Bedside shift report: Positive implications on patient care

Bedside shift report. Like it or love it, it’s a cornerstone of the nursing profession, no matter your practice area. 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, effective patient care. Patients don’t feel included when report is centralized, and errors leading to patient harm are more likely to occur.

So, if bedside shift report is so great, how can you establish this evidence-based practice inside your own organization? It takes a little planning and effort, but with the right tools and support, you can help your facility move toward a BSR care model that benefits patients the most.

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. In one study, common patient frustrations with centralized shift reporting included:

• Not hearing from nurses during change of shift
• Concerns that incoming nurses didn’t know anything about them
• Fear that nurses are hiding information
• Feeling alone, like the nurse has abandoned them

Obviously, these fears and frustrations aren’t therapeutic. But does bedside shift report really make that much of a difference?

Enhancing communication

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.

Most patients appreciate the invitation to have their questions or concerns addressed. Bedside discussions with the patient also offer an excellent opportunity to clear up any misunderstandings about the care plan. Additionally, BSR provides a chance to better understand patient expectations and goals, which helps increase compliance and the likelihood of positive outcomes.

BSR helps keep patients safe

Unfortunately, sentinel events are more likely to occur during change-of-shift when patients are left alone for longer periods of time. 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.

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.

Bringing BSR to your organization

Implementing BSR in your facility isn’t impossible, but you need the support of nursing leadership and your fellow teammates. It’s simple to adapt the SBAR handoff method to bedside reporting using the same process as you would for centralized reporting. Tools like dry erase boards can be used to communicate essential information at the bedside, like nurses’ names, daily patient care goals, medication allergies, or falls risks.

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.

Does your organization utilize bedside shift reporting, and if so - are you noticing any differences in the quality of patient care?  Leave us a comment!