Bedside Shift Report
When does bedside shift report occur?
What is at change of shift.
What do the 5 P's stand for?
What is pain, potty, position, possessions, plan.
In what ways do we provide a Warm Welcome to our patients?
What is AIDET, HELLO, 10/5 Rule, and Managing Up
What does HEART stand for?
What is Hear, Empathize, Apologize, Respond, Thank.
A patient decided to wait for the next time a staff member was in her room to use the bathroom instead of putting on the call light. Noone was in her room for two hours and she finally put on the call light when it was really urgent to use the bathroom. She ended up having an accident. What patient experience best practice could have avoided this?
What is intentional hourly rounding
What format do we use as a bedside shift report checklist?
ISHAPED
When closing the connection with the patient you should promise to return in about an _________?
What is an HOUR
What does AIDET stand for?
What is Acknowledge (10/5 rule), Introduce, Duration, Explain, Thank
We _________ by restating the main point, allowing the individual to confirm accuracy, and reflect on the feeling.
What is Empathize
Mr. Henderson, an elderly patient, is waiting to be taken to Radiology for a scheduled chest X-ray. A transport aide walks into the room, grabs the back of Mr. Henderson’s wheelchair, and starts pushing him toward the door without saying a word. Mr. Henderson, who is hard of hearing and feeling anxious, panics because he doesn't know who the person is or where he is going. He yells for his nurse, tries to stand up (putting himself at risk for a fall), and refuses to leave the room. The transport aide becomes frustrated, leading to a delay in care and a very distressed patient. What patient experience initiative could have prevented this?
What is a Warm Welcome using AIDET or HELLO
What does ISHAPED stand for?
What is Introduce, Story, History, Assessment, Plan, Error, Dialogue.
The following should be included in the Closing Connection of Intentional Hourly Rounds
a. Pause and make eye contact when asking “what else can I do for you?
b. Pause and ask yourself “am I leaving this patient safe?
c. Let the patient know when you will return
What does HELLO stand for?
What is Humankindness, Eye Contact, Listen, Learn, Offer information and assistance.
We _________ when we avoid making excuses or placing blame on other team members or departments.
What is apologize.
Mr. Henderson arrives for his 10:00 AM appointment. Due to an emergency add-on case and staffing shortages, he is left sitting in the waiting room until 10:45 AM without any updates. When he is finally called back, he is visibly agitated and snaps at the medical assistant, saying, "My time is valuable, and nobody here seems to care!" What patient experience initiative should the medical assistant use now?
Applying the HEART Framework
Hear: The medical assistant stops what they are doing, makes eye contact, and listens without interrupting. They allow Mr. Henderson to express his frustration fully, even though his tone is sharp.
Empathize: The assistant validates the patient's feelings, showing they understand why he is upset.
Apologize: The assistant offers a sincere, direct apology without making excuses or blaming other departments.
Respond: The assistant offers a tangible solution to "fix" the issue and ensures the rest of the visit is efficient.
Thank: The assistant expresses gratitude for the patient’s patience and for his feedback, which helps the clinic improve.
Why this works:
By using HEART, the medical assistant transitioned the interaction from a confrontation to a collaboration. Instead of defending the clinic’s lateness (which would have likely escalated the patient's anger), the assistant focused on the patient's experience, effectively de-escalating the situation and restoring trust.
What are three reasons bedisde shift report is important?
What is: creates a culture of safety, develops partnerships and delivers on the promise of humankindness, improves quality, safety, and experience.
The following should be included in the Care and Safety Assessment of Intentional Hourly Rounds
a. Provide scheduled cares/treatments
b. Visual inspection of room for any safety concerns, ensure bed alarm on as appropriate
c. Ensure that patient’s belongings are within easy reach (cell phone, charger, water)
Give an example of managing up?
What is mention skill set, experience, and certifications.
___________ the individual for bringing the concern to you.
What is Thank
Patient: A 68-year-old male post-operative hip replacement patient on a continuous Heparin infusion to prevent deep vein thrombosis (DVT).
The Situation: During a shift change, the outgoing nurse gave a hurried, hallway-based report. She mentioned, "He’s doing fine, labs are stable," but failed to explicitly mention that the Heparin infusion was nearing the end of the bag and that the patient’s PTT (a blood clotting lab test) had been trending toward the high side of the therapeutic range.
Because the report was not done at the bedside, the incoming nurse did not visually check the IV pump. The incoming nurse assumed the infusion was running smoothly and was preoccupied with a new admission.
The Failure: Two hours into the new shift, the Heparin bag ran dry. Because the alarm was silenced (or unheard in the busy unit) and the infusion was not prioritized in the handoff, the line clotted. By the time the nurse noticed the pump had stopped, the patient had developed a pulmonary embolism (PE) due to the sudden cessation of anticoagulation and subsequent clot formation. What patient expereience inititiative and tool could have prevented this?
What is bedside shift report and the ISHAPED tool.
Who is accountable for bedside shift report and is there ever a time we do not complete bedside shift report?
What is everyone (all nurses) and no there is never a time we do not complete bedside shift report.
List three reasons why intentional hourly rounds is important?
1: Identifies potential changes in condition quicker
2: Reduces anxiety, worry and waiting for patients
3: Decreases need to use the call light
4: Increases sharing of concerns with caregivers quicker
5: Increases partnership in cares
6: Reduces the patient perception of “being alone”
7: Accountability time management/Quality/Safety/Experience
What is the 10/5 rule?
What is at 10 feet you connect with your eyes, nod and smile, show positive body language and at 5 feet you verbally acknowledge by saying hello and ask if the person needs assistance.
We ______ when we actively listen, recognize the concern, and promptly acknowledge the concern.
What is Hear
Nurse A is rushing to leave and decides to give report to Nurse B in the breakroom rather than in the rooms. Nurse A mentions, "The patient in 402 is stable; just keep an eye on his IV fluids." They do not enter the room together. Thirty minutes into the new shift, Nurse B enters Room 402 to perform an assessment. Upon entering, Nurse B discovers that the patient’s potassium infusion is completely empty. It was supposed to be running at a strictly controlled rate and the previous nurse had set the rate wrong in the pump. Because Nurse B had not visualized the equipment with the outgoing nurse, they had no way of knowing the infusion volume was incorrect. This led to a cardiac arrhythmia alert shortly thereafter. What patient experience best practice could have caught this error?
What is bedside shift report.