Staff and family attitudes to keeping joint medical and nursing notes at the foot of the bed: questionnaire survey.

We distributed questionnaires to all doctors and qualified nurses who had been working on the children’s wards for at least three months. We asked staff to list up to three advantages and three disadvantages of keeping notes at the foot of the bed. On about 10 occasions SGML visited the wards and distributed a questionnaire to all English speaking parents present at the time. Parents were asked about their experiences of reading their child’s notes and whether the practice of keeping notes at the foot of the bed should be continued. She collected the questionnaires after about 30 minutes. All 35 questionnaires given to nursing staff and 36 of the 39 questionnaires given to doctors were returned. Staff cited similar numbers of advantages and disadvantages (table). Ten members of staff had seen an unauthorised person (usually a family member other than parents) reading the notes. However, despite prompting, no member of staff reported any problems arising from these episodes. Concern about previous hospital attendances being overlooked arose because the old notes were kept in the ward office, not at the foot of the bed. Altogether, 105 of the 110 parental questionnaires were returned. Sixty six parents had read their child’s notes “thoroughly” and 25 had read them “briefly.” Seventy five parents felt better informed about their child’s progress. Fourteen parents valued the openness of the innovation, and 12 reported that the innovation involved them in decision making. Seventy eight parents were “not worried” about someone unauthorised reading the notes, 17 were “slightly worried,” and 8 were “very worried.” Seventy four parents who read the notes found them “very helpful.” Most (102) parents stated that they would like to see the innovation continued. Three parents suggested that the notes should be kept in the child’s bedside locker.