The Types of Shift-Change Reports Used by Nurses

Shift change reports allow the off-going nurse to communicate with the on-coming nurse about the patient's case. Passing quality information from one shift to the next promotes patient safety and enhances continuity of care. Taped (or written) reports and verbal reports are traditional methods of exchanging data during shift change, while bedside reports are a new trend.

Taped (or Written) Reports

• With taped or written reports, the off-going nurse records patient information on audio tape or writes it down on paper for the relief nurse. She then returns to take care of her patients. The on-coming nurse either listens to or reads the report when she arrives on the unit. Health care facilities may or may not have guidelines about what information to include in the report. Without guidelines, the quality of reports is inconsistent from one nurse to the next. Information may be redundant or irrelevant. Because the two shifts do not meet face-to-face, the on-coming nurse is unable to ask questions about the patient unless she actively looks for the off-going nurse. Important details may be missing from the report, especially if the off-going nurse was extremely busy.

Verbal Reports

• With verbal reports, the on-coming nurse first familiarizes herself with the patient by looking over the Kardex. The Kardex is a card that lists basic information such as name, age and diagnosis. During the report, the off-going nurse talks about the patient, while the on-coming nurse writes down pertinent data and asks questions as necessary. Verbal reports can last anywhere from 30 minutes to 1 hour. They often lack structure as nurses recollect events that occurred during their shift rather than provide essential patient information. A major drawback of verbal reports is it takes two nurses away from the bedside; thus, patients may wait long periods at shift change to see a nurse.

Bedside Reports

• Bedside reports strive to correct the weaknesses of traditional methods by including the patient in the process. The off-going nurse introduces the on-coming nurse to the patient, and they discuss his plan of care. By being in the room, the patient listens to the report and is able to clarify areas that are confusing. He can even ask questions about his care. Individualized goals and patient progress are also included in the discussion. Therefore, the patient, the off-going nurse and the on-coming nurse are aware of the plan of care. The bedside report generally lasts several minutes per patient. It benefits the on-coming nurse because it allows her to meet the patient and interact with him. As a result, she is able to identify his needs and prioritize for the shift. The off-going nurse may even show the on-coming nurse how to use medical equipment in the room. When shifts work together face-to-face, there is a teamwork spirit that allows the nurses to achieve common goals.