Bedside Shift Report in the Nursing Presentation

Create an opportunity for patient and family to participate in care delivery.
Create a team to identify areas of improvement.
Standardize the process of BSR.
Find ways to implement nursing BSR strategy.
Direct implementation of BSR.
There are four main types of nursing reports described in literature: a written report, a tape-recorded method, a verbal face-to-face report conducted in a private setting, and off, also called a Bedside Shift Report.

Currently, the latter method is a significant topic of research in nursing. Although it is not new, studies into its effectiveness have only started appearing recently, and most of them agree that switching to bedside report is beneficial to everyone: hospital staff, patients, and their families alike.

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The ultimate goal for this project is to create an opportunity for the patient and his or her family to participate in care delivery by implementing this practice. The steps necessary to reach this goal are

The steps are taken directly from the project paper.

What is Bedside Shift Report (BSR)?
A shift report done at the patients bedside.
Occurs between the outgoing nurse, incoming nurse, patient, and patients family (if permitted).
Participants are introduced to one another.
Done in language everyone present can understand.
Report and assessment of the patient and room.
Verbal report using the SBAR+T format.
Review the incoming nurses tasks.
The patient and their family are encouraged to participate.
The patients and familys needs and concerns can be identified.
A bedside shift report is, as the name implies, a nurses shift report done in person, at the patients bedside.

It involves the two nurses changing shifts, the patient him- or herself, and his or her family. For this practices purposes, the patient defines who the family is and whether they are allowed to be present.

First of all, the outgoing nurse makes sure everyone is introduced to one another, and uses language that everyone present can understand no medical jargon that can confuse the patient.

As a part of the report, the nurses conduct focused assessment of the patient and the rooms safety.

Next, the outgoing nurse conducts a verbal reports. He or she should use the SBAR (Situation, Background, Assessment, Recommendation) with an additional step: always thank the patient.

Then the incoming nurses tasks are reviewed.

The BSR practice focuses on communication between the two nurses and the patient, who is encouraged throughout the process to participate, raise concerns and ask questions to clear up any misunderstandings. If any family is present, they are also encouraged to join, if the patient allows.

What is Bedside Shift Report (BSR)?
Use the first two slides to describe what BSR is.
What is Bedside Shift Report (BSR)?
The description is taken from the Ofori-Atta article; go into as much detail as necessary.
Patient benefits of BSR
Significant improvements to patient safety: fewer sentinel events during shift change (Ofori-Atta, 2015).
Patient falls significantly reduced (Sand-Jecklin & Sherman, 2014).
Assessment of the patient allows to check surgical wounds, pressure ulcers, other physical issues (Ofori-Atta, 2015).
Medications are verified at BSR, reducing medication errors (Sand-Jecklin & Sherman, 2014).
General patient satisfaction is improved (Dorvil, 2018).
Patients can clarify information, better set their expectations, and clear misunderstandings (Gregory, Tan, Tilrico, Edwardson, & Gamm 2014).
Patients get a clearer understanding of their care (Gregory et al., 2014).
Patients feel better informed and more engaged in their care (Dorvil, 2018).
The patient is the central focus of a health care provider. Previous studies have noted that a significant portion of sentinel events happen during the shift change, causing negative outcomes that could have been prevented. Since BSR is done in the patients presence, events lake patient falls can be responded to immediately or prevented. Furthermore, as the process includes an assessment of the patient as part of the SBAR+T model, any physical issues can be spotted, and medication pumps verified for accuracy.

As a consequence of a more personal report process that includes them, patients satisfaction increases. The two-way communication with the nurses allows them to ask any questions and voice any concerns they may have. Thus empowered, they can clear up any misunderstandings or offer feedback and suggestions, becoming better informed and engaged in their care. Furthermore, getting more opportunities to interact with nurses allows them to build trust and feel safer overall.

Patient benefits of BSRPatient benefits of BSR
Nurse benefits of BSR
Shorter report times mean less overtime, causing less stress and saving up to $143,520 in expenses (Dorvil, 2018).
Oncoming nurse can begin direct patient care sooner (Gregory et al., 2014).
Better assignment prioritization due to better communication (Ofori-Atta, 2015).
Greater report efficiency and accuracy compared to other report methods (Dorvil, 2018).
and emotional support (Gregory et al., 2014).
Improved teamwork, coordination and collaboration (Gregory et al., 2014).
Increased ability to answer physicians questions at the beginning of the shift (Sand-Jecklin & Sherman, 2014).
Less patient call-light use (Sand-Jecklin & Sherman, 2014).
Increased accountability (Ofori-Atta, 2015).
More opportunities for mentoring, coaching, and networking (Gregory et al, 2014).
Nurses can visualize the patient and build rapport (Gregory et al., 2014).
Fewer delays and to better nurse satisfaction (Gregory et al., 2014).
Nurses benefit from the implementation of BSR, as well. Studies have shown that this method takes less time than the other three shift report methods. This means less overtime is accrued in one study, over a hundred thousand dollars was saved in overtime expenses. For the same reason, the oncoming nurse can begin direct patient care sooner, and thanks to the SBAR framework, they can prioritize their assignments better. Finally, direct communication is more efficient and accurate than reading or listening to a report.

Since the incoming and outgoing nurse communicate directly during their report, they get an opportunity to socialize, tell stories, and provide emotional support to one another. Thanks to that, they collaborate and coordinate their activities better, becoming a stronger team.

Some studies have even noted that nurses can answer physicians questions better at the beginning of their shift, as they have more hands-on experience with the patient and are directly informed of any issues that may be present. Others have noted that patients are less likely to use the call-light after implementation of BSR.

Working closely together during the report also improves accountability, as the incoming and outgoing nurse can corroborate, verify, and support each others statements. It also means they can assist one another through mentoring, coaching, or networking.

Seeing the patient and talking to them directly allows nurses to build trust and rapport with them, once again contributing to those feelings of satisfaction and safety.

Ultimately, as are so much more efficient than other methods, being conducted in real-time, general nurse satisfaction tends to increase.

Nurse benefits of BSRNurse benefits of BSRNurse benefits of BSR
Drawbacks and concerns
Privacy concerns: nurses have to report potentially sensitive information in semiprivate rooms (Gregory et al., 2014).
Patients were less concerned about privacy (Sand-Jecklin & Sherman, 2014).
BSR does not violate HIPAA (Agency for Healthcare Research and Quality, 2017).
Redundancy, medical jargon, or hearing about their condition tiring and anxiety-inducing to some patients (Sand-Jecklin & Sherman, 2014).
Some nurses found BSR more stressful than other report methods (Sand-Jecklin & Sherman, 2014).
Patients can ask questions that require a long answer or cannot be answered (Dorvil, 2018).
Some nurses perceive the report time as longer. This was not supported by overtime data (Sand-Jecklin & Sherman, 2014).
Time-consuming to fully implement (Dorvil, 2018).
There are several issues related to sustainability (Dorvil, 2018).
Some outcomes rebounded to after a short-term increase (Sand-Jecklin & Sherman, 2014).
Standardization seems to alleviate these issues (Dorvil, 2018).
However, several drawbacks and concerns have been established with BSR.

Privacy is a somewhat obvious concern. After all, giving a report, talking about potentially sensitive medical issues in a semiprivate room or accidentally disclosing information the patient has not been made aware of can be an issue. AHRQ has stated that as long as reasonable precautions have been taken, BSR does not violate HIPAA. Most patients, meanwhile, dont seem to share such concerns. Some found the disturbance of the report tiring, however.

On the nurses side, some found talking in front of patients uncomfortable and BSR more stressful. Furthermore, some studies noted concerns that the report can be prolonged by patients asking difficult questions that either require an extended explanation or cannot be answered at the time. However, this is simply a matter of training: one can delay answering such questions until later. Possibly related to these concerns, some nurses claimed that the report took longer than before. Actual overtime statistics were consistently lower across studies.

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