medical information unknown to the patient and may have concerns about violating patients' privacy.9,21But the main nursing disadvantage in relation to bedside shift report that's been reported in the literature is longer change-of-shift report time as a result of patients interrupting nurses during the process.8

Why do nurses use BSR?

But research also shows that BSR helps decrease the frequency of both sentinel events and medication errors that could harm patients. When handoff occurs at the bedside, both nurses have the opportunity to review medications, check pump rates, and discuss patient allergies and potential adverse drug reactions. Additionally, oncoming nurses learn about any changes to physical assessment findings or the plan of care and can review the patient’s health history with both the departing nurse and the patient.

What is centralized report?

Centralized reports, from the patient perspective. Most patients want to be part of their healthcare experience. But many complain that report occurring away from the bedside makes them feel alone, like they’re just another cog in the healthcare wheel.

Why is BSR important?

Effective communication is a key driver to improvements in the delivery of high quality patient care and patient safety. BSR is the perfect time to develop the nurse-patient relationship, building trust and confidence in care. The nurse-patient relationship is strengthened when patients are free to ask questions about their care, share information about their personal medical history and needs, and take an active role in the planning and decision making process.

Why do sentinel events occur?

Sentinel events also occur more often due to handoff errors. Indeed, some research shows that miscommunication between healthcare providers during shift change may contribute to at least 35% of all sentinel events.

Where is a BSR carried out?

In many facilities, bedside shift report (BSR) is carried out behind closed doors, either at the nurse’s station or in a private office. Some healthcare organizations even allow nurses to record their reports for the next shift to listen to later. But a growing body of research indicates that shift report away from the bedside isn’t ideal for safe, ...

Can you decline BSR?

Even though BSR has big benefits for patients, you may still worry about discussing sensitive medical information in front of the patient and any other people that may be in the room, like visitors. After all, HIPAA violations are no laughing matter. But your patient always has the right to decline participation in BSR, and they can ask visitors to give you privacy while the report is given. In fact, encouraging your patient to say “no” to BSR if they aren’t comfortable is empowering and helps your patient trust you even more.

Is it safe to shift a report away from the bedside?

But a growing body of research indicates that shift report away from the bedside isn’t ideal for safe, effective patient care. Patients don’t feel included when report is centralized, and errors leading to patient harm are more likely to occur.

Why are nurses always on the same page during the report?

Nurses are always on the same page during the report because they're both looking at the same information at the same time. 12. The patient benefits from BSR too.

How many people died from BSR in 2010?

According to the Inspector General Office, Health and Human Services Department, less-than-competent hospital care contributed to the deaths of 180,000 Medicare patients in 2010. However, the real number may be higher: According to one estimate, between 210,000 and 440,000 patients who go to ...

How did BSR save a patient's life?

Federwisch gives an example of how BSR saved a patient's life at one facility. 9 A postoperative patient prescribed patient-controlled analgesia was given an antiemetic at 1910 just before change of shift. When two nurses entered her room at 1920 for the BSR, her respiratory rate had dropped to 6 breaths/minute. One nurse stayed in the room while the other obtained and administered naloxone as per protocol. The patient quickly recovered without complications. Had the nurses been engaged in traditional shift report away from the patient, the result could have been tragic.

What is BSR in nursing?

By definition, BSR is the change-of-shift report between the offgoing nurse and the oncoming nurse that takes place at the bedside. This makes patients a part of the process in the delivery of their care.

What is BSR in healthcare?

The Agency for Healthcare Research and Quality (AHRQ) defines BSR as “an opportunity to make sure there is effective communication between patients and families and nursing staff.” It also states that one of the rationales for BSR is the creation of an environment where patients, families, clinicians, and hospital staff work together to improve the quality and safety of care. 7 Research has shown that when patients are that third voice engaging in decisions that impact their health, measurable improvement in safety and quality result. 8

Why is BSR important in nursing?

Because nurses are the first line of defense when it comes to patient safety, BSR is an integral part of the care plan. The nurse is accountable for the communication that occurs during the change-of-shift report.

Why should time be set aside before or after BSR?

If the patient wants complete privacy during this time, the nurse can courteously ask family and friends to leave to allow interaction between nurse and patient. In addition, time should be set aside before or after BSR for the sharing of sensitive information that hasn't been told to the patient with the oncoming nurse.

Why do nurses shift?

Nurse shift changes require the successful transfer of information between nurses to prevent adverse events and medical errors. Patients and families can play a role to make sure these transitions in care are safe and effective.

Why is patient engagement important in healthcare?

Research shows that when patients are engaged in their health care, it can lead to measurable improvements in safety and quality. To promote stronger engagement, Agency for Healthcare Research and Quality developed the Guide to Patient and Family Engagement in Hospital Quality and Safety, a tested, evidence-based resource to help hospitals work as partners with patients and families to improve quality and safety.

Why are Word and PowerPoint files provided to hospitals?

Word and PowerPoint files are provided so that hospitals can tailor them for their organizations.

What is Bedside Shift Report?

BSR is defined as “the change-of-shift report between the offgoing nurse and the oncoming nurse that takes place at the bedside. This makes patients a part of the process in the delivery of care.” Although BSR is a relatively new concept, there have been facilities who have performed BSR for almost 40 years.

Bedside Shift Report – the Rewards and Evidence

Though many nurses have concerns when BSR is initiated, most nurses find that BSR is a great way to interact with their coworkers and with their patients as it promotes teamwork and increases patient satisfaction. This is often because of communication – during traditional nursing report, information may be left out or forgotten.

BSR Concerns

Despite its benefits, many nurses have concerns with BSR. For example, BSR can be difficult when the patient is sleeping. The question arises whether to wake the sleeping patient or allow them to continue to rest. This can be amended by discussing BSR with the patient immediately upon admission and asking them their preference.

How to Perform BSR

Each facility will need to implement a BSR that works best for their staff. In order to do this, it is recommended to begin with one unit as a pilot. Starting BSR on a smaller scale allows for staff to determine what works – and what doesn’t.

About The Author

Krystina is a 30-something RN, BSN, CDE who has worked in a variety of nursing disciplines, from telemetry to allergy/immunotherapy to most recently, diabetes education. She is also a writer and has enjoyed expanding her writing career over the past several years. She balances her careers as a nurse and a writer with being a wife and a mother.

What is the purpose of shift hand offs in bedside nursing?

Bedside nursing addresses two different goals as set forth by the Joint Commission: first, shift hand-offs are to provide accurate and timely information regarding the current condition, care, treatment and recent/anticipated changes in patient condition.

Is bedside reporting better than traditional reporting?

The advantages of bedside reporting seem to outweigh any disadvantages. Patients, nurses and physicians are more satisfied with this type of reporting over traditional reporting. Most importantly, bedside reporting has proven to be safer in terms of prevention of errors.

Is Catholic Healthcare West changing to bedside reporting?

Numerous hospitals have switched to bedside reporting. A recent example published in Nursing Management (January, 2012) describes the experience of Catholic Healthcare West in changing from a traditional model of reporting to bedside reporting. Although the process was time-consuming, results show that patients are more satisfied with their care since the implementation of bedside reporting. Patient satisfaction scores have improved in numerous areas, including the patients’ perceptions about the amount of time staff spends with them, their understanding of their health condition, and feeling included and informed regarding their condition.