We are all familiar with the end-of-shift “report”, in which patient care is handed off from the departing to the oncoming shift. This has traditionally involved a verbal report given at the beginning of the shift, detailing the particulars of each patient’s care since admission and what took place during the preceding shift. Pre-recorded shift reports are also 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?
Advantages
– Patients who are included in their care recover more quickly, are more likely to adhere to prescribed treatment and are more satisfied with the care provided to them.
– Patients are able to add to the discussion and ask questions of their caregivers during hand-off.
– The oncoming nurse has a firmer grasp on her patient’s needs and is better able to prioritize care.
– Accountability between shifts is improved.
– Staff relationships can be strengthened through team-building, rather than shifting blame for tasks left uncompleted.
– Nurses are more knowledgeable about their patients and can share information with physicians more effectively/efficiently.
– There is a decreased potential for errors.
– Bedside reporting takes less time than traditional reporting, therefore leading to lower costs.
Disadvantages
– Making the change to bedside reporting may be met with resistance by nursing staff who are firmly entrenched in the “old” ways of doing things.
– Some patient situations may present challenges to bedside reporting (i.e., patient has not been made aware of their diagnosis, the patient is sleeping, the patient has many questions which prolongs the report, or the patient is uncooperative).
– Costs may be high initially due to the need to train staff in the method.
The Joint Commission develops goals which are designed to improve patient safety. 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. Secondly, patients are to be actively involved in their care. Bedside nursing meets and exceeds both of these goals.
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.
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.