Studies show that purposeful, hourly rounding helps limit the use of call lights, wait time for patients, reduce noise in the hospital environment, prevent falls and improve patient satisfaction. Researchers have found purposeful rounding can improve nurse satisfaction and efficiency, because it helps clinicians feel like they have more control over their time and care for patients.
In the Journal of Nursing Administration, researchers explain that a hospital stay can cause both patients and their family members or loved ones to feel stressed or anxious:
“In addition to facing bewildering medical conditions that require tests and treatments from doctors, nurses and other healthcare personnel, patients are placed in dependent roles and become socially and emotionally vulnerable. They are compelled to request assistance with basic needs as repositioning, eating and elimination. … Intentionally checking on patients at regular intervals, known more colloquially as hourly rounding, has been suggested as a primary mechanism to address basic patient needs as well as enhance patient safety and experience.”
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In addition, research from Stanford Health Care reveals that in 14 hospitals that implemented purposeful, hourly rounding, there were impressive improvements: a 12 percent increase in patient satisfaction scores, a 52 percent reduction in patient falls, a 37 percent reduction in light use, a 14 percent decline in skin breakdowns, and, at one hospital, there was even a 20 percent reduction in the distance walked every day by nursing staff.
However, despite the obvious, evidence-based benefits, purposeful, hourly rounding isn’t performed consistently in every hospital. Why? A study in the journal Nursing Management suggests that obstacles to implementing hourly rounding include “buy-in, acuity levels, time management and unexpected interruptions.” Plus, research from the Cleveland Clinic suggests that purposeful, hourly rounding isn’t always accomplished because patients are sleeping, a lack of communication with other staff members, a contradiction in policies for rounding, and even emergencies on the unit floor.
So, how can you help your clinical team improve rounding compliance and make it more purposeful? Try these tips.
1. Create a rounding protocol/program. Rounding is most effective when it is done consistently. Checking in on patients on a random basis will never result in better outcomes or better patient satisfaction. Create a protocol based on the needs of your patient population. Determine whether clinicians should round every hour or every two hours, and decide how to handle rounding during nighttime hours. Nurse leaders should also conduct administrative rounds as part of a rounding program. Administrative rounds can help boost patient satisfaction ratings. For example, leadership at Lucile Packard Children’s Hospital Stanford, a part of Stanford Children’s Health, found that adding nurse leader administrative rounds was a key factor in driving a better patient experience.
2. Develop a rounding template and script. A rounding script gives specific direction to the frontline staff who are interacting with patients on a daily—or hourly—basis. A checklist template can help nurses and staff ensure they are covering all the bases during their interaction with the patient. For example, a template may look like this:
Knock on door prior to entering and ask for permission to come in.
Use eye contact, greet the patient by name, and introduce yourself to the patient, writing your name on the whiteboard.
Address the four Ps—potty, pain, position and possessions.
May I assist you to the restroom?
What is your pain level?
Are you comfortable or do you need help changing positions?
Can I get anything for you or move items (such as food tray, telephone, nurse call button, or water) within reach?
Perform any scheduled tasks, such as completing physician-ordered treatments or procedures or administering medications.
Inform the patient of the next time a clinical team member will be back to the patient room. Prior to exiting the room, ask the patient if there is anything else you that can be done to ensure the patient feels comfortable.
Incorporate different patient scenarios: Sleep, clinical stability, etc. into the protocol.
3. Offer coaching and assistance. Rounding isn’t always easy, and patient encounters aren’t guaranteed to be pleasant experiences. Make sure the clinical team receives adequate training so that when patients share negative opinions or comments, they know how to respond—with a genuine apology, recording the problem and ensuring the issue will be addressed and resolved. Nurse leaders should also routinely go on administrative rounds to ensure that rounding is being implemented, patients’ needs are being addressed, and that care is being delivered quickly and appropriately. Plus, when nurse leaders conduct administrative rounds, they more easily see areas where more coaching is needed or recognize nurses that should be praised for their work.
At Amplion, we’re committed to helping clinicians deliver better care. The Amplion Alert Care Assurance Platform helps support clinicians, allowing nurses and nurse leaders to see up-to-the-minute data and balance clinical workflows. Plus, Amplion’s messaging and reminders suite helps enhance patient nurse call and clinical device response, rounding compliance, assure regular patient turn schedules, and assessing pain.
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