Patient Safety: Who Guards the Patient?
February 15, 2019
Response by Troy Nunes to “Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project” by Edward R. McAllen and colleagues (April 9, 2018)
I am writing in response to the article titled, “Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project,” (McAllen, Stephens, Swanson-Biearman, Kerr, & Whiteman, 2018). I found the article highly informative about the benefits of moving shift report to the bedside has on both patient and nurse satisfaction levels. The author’s use of evidence-based research to support bedside report adds support for nurses to use this style of shift change in their practice. However, I am writing to you because I noticed the author presented the idea with little to no setbacks, as though bedside report is something that every nurse should do every time.
While I agree that bedside report is beneficial, the author noted that some information would be withheld during report, pertaining to test results and prognoses. Reading this provoked me to reflect on instances where moving my report to the patient’s bedside would have been problematic. I work in an ICU where the family is often present in patients’ rooms and pending test results may often yield negative news. The issue is that some patients may not want personal information shared with visitors, or they may have not been made aware of their test results. Further reflection brought me to ponder whether using both a nurse-to-nurse report away from the bedside, and bedside report, could yield further benefits by allowing this information to be kept within staff and protect patient privacy.
Working in an ICU, we have recently been pushing nurses to move shift change from the nurses’ station to the patient room. Overall, our nurses have shown effort, but are still apprehensive for a number of reasons. While the author uses an increase in nurse satisfaction as a reason to use bedside report, my experience says otherwise. In addition, the author uses instances where a fall was prevented and a time where a patient’s change in the level of consciousness was caught during the study to illustrate the benefits of bedside report. Perhaps a hybrid of both traditional report and bedside report could provide higher nurse satisfaction levels while also allowing the possibility of fall prevention and level of consciousness changes to be caught.
Again, I believe the author effectively presented the use of bedside report as a positive benefit for both nurses and patients. But, I also believe there is a possibility to benefit both parties if a combination of bedside report and traditional report were to be implemented.
Troy Nunes, RN
McAllen, E.R., Stephens, K., Swanson-Biearman, B., Kerr, K., & Whiteman, K (2018). Moving shift report to the bedside: An evidence-based quality improvement project. OJIN: The Online Journal of Issues in Nursing, 23(2). Available: http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No2-May-2018/Articles-Previous-Topics/Moving-Shift-Report-to-the-Bedside.html