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Change of shift report is unique to the nursing profession. During report, nurses transfer critical information to promote patient safety and best practices. Nurse-to-nurse bedside report is described as a strategy that includes the patient in the reporting process and is an innovative alternative to traditional shift report.
Shift report among nurses has been defined as "a system of nurse-tonurse communication between shift changes intended to transfer essential information for safe, holistic care of patients" (Riegel, 1985, p. 12). Report, or handoff, is unique to the nursing profession. Although shift work is a common concept, nurses are not simply changing personnel during this critical moment. Change of shift signifies a time of careful communication in order to promote patient safety and best practices. The risk exists, however, for this critical opportunity of relaying important information to become muddled by irrelevant information instead of focusing on the needs of the patient. In addition, the person at the center of the communication - the patient - is seldom part of this process. Many different approaches to shift report exist, including written report, phone recording and tape recording with possible verbal updates, or verbal reports in a designated room, nurses' station, or at the patient's bedside. In the best of circumstances, the report will be patient-focused and patient care will proceed with minimal disruption.
In a qualitative study conducted by Kerr (2001), the researcher identified report as a highly complex communication event with multiple functions. This finding highlights the importance of continuous quality assessment and improvement of this critical nursing practice to ensure continuity in patient care and best practice. The importance of an informative and effective nurse-to-nurse report has been highlighted most recently in the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) National Patient Safety Goals (NPSGs). The JCAHO recommends that organizations "implement a standardized approach to hand off communications, including an opportunity to ask and respond to questions" (p. 6). Attributes of effective handoff communication are further identified by JCAHO as interactive, up to date, and with limited interruptions.
Background
The medical-surgical cardiology unit described in this article is divided into three pods with 12 beds each. It is staffed according to an all-registered nurse (RN) model of care. Cardiology specialties include medical and...