Variable change of shift processes expose patients to risks and create inefficiencies:
Hear the difference yourself
The Nurses First (N1) version of Bedside Handover differs from current shift report:
Nurses will hand off patients more than 100,000 times this year at your hospital
High-reliability hospitals can’t afford to let things fall through the cracks
For 160 years, nursing has advanced by elevating tasks into elite competencies
Works with hospital complexities and reduces burnout
Yes, both Change of Shift Huddle and Bedside Handover are nursing processes that we do in the first 30 minutes of the shift.
There are a few reasons we focus on this first half-hour:
Nurses First (N1) is designed by nurses for nurses. We offer N1 to units ready to start each shift with the support and information to be our best.
N1 is designed to improve the culture, safety, and efficiency profile of nursing care. It has been developed in the field from thousands of nursing shifts and refined across dozens of implementations.
N1 units standardize and sustain the following evidence-based communication processes through each nursing shift:
Nurses in over 100 hospital units worldwide have field-tested and refined these two processes for Nurses First — timeless principles and fresh evidence-based practice.
N1 is based on a ‘pay-it-forward’ ethos of nurses caring for each other first, starting every shift feeling supported by each other.
For the first act of every shift, N1 brings the outgoing and oncoming nursing staff together in a Change of Shift Huddle, handing over the unit as if it were a patient.
Then we go to the heart of nursing by visiting the patient, transferring care and responsibility in a warm, super-professional Bedside Handover. Nurses First elevates Bedside Handover from a task into purposeful skill set we learn, practice, and role model.
Actually, since the right information and details are handed over at the change of shift, we spend less time searching for information and much less time playing catch-up and dealing with surprises later in the shift. The pay-it-forward approach is less work because it’s more proactive. The work also feels more purposeful and collaborative.
Customization happens during in-service training and launch usually happens the following Monday. When ready, the unit has the chance to try to achieve Nurses First Excellence.For participating units, implementation proceeds through several stages, culminating in Nurses First Excellence:
In-service training typically happens over a 3-day period (e.g., Tue – Thurs) so we can reach as many nurses as possible.
When >90% of nurses on a unit have been skills-verified in Bedside Handover competence, the unit has achieved Nurses First Excellence and there is a governance and accountability model in place to maintain training, verification, and service level commitments on each unit.
This is an important milestone. It means a pay-it-forward skill set is verifiable on the unit. Nurses First Excellence means nurses, leaders, and patients can have high confidence in the communication between shifts for that unit.
A unit can maintain Nurses First Excellence by refreshing verification for >90% of nurses at least every other year. This includes training and verifying the Bedside Handover skills of new hires.
In Team Huddle, the out-going charge nurse gives a 3-minute structured presentation to the entire on-coming shift, handing over the unit as if it were a patient.
Structured Bedside Handover standardizes each handover with a single-page shift report form. It uses an ISBAR framework, Review of Systems outline, and it’s customized for each unit.
The easy way to reveal frontline enthusiasm for a safer and more efficient nursing handover.
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