1. Stephanie Stewart, RN Midtown Medical Center PACU

2.  Bedside reporting has been proven to improve patient satisfaction, increase their understanding of their condition and safety, and improve teambuilding of staff members (Rush, 2012).  Consideration for PACU nurses to give bedside Report Northwest Memorial Hospital. (2012). [Nurses giving report]. Retrieved from http://ww2.nmh.org/oweb/MagnetDoc/04_ep_exemplary_professional_practice/ep1_narrative. htm http://ww2.nmh.org/oweb/MagnetDoc/04_ep_exemplary_professional_practice/ep1_narrative. htm

3. ”Effective communication among health professionals is key to ensuring quality care in clinical practice” (Chaboyer, McMurray & Wallis, 20120, 27). Communication between nurses during a change in level of care is critical to the patients well being.

4. CLS Cartoonstock. (2010). Retrieved from http://www.cartoonstock.com/directory/r/respiration. asp http://www.cartoonstock.com/directory/r/respiration. asp Clear messages, use good listening skills, and watch body language  Standardized report tool plus question/answer time for clarification

5. The Handoff  Paints a picture of our patient  Done between shifts, breaks or changes in the level of care  Handoff reports are between care givers (ie tech-tech, nurse-nurse, CRNA-nurse etc.)  Standardized form “SHARQ” tool at MMC

6. (Columbus Regional Healthcare, 2010)l

7.  PACU to floor or ICU ◦ Call department to give report ◦ Wait to give report to the receiving nurse ◦ Give report to receiving nurse ◦ Transport the patient to the assigned room ◦ Rearrange room and/or equipment ◦ Await the receiving nurse to receive the patient ◦ Answer additional questions

8.  Can be a frustrating process A Geneaology Hunt. February, 2011). Retrieved from http://agenealogyhunt.blogspot.com/2011_02_01_archive.html http://agenealogyhunt.blogspot.com/2011_02_01_archive.html  TIME consuming  Floor nurse often gets tied up with other patients care  Give second “mini-report”  No one “lays eyes” on a fresh post-op patient SO…

9. Respiratory System Compromised CLS Cartoonstock. (2010). Retrieved from http://www.cartoonstock.com/directory/r/respiration.asp http://www.cartoonstock.com/directory/r/respiration.asp Fall Risk due to Anesthesia and Pain Medications

10.  Allows for a quick assessment of the patient’s status (including lines, patency of IV, surgical dressings, respiratory status, pain etc.)  Provides an opportunity of accountability

11.  Allows the patient the opportunity to ask questions  Gives a smoother transition between levels of care  Improves patient safety and satisfaction (Rush, S., 2012)

12.  Improves HCAHPS scores  Improves communication between departments  Meets three National Patient Safety Goals ◦ Patient identification ◦ Improving communication between caregivers ◦ Increases patient involvement in their own care (The Joint Commission, 2013).

13.  Some things are just HARD TO EXPLAIN without seeing first hand!

14.  PACU STAFFING ◦ Must maintain certain ratio in PACU based on acuity ◦ Potential to slow OR flow if bedside report takes too long  Floor STAFFING o Should be to where the receiving nurse can meet the PACU nurse and patient upon arrival, bedside for report o Floor charge nurse may have to take receiving nurses team to allow this to happen

15.  HIPPA Violation ◦ Patient has the right to decide who listens to the report ◦ Non communicative patients  We must follow our hospital privacy practices  Must be discrete with sensitive/social information  Nurses resistant to change

16.  Study shown in several Kaiser Permanente hospitals with 100% compliance after seven months, bedside report took 1.5-5 minutes to complete (Lin, Hughes, Katica, Dining- Zuber & Plsek, 2011).  Less than a normal “hold time” on the phone waiting to give report

17.  At MMC, Adult services started bedside shift reporting a few years ago  Well received  ICU gives bedside reports to holding when bringing down a patient  ER nurses give bedside report when bringing a patient to surgery

18.  Establish a committee to design and implement change ◦ Nurse managers from PACU, ICU, Adult services and Pediatrics ◦ Nurse representatives  Design a system that works between departments (Lin, Hughes, Katica, Dining-Zuber & Plsek, 2011)

19.  All un-needed equipment removed from room and needed items in room prior to arrival  PACU to have a daily assigned “floater” to take over care of the recovering patients left in PACU

21.  Alliod, B. (November, 2013). A transformational approach for delivering patient hand-off report using a pull vs. push methodology. Retrieved from https://stti.confex.com/stti/bc42/webprogram/Paper59455.html https://stti.confex.com/stti/bc42/webprogram/Paper59455.html  Chaboyer, W., McMurray, A., and Wallis, M. (2010). Bedside nursing handover: a case study. International Journal of Nursing Practice. 16. 27-34.  Lin, M., Hughes, B., Katica, M., Dining-Zuber, C., Plsek, P. (2011). Service design and change of systems: human-centered approaches to implementing and spreading service design. International Journal of Design, 5(2). Retrieved from http://www.ijdesign.org/ojs/index.php/IJDesign/article/view/928/348#5 http://www.ijdesign.org/ojs/index.php/IJDesign/article/view/928/348#5  The Joint Commission. (October, 2013). Hospital: 2014 national patient safety goals. Retrieved from http://www.jointcommission.org/standards_information/npsgs.aspxhttp://www.jointcommission.org/standards_information/npsgs.aspx  Rush, S. (January, 2012). Bedside reporting: dynamic dialogue. Nursing Management, 43(1). 40-44. Retrieved from http://journals.lww.com/nursingmanagement/Fulltext/2012/01000/Bedside_reporting__Dyna mic_dialogue.11.aspx# http://journals.lww.com/nursingmanagement/Fulltext/2012/01000/Bedside_reporting__Dyna mic_dialogue.11.aspx#  Columbus Regional Healthcare. (2010). SHARQ Handoff Tool.