Bedside Shift Report


A red asterisk (*) indicates required questions.

  1. Which unit do you presently work on?*
    6E
    6W
    7E
    7W
    Pool/Resource


  1. On a scale, how frequently do you perform bedside shift report? (5 being always and 1 being never) *
    1 2 3 4 5


  1. On a scale, how frequently do you see others performing bedside shift report? (5 being always and 1 being never) *
    1 2 3 4 5


  1. In your opinion, what has been going well with bedside shift report?*


  1. In your opinion, list the top three barriers with bedside shift report.*


  1. Do you feel the paper shift to shift report sheet can be eliminated? *
    Yes
    No


  1. Do you feel all of the items that are usually written on the shift to shift report sheet can be documented somewhere in EHR? *
    Yes
    No


  1. Please share any addition questions, comments, or concerns




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