The handoff report from one nurse to the next nurse is a critical part of the nursing process. Traditionally, this report has occurred at the nurses station or in any place where communication between nurses is not impeded by beeps and alarms from monitors and IV pumps. And, wherever the location, it is usually not within earshot of the patient.
But as part of the new philosophy of patient-centered care, bedside reporting has emerged as a trend, allowing participation in health care from patients and their families.
In March 2007, Jill Tahmooressi RN, C, MBA, BS, director, medical/surgical services at Miami Children’s Hospital, introduced bedside reporting. The ward selected to test the practice was 3 Northeast. The staff of 3 Northeast had many questions and concerns, such as how to give a report in a semi-private room without breaching patient confidentiality. The solution reached was to ask parents if they would like to participate in this program or not. To date, there have not been any parents who have opted to decline on this ward.
After six months in trial, I conducted a study to find out how parents of pediatric patients feel about bedside reporting. On Sept. 27, 2007, I began a quantitative study using a four-point Likert scale questionnaire consisting of 10 questions.
To qualify for the study, the parents had to have participated in nurse-to-nurse bedside reporting on at least two occasions. Those that qualified were then chosen at random. The questionnaires were handed out to them immediately after a reporting session and were collected within the same shift.
Neither the nurses nor the parents were notified of the study prior to receiving the questionnaire. The study lasted three weeks and consisted of 50 sets of parents.
The results of the study demonstrated overwhelming support for bedside reporting from parents. We love it. We feel more involved, one patient commented.
A full 94% of parents polled strongly agreed that bedside reporting was informative to their childs condition and needs; 92% strongly felt that they were able to clearly hear what was being said. This is good because I get to hear what nurses are actually doing for my son, a patient commented.
In contrast, when asked if words used during the reports were words they understood (not filled with medical jargon), only 70% strongly agreed. So they sometimes didnt fully understand what was being said.
My most controversial question was in regard to protection of personal health information as stipulated in the U.S. Health Insurance Portability and Accountability Act.
I asked if having another patient in the room affected the parents participation in bedside reporting. The response was a resounding 98% of those surveyed strongly disagreeing, meaning it did not matter to them that their roommate could overhear the discussions pertaining to their own child.
It appears that breach of patient confidentiality in a semi-private-room setting is not as worrisome for parents as it is to nurses.
In fact, Adam Fader RN, BSN, chair of the Family Centered Care Committee, says bedside reporting has been especially beneficial for nurses caring for patients with an extensive history of nursing care because parents are able to provide valuable input.
Nurse participants are also pleased with the results. I think it’s great. It allows parents to get involved in their child’s care, says Lisa Martinez, RN.
Bedside reporting is now hospital-wide and the nurses are reporting improvement in patient care. I like bedside reporting because its a smooth transition from shift to shift and it enhances communication between the family and the healthcare team, says Melissa Iglesias, RN, BSN.
As with any new clinical practice, there is evidence of areas that can improve. Suggestions include minimizing use of medical jargon such as NPO and instead saying nothing to eat or drink. Another suggestion is to ask parents if they understood everything and if they have questions on anything said. Another is to bolster parent participation by asking direct open-ended questions.
Now I understand what the nurses are talking about, a patient commented.
Richard Bolanos, RN, CPN, is a dialysis nurse in pediatrics at Miami Children’s Hospital.