Dissemination Plan: Hourly Nursing Rounds
Ronald Douglass Jr.
Saint Joseph College of Maine
Dissemination Plan: Hourly Nursing Rounds
Hourly nursing rounds as reported by Halm (2009), is the systematic, scheduled checking of patient needs in an hourly format by nursing and associated staff. Patient needs and wants will be assessed hourly related to four basic areas: pain, posturing, potty, and proximity of commonly used items. Hourly nursing rounds is described by Deitrick, Baker, Paxton, Flores and Swavely, (2012), as an evidence based intervention, developed to anticipate patient needs, reducing unscheduled call bells, and by so increasing patient and nurse safety and satisfaction. Patient satisfaction has become increasingly important, as hospitals and other healthcare institutions have struggled to maintain levels of service, and fiscal stability in the face of increasing regulatory controls, shrinking reimbursement rates, and increased competition (Buerhaus, 2012). Patient safety has likewise become increasingly important to organizations in 2008, when the Center for Medicare and Medicaid developed a list of eight negative patient outcomes, which should never happen to patients while under the care of hospitals and other healthcare institutions. Designated as never occurrences they would no longer be eligible for reimbursement for care provided (Tevington, 2012). The first four of these conditions; falls with injury, pressure ulcers, catheter associated UTI’s and vascular associated infections, as reported by Buerhaus, DesRoches, Donelan and Hess (2009) are directly related to nursing care. Additional pressure relating to competition has resulted as the Center for Medicare and Medicaid services now collects and reports patient satisfaction data generated through patient surveys. Nursing care has been identified by Blakley, Kroth and Gregson (2011), as the driving force behind patient perceptions of safety and satisfaction. The greatest concerns expressed by patients as reported by Blakley et al. (2011) relates to nursing functions; communication, pain management, and the timely response to call bells. Nursing manages patient care prior to admission to after discharge, providing the vast majority of patient care at the point of contact Miller (2009). Hospitals and other healthcare facilities facing increasing regulations, competition and shrinking reimbursement sources, as stated by Ford (2010), are continually looking for new ways to improve nursing services, and increase patient’s perceptions of safety and satisfaction. Hourly nursing rounds are viewed as being an innovative evidence based intervention, designed to increase and improve patient / nurse interactions Ford (2010). Research
In seeking an evidenced based practice, designed to improve patient’s perceptions of safety and satisfaction through nursing care, the term hourly rounding was researched as the following PICOT formatted question. In acute care patients, how does hourly rounding compared to unscheduled care and call bell answering affect, both patient outcomes and satisfaction? MEDLINE, and CINHAL data bases were accessed in searching for related and appropriate research and quality improvement projects in determining the efficacy of hourly nursing rounds as supported best evidence based practice. Findings
Research conducted to assess the effects of the introduction of an hourly rounding schedule had on patient care, demonstrated a clear, and impressive decline in fall rates. Authors Saleh, Nusir, Zubadi, Shloul, and Saleh, (2011) reported a 75% decrease in falls. A less impressive decline in the rates of hospital acquired pressure ulcers was additionally supported through review of the literature, as was an increase in patient satisfaction with care provided. While much of the data collected by the studies researched relied on data from subjective reporting by patients and nursing...
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