Hourly Rounding

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Hourly Rounding
Jessica Williams
Technical Communications
Allison Johnson
November 2010

Have you ever felt like you have been running from call light to call light your whole eight hour shift, haven't had any time to sit down to chart, and didn't even get a chance to get to know your patients? There is a solution out there, and it is proven to be the simplest, easiest option available; hourly rounding. Rounding on your patients every hour is proven to reduce the amount of call lights, raise patient satisfaction scores, and make the hospital a safer place for patients by reducing the amount of falls that occur. Hourly rounding on your patients is proven to reduce the amount of call lights on the unit. Call lights are both frustrating and essential features in most hospital units. Although the lights are invaluable for alerting staff to patient needs, those needs often are not emergencies, and constantly answering the calls can tie up a workday. As nursing staff, we have becoming our own worst enemy when it comes to instructing patients to use their call light. We tell the patient to push the call light if they need anything at all. This makes the patient rely on the call light as the only source of communication with the nursing staff. In order to reduce the amount of call lights when rounding every hour, you need to make sure you follow a certain dictation. Make sure to let the patient know that you are doing hourly rounding, ask if there is anything else they need before you leave, and assure them you will be back in an hour to check on them. Reminding your patient you will be back in an hour, and actually following through with this, will build trust between the patient and nursing staff. The patient is more likely to only push the call light for urgent reasons and keep the non-urgent issues for when the nursing staff returns. Lyn Ketelsen is a coach for the Studer Group, which conducted a study on hourly rounding. She says the group came up with this idea after the group would go to hospitals for consulting work. The group noticed that most nursing units are continuously reacting to events after they would happen, which kept staff agitated and under stress. When this happens, it led to call lights that weren't answered, which would anger patients. "You could see which units functioned proactively and which ones did not. There's a disparate difference, and patients feel that difference. The group devised the program of hourly rounding, along with required key language and points to cover during rounds for clients to try. They noticed a positive change and decided to study the concept. It may seem counterintuitive, but asking nurses to commit to rounding every one or two hours actually saves them time overall. That is because patients used their call lights less frequently, which led to less running back and forth for nurses. They felt they had control of the day, now the standard of care is consistent" (Ketelsen). While working on a forty-bed medical and oncology unit, we trialed hourly rounding. Down on hallway we rounded every single hour, while the other side did not. In a three hour period, on average, the hallway that was rounded on had six call lights go off, where the other hallway had twenty-one call lights. Sharp Memorial Hospital in San Diego also saw a huge success with hourly rounding. The 340-bed hospital has since implemented hourly rounding for eight hundred nurses and nursing assistants in all impatient units (Leighty). Jennifer Jacoby, RN Chief Nursing Officer of Sharp Memorial Hospital had her nursing staff wear pedometers before and after hourly rounding. She found her nurses walked 5.2 miles per shift before the implementation of hourly rounding, and 4.3 miles per shift afterward. "They were shaving 20% off the steps they were taking to meet patient’s needs by being more proactive" (Leighty). Using the correct dictation when rounding hourly on your patients will...
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