Bedside reporting is a major component of Christiana Care’s patient and family centered care initiative, which pledges commitment to partnering with our patients and families in their health care decisions. The process brings the reporting that nurses typically do during shift change—when care of a patient is being handed off from one nurse to another—into the patient room. By involving the patient in the discussion, the nursing staff is best able to welcome patients, their families and friends as partners and encourage their input. Patients and their families have an opportunity ask questions and voice any concerns they might have. Plus, nursing accountability and communication skills improve.
Not long after nursing unit 7E at Christiana Hospital launched bedside reporting, the unit’s education council decided to measure the nursing staff’s level of engagement by asking eye witnesses: the patients themselves. Nursing unit 7E cares for spine-surgery and bariatric-surgery patients. The council requested a question be placed on the GetWellNetwork, the bedside interactive computer and television service, asking patients about their experience with bedside reporting.
“The 7E management team and council members monitored bedside report closely at the beginning as staff transformed the report at shift change from a nursing station activity to something that includes the patient and family at the bedside,” said 7E Nurse Manager Jennifer Johnson, RN. “We employed the GetwellNetwork to further improve the process and follow up.”
The question is: “Have the nurses on 7E come into your room at the change of shift to review your care?” Possible answers include: “Yes,” “No,” and “I declined to participate.” There is also an option to add a comment. “No” answers prompt an automatic e-mail to the nurse manager for followup with the staff who have cared for that patient.
Between June 2011 and the end of December 2011, 666 patients responded to the prompt with positive feedback.
“Bedside report improves communication with family members and answers their questions ahead of time,” said Nicole Farrell, RN, 7E staff. “It also saves time for the nursing staff at the change of shift.”
Here are just a few patient comments:
“It’s nice to feel included in my care and knowing what is going on. Great Idea!”
“The nurses always ask for my input as well.”
“The nurses came into my room and gave report. They were very considerate of my privacy and included me in when clarification was needed. It felt good to be included in the process.”
The nurse manager/staff development specialist follows up with staff members who are not engaging patients in bedside report, and the number of “no” responses consistently remains low. Because of the great response that 7E saw through the GetWellNetwork prompt, seven other units plan to add similar patient surveys.
“The Education Council did a wonderful job launching bedside report on 7E,” says Staff Development Specialist Barbara Feeny, RN. “The staff was well prepared for the change. Patients and families prefer being involved in the plan of care and having opportunities to ask questions.”