This is our Nursing Management professional presentation for bedside reporting

1. Bedside Reporting Role Development and Nursing Management Erin Voyles, Wendi Woolley, Dan Schmit

2. How bedside reporting relates to nursing Bedside reporting is “a strategy that includes the patient in the reporting process” during change of shift report (Caruso, 2007). Shift change is when nurses hand responsibility of patient care to another nurse andthis time period isa critical component of patient safety Detailed communication of patient status is essential to best quality nursing care

3. Types of shift change report Written report Phone recording Tape recording Verbal report in designated room Verbal report at nurses’ station Verbal report at patient’s bedside

4. Problems surrounding shift change reporting Providing adequate information Including patient regarding plan of care Communication deficits

5. The Challenge 2007 National Patient Safety Goals forHospitals (Joint Commission, 2006) Implementing a standardized approach in change of shift reporting Improving communication among caregivers and reducing sentinel eventsthat resultedfrom gaps in communication (Laws & Amato, 2010)

6. Benefits to bedside reporting Patient empowerment Patient involvement Patient centered with emphasis on team effort Patient becoming an additional resource (Caruso, 2007) Visual learning

7. Disadvantage of bedside reporting Time consuming Lack of privacy for patient information Interrupting rest Elevated patient anxiety

8. What is being done?Key Practice Points Bedside communication meets the needs of both patients and nurses (Laws & Amato 2010) Bedside reporting reassures patients that the nursing staff works as a team and allows the patient to see a transfer of responsibilities

9. Results of Implementing Beside Reporting Protocol (Laws & Amato, 2010) Posttest survey results of implementation found that nurses believed there was: Improved Patient safety Patient collaboration in plan of care Accuracy of information Patient visualization of diagnosis Staff satisfaction including encouragement of teamwork and accountability Improved planning and prioritization of nursing interventions

10. Results continued Laws & Amato (2010) found that the biggest challenge wasengaging patient during report Laws & Amato suggestedutilization of champion nurses that can communicate effectively with patient regarding plan of care

11. Patient Participation Timonen & Sihvonen (2000) identified main reasons by patients for lack of participation during bedside report: tiredness, difficulties in formulating questions, lack of encouragement, difficulties with the language used, nurses concentrating more on their papers than on them, and brevity of reporting sessions Nurses reported that patients took a more active role in report than patients thought

12. Patient Participation Suggestions to nurses to improve patient participation during bedside reporting: Encouraging patient to ask questions Using common, everyday language Concentrating on patients Giving patients more time

13. TCAB initiative Transforming Care at the Bedside (TCAB) This initiative implemented three changes to improve communication of patient care: Moved location of change of shift report to bedside Implemented the safety huddle (brief meeting with all team members prior to bedside rounds) Established nurse-physician “intentional” rounds at bedside * “The current challenge in health care is to create an environment in which open and transparent communication is the norm rather than the exception.” Chapman, 2009

14. Positive Patient Results of Improved Communication Patients reports from the TCAB initiative: Enjoyment of nurses and physicians coming in room together to talk to them A different and better experience than previous hospitalizations Higher patient satisfaction

15. Positive Staff Results of Improved Communication Staff reports from the TCAB initiative: Nurses believed that they were apart of an effective work environment TCAB units indicated a voluntary turnover less than other units in the hospital

16. Improving Communication for the sake of the patients… “Multiple tests of change have produced a sustained culture of reliable, patient-centered care in which all caregivers continually strive for optimal communication.” - Chapman, 2009

17. Synthesis Given the current studies supporting bedside reporting, those in the nursing profession should aim to increase communication tools that increase patient participation. According to Timonen & Sihvonen, bedside reporting gives the patient an active role in their own care. The overall goal is to provide optimal health care for the patient, and utilizing bedside reporting is a venuefor facilitate that goal.

18. References Caruso, E. (2007). The evolution of nurse-to-nurse bedside report on a medical-surgical cardiology unit. Medsurg Nursing, 16(1), 17-22. Chapman, K.B. (2009). Improving communication among nurses, patients, and physicians: A series of changes leads to cultural transformation at a TCAB hospital. American Journal of Nursing, 119(11), 21-25. doi: 10.1097/01.NAJ.0000362013.53342.17 Laws, D. & Amato, S. (2010). Incorporating bedside reporting into change-of-shift report. Rehabilitation nursing, 35(2), 70-74. Timonen, L. & Sihvonen, M. (2000). Patient participation in bedside reporting on surgical wards. Journal of Clinical Nursing, 9, 542-548.