26 hours ago · Coronary Care Unit Patient-Centered Bedside Shift Report (BSR) Capstone Project: Coronary Care Unit Patient-Centered Bedside Shift Report (BSR) Capstone … >> Go To The Portal
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
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.
The implementation phase includes conducting staff meetings, obtaining ongoing nursing feedback, identifying barriers and facilitators to the new practice, modifying bedside handoff based on process evaluation techniques, encouraging adherence to the new reporting practice through positive reinforcement, and continuously monitoring the compliance rate and measuring outcomes. 2,9,15-18,20,27
The SBAR communication tool can be adapted for BSR as follows. A dry erase board placed in the patient's line of vision can be used to convey information such as the names of nurses and healthcare providers and to highlight the patient's goal for the day.
S ituation: The offgoing nurse introduces oncoming nurse. The oncoming nurse greets the patient, always calling the patient by name while checking patient's wristband to verify name and date of birth. The diagnoses are also given in this section and the nurse takes this time to update the in-room patient information board.
The patient benefits from BSR too. Listening to report, the patient learns about the plan of care and the goal for the day. The BSR process acknowledges the patient as a partner and reassures the patient that the nurses work as a team. Knowing that nursing staff is getting the information needed to facilitate care decreases patient and family anxiety and improves patient satisfaction. 12,13
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