The content and context of change of shift report on medical and surgical units.

OBJECTIVE This study was conducted to describe the current content and context of change of shift report (CoSR) on medical and surgical units and explore whether nurses use computerized support during the CoSR process. BACKGROUND Change of shift report is a commonly occurring handoff that could contribute to gaps in care. METHODS Bedside, face-to-face, and audiotaped CoSRs were audiotaped and observed on 7 medical and surgical units in 3 acute care facilities in the Western United States. RESULTS Conventional content analysis revealed 4 themes: the Dance of Report, Just the Facts, Professional Nursing Practice, and Lightening the Load. Observations exposed the lack of content structure, high noise levels, interruptions, and no use of electronic health records in these facilities as a part of the report process. CONCLUSION Improvements to CoSR include determining a consistent and tailored structure for report, evaluating types of report suitable for particular units, reducing interruptions and noise, and determining content amenable to computerization.