HealthOctober 29, 2015

Why it's vital to standardize nursing bedside care

When a shift change is necessary, patients and nurses are more satisfied if the handoff occurs at the bedside with the incoming and outgoing nurse both present. Even though bedside reporting improves patient safety and promotes patient trust and nursing teamwork, many nurses still do not perceive it as best practice for their clients.

Studies have shown that nurse-to-nurse bedside handoff can accomplish many important goals necessary to meet the Joint Commission’s 2009 Patient Safety Goals. Bedside handoff:

  • Allows nurses to exchange necessary patient information.
  • Helps nurses to ensure continuity of care and patient safety.
  • Gives the patient an opportunity to contribute to his or her plan of care.
  • Lets the oncoming nurse visualize the patient and ask questions.
  • Encourages patients to be involved actively in their care.
  • Implements standardized handoff communication between nursing shifts.
  • Promotes patient safety and allows an opportunity for patients to correct misconceptions.

Patient privacy concerns

So, why are nurses hesitant to adopt bedside handover as a standard protocol? One reason is fear of compromising patient privacy, particularly if the patient is in a shared room. The worry that bedside handoff (and reporting) would be a violation of the Health Insurance Portability and Accountability Act (HIPAA) may be overstated. In fact, the HIPAA Privacy Rule “permits certain incidental uses and disclosures of protected health information to occur when the covered entity has in place reasonable safeguards and minimum necessary policies and procedures to protect an individual's privacy” (Office for Civil Rights, 2002, para. 1).

Dangers of reporting away from patient bedside

It can be downright dangerous to continue patient handoff away from the patient. Not only is the practice riddled with potential for miscommunication, but it also heightens distrust and dissatisfaction on the part of the patient and his/her family. Last, nurses themselves are actually more satisfied when they participate in a standardized bedside patient handover protocol.

Costly communication errors

Effective communication is essential to maintain a safe and trusting environment for clients. According to the American Nurses Association, eighty percent of medical errors are attributed to miscommunication among caregivers. Communication errors can be verbal or written and involve all members of the healthcare team. Examples include a failure to relay critical laboratory results, or neglecting to provide medication information to another caregiver. These types errors often result in preventable complications, and although they can occur at any time during client care, studies have shown that the greatest risk for miscommunication is during shift handover. Standardized bedside shift handover and reporting can greatly reduce this risk.

Patients – more involved and more informed

And, today’s clients are much more informed, thanks to the Internet, and they want to be involved in their care plan as well as be kept informed of their condition and treatment options. When the caregivers are collaborating away from the bedside, the patient is denied a chance to participate fully and/or to correct misconceptions.

Increased nurse satisfaction

While many nurses would rather be doing hands-on patient care than reports, communication and documentation are critical to safe and effective patient care. Bedside nurse-to-nurse reporting can actually reduce the time nurses spend doing reports. In a 2013 survey, following the initiation of bedside report at a major U.S. hospital, nurses reported that time spent on reports decreased, the reports were more accurate and concise, there was more staff accountability, and they achieved a greater sense of confidence in themselves.

Standardizing bedside nursing care and reporting has a direct correlation to increased satisfaction among both patients and their nursing caregivers. Nurses in professional development should explore implementing a standardized nurse-to-nurse bedside patient handover in their facilities.

Does your hospital have a bedside report protocol? If so, how does it help?  If not, what are your thoughts?

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