Bedside Reporting - ONA

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Bedside Reporting

Hospital Contract Interpretation Teleconnect November 8, 2016

Presented by: Linda Haslam-Stroud, Andy Summers, Sheila Riddell & Fil Falbo

Ontario Nurses’ Association www.ona.org

Our Union. Respected. Strong. United. 2

A Form of Reporting that includes:

What is Bedside Reporting?

• Information sharing.

• Face-to-face contact.

• Transfer of accountability.


Advantages of Bedside Reporting

• Patient can correct information, misconceptions. • Patient learns nurse’s name and recognizes nurse. • Increases nurse/patient rapport. • Oncoming nurse can visualize patient and prioritize care.


Advantages of Bedside Reporting (cont.)

• Increases accountability.

• Better staff-to-staff relationships than in taped report.

• Eliminates subjective and irrelevant comments.


Disadvantages of Bedside Reporting

• Potential violation of confidentiality . *** • Waking up patients who need rest. • Nursing jargon can confuse patients. • Loss of the social aspect of nursing handovers.


Disadvantages of Bedside Reporting (cont.)

• Longer reports because patient and/or family involved.

• Avoiding certain information at bedside may necessitate second report away from bedside.


CNO Standards

• CNO endorses bedside reporting. • Which Practice Standards are relevant to bedside reporting?

1. Confidentiality 2. Documentation 3. Therapeutic Nurse/Client Relationship 4. Accountability

Professional Standards


Complying with Confidentiality Standard

• Close door and speak quietly. • Ask visitors to leave unless express consent from patient. • Chart this consent. • Discuss bedside reporting and consent when patient is

admitted and is alone. • In shared room, explain that others may overhear. Confirm

consent.


Complying with Therapeutic Nurse/Client Relationship Standard

• Talk to the patient, rather than about them. • Ensure patient has chance to ask questions. • Include the patient and family in discussions of plans and

goals. • Use professional language; no judgmental or negative

comments.

• Avoid jargon and acronyms.


Complying with Therapeutic Nurse/Client Relationship Standard (cont.)

Do not discuss: • mental health or addictions, DNRs, communicable

diseases. • embarrassing issues. • anything patient has identified they do not want to

share. • Do not give bad news or reveal diagnosis or prognosis doctor

has not yet conveyed. • Be concise but thorough. Use a tool or checklist.


Strategies and Using PRC Process

• Advocate for detailed employer policies and protocols. • Policies should address confidentiality concerns. • Need materials for patients re bedside reporting – how it is

used; whether patients can opt out. • Advocate for adequate training of staff.


Practical Applications

What can be shared? How can it be shared? • Environment • Tools • Advocacy

o Staff Unit Meetings o Committees o Unit Councils


Face-to-Face

• Who needs to be present for this type of reporting? • Contracting with the patient. • Tools.


Complying with Transfer of Accountability & Documentation Standards

• Not just end-of-shift reporting. • Tools.


Bedside Reporting – Labour Relations Issues

• Relevant collective agreement provision: Hospital Central agreement, Article 13.02 (a) Relevant Articles in Hospital Central Collective Agreement is, Article 13.01 (a) & Article 14.01(a). Normal Hours of Work & Premium Payment.

13.01 (a) The normal daily tour shall be seven and one-half (7½) consecutive hours in any twenty-four (24) hour period exclusive of an unpaid one-half (½) hour meal period, it being understood that at the change of tour there will normally be additional time required for reporting which shall be considered to be part of the normal daily tour, for a period of up to fifteen (15) minutes duration. Should the reporting time extend beyond fifteen (15) minutes, however, the entire period shall be considered overtime for the purposes of payment under Article 14.

• Many other collective agreements have similar or identical language.


Labour Relations - Article 13.02 (a)

• Normal daily tour is 7½ hours (with ½ hour unpaid meal break) unless working extended tours.

• At end of tour, extra time is normally required for reporting.

• This is part of normal tour, only if “up to 15 minutes.”

• If reporting takes greater than 15 minutes, the entire period

beyond normal daily tour is entitled to premium payment as outlined in Article 14.


Article 13.02 (a) (cont.)

14.01 (a) (Article 14.01(a) applies to full-time nurses only). If a nurse is authorized to work in excess of the hours referred to in Article 13.01 (a) or (c), she or he shall receive overtime premium of one and one-half (1½) times her or his regular straight time hourly rate. Notwithstanding the foregoing, no overtime premium shall be paid for a period of less than fifteen (15) minutes of overtime work where the nurse is engaged in reporting functions at the end of her or his normal daily tour. If authorized overtime amounts to fifteen (15) minutes or more, overtime premium shall be paid for the total period in excess of the normal daily tour…. (similar provision for part-time nurses 14.01(b).)

• Nurses should not start shift early to accommodate longer report.

• If not paid overtime for entire period, grieve. • Use Hospital-Association Committee (HAC) to raise concerns

regarding bedside reporting.


Bedside Reporting

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Bedside Reporting - ONA

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