| Primary Author: | Maria Gonzales, RN, AND, PCCN |
| Co-Principal Investigators/Collaborators: | Andreann Broglia, RN, AND, Grace Nabas, RN, MSN, Jennifer Borrelli, RN, BSN, Kathryn Jaramillo, MS,RN, CNS-BC |
| Organization | El Camino Hospital |
Abstract
Purpose
To determine if implementation of a staff-developed process for tailoring hourly rounding to patients’ needs improved nursing culture and acceptance of the practice.
Background
Ample research supports the benefits of hourly rounding on patient safety and satisfaction, decreased falls, decreased incidence of hospital acquired pressure ulcers and fewer call light usage (Halm, 2009; Ford, 2010). But how do you get buy-in from staff to create a meaningful culture change?
Materials & Methods
Bedside nurses and nursing assistants on a Stroke-Telemetry Unit reviewed evidence and collaboratively determined a strategy: leaders from each shift as trainers/mentors, sharing the hourly rounding commitment, and adapting the rounds to meet the specific needs of each patient. Before and after implementation, staff were surveyed for perceptions on a) current communication with patients; b) attitudes toward hourly rounding; and c) how purposeful rounding should be done.
Results
At baseline, staff were not completely satisfied with communication with their patients, but uniformly agreed that frequent interactions would improve safety. They conveyed the need to shape hourly rounding to be realistic and applicable, and had mixed opinions regarding a script vs. daily determination between nurse and patient on rounding purpose. After implementation of a program of hourly rounding that was tailored to the shift, nurse, and flexibility of patient needs, staff satisfaction with interactions with patients improved significantly (p=.036).
Conclusion
Tailoring rounding to match the unique culture of each unit and allowing frontline staff to decide on best-fit rounding strategies have facilitated support for this patient-centered practice. A gradual implementation process has been embraced and champions have been made who are establishing ownership in this new environment. When stories of success are communicated by their peers, nurses are more likely to feel positively about the program. Improvement in nurse satisfaction with patient interactions may be a result of this empowerment of frontline staff in designing change.
Bibliography
Davies, K. (2011). Hourly patient rounding: Effective programs decrease call bells and falls, and increase patient and staff satisfaction. Advance for Nurses. Retrieved from http://nursing.advanceweb.com/Continuing-Education/CE-Articles/Hourly-Pa…
Federwisch, A. (2008, September). Collaboration helps hospitals fine-tune hourly rounding. Nurse.com. Retrieved from http://news.nurse.com/apps/pbcs.dll/article?AID=/20080908/CA01/109080109
Ford, B. (2010). Hourly rounding: A strategy to improve patient satisfaction scores. Medsurg Nursing, 19(3), 188-191.
Halm, M. (2009). Hourly rounds: What does the evidence indicate? American Journal of Critical Care, 18(6), 581-584.
Leighty, J. (2007, January). Hourly rounding strategy dims nurse call light volume. Nurse.com. Retrieved from http://news.nurse.com/apps/pbcs.dll/article?AID=200770111056
Mazurek-Melnyk, B. (2007). The latest evidence on hourly rounding and rapid response teams in decreasing adverse events in hospitals. Worldviews on Evidence-Based Nursing, 4(4), 220-223.
McCartney, P. (2009). Hourly rounds: An evidence-based practice. The American Journal of Maternal/Child Nursing, 34(5), 327.
Meade, C., Bursell, A., & Ketelsen, L. (2006). Effects of nursing rounds on patients’ call light use, satisfaction and safety. American Journal of Nursing, 106(9), 58-70.
© Improvement Science Research Network, 2012
The ISRN published this as received and with permission from the author(s).