Steps for RN/Patient Bedside Report Process
Steps for RN/Patient Bedside Report Process
1. On-coming nurse does preliminary information gathering prior to entering patient’s room for bedside report.
2. Both nurses share any sensitive information prior to entering patient’s room.
3. On-coming nurse brings clipboard with kardex, flow sheet, and care plan, into patient’s room. Computer can be brought into room if desired.
4. Off-going nurse introduces on-coming nurse and other care team members to patient.
5. The off-going nurse briefly explains to the patient what they will be doing during bedside report. This ensures that the patient knows it is a brief assessment and that their nurse will be back later. Off-going RN should maintain eye contact with patient.
Note: this is not the full head to toe assessment
6. Together, on-coming and off-going nurses perform bedside verbal report with patients to include:
a. Whiteboard update, avoiding acronyms and medical jargon
b. 0700, 1500 & 2300 – IV pump clearing
c. Review today’s goals with patient
As specific to patient status:
d. Verify doses of high risk IV medications
e. Check IV sites
f. Wound site, pulses, neurological check
g. Zero pressure monitoring lines
7. Together, on-coming and off-going nurses update whiteboard, avoiding acronyms and medical jargon.
8. Close bedside report by:
a. Asking the patient, “Is there anything that we discussed that you did not understand?”
b. Asking the patient, “Is there anything else that you would like (on-coming nurse) to know?
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