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Shadow Health Delegation questions and answers.
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Shadow Health DelegationBedside Shift Report
Holly: Mr. Liu, this is your new nurse. They'll be taking over for me.
Samuel: Hello.
Nice to meet you. I'll be checking in with you every hour or so.
Holly: All right, Mr. Liu, I'm going to hand you off to your new nurse using a Bedside Shift
Report. At Shadow General, we perform our handoffs at the patient's bedside to make sure
that you can stay involved in your care.
Samuel: Sounds good.
Holly: OK, I'm going to start with Mr. Liu's Situation . . .
Holly: Mr. Liu is a 28-year-old man with pneumothorax secondary to blunt chest trauma. He
has three broken ribs, and is being treated with a chest tube and water-seal drainage unit.
What else do you need to ask Holly about Samuel Liu's Situation?
Who is Mr. Liu's provider?
The provider name belongs in the Situation section of a Shadow General SBAR, and it's a
good idea to get a verbal confirmation of information even when it already appears in your
patient's EHR.
Bedside Shift Report
Holly: Mr. Liu reported at our ED a week ago with 3 broken ribs (left 7th-9th) after falling off
his neighbor's roof. A chest X-ray revealed that he was negative for pneumothorax. He was
observed for 8 hours and discharged with instructions to return if his symptoms worsened.
Yesterday, he was reaching for something on a high shelf when he experienced sharp chest
pain on his left side followed by difficulty breathing.
Holly: He reported to the ED within the hour, where he was diagnosed with pneumothorax
secondary to blunt chest trauma, confirmed via chest X-ray. Physical examination revealed
tracheal deviation to the left, air in the left side of the chest, and absent breath sounds on the
left side of the chest.
Holly: At 1600 hours yesterday, Mr. Liu received a 28 F chest tube, inserted at the left 4th
intercostal space, anterior axillary line.
, Holly: Mr. Liu has a hydromorphone patient-controlled analgesia pump at a concentration of
2 mg/mL. He was given a loading dose of 0.4 mg, and set up with with an on-demand bolus
of 0.1 mg. The PCA pump has a lockout interval of 10 minutes and an hourly dose limit of
0.6 mg.
Holly: Mr. Liu's vital signs are all within normal limits. His respirations are 18 per minute and
his oxygen saturation is 94%.
Holly: Current provider's orders are to monitor the chest tube and drainage unit every hour,
to record patient vitals every hour, and to monitor Mr. Liu's pain level and level of
consciousness every hour, in addition to checking the dressing at the site of the chest tube
insertion once every 2 hours.
What else do you need to ask Holly about Samuel Liu's Background?
Does Mr. Liu take any home medications or have any allergies?
You request new information, suitable to the Background section of the SBAR report, which
will support your ability to administer treatment to your patient safely and confidently.
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Bedside Shift Report
Holly: The chest tube and water-seal drainage unit are working as expected. Chest tube to
water seal, no air leak noted. No drainage. The dressing at the site of the chest tube
insertion is clean with no sign of infection. No problems. Mr. Liu is currently stable, alert and
oriented x4.
What else do you need to ask Holly about her Assessment of Samuel Liu's condition?
How effective is the pain medication?
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