A Brief Note On Hourly And Rounding And Patient Satisfaction

The healthcare sector is one where all key players should strive to ensure that they do not commit any errors in their operations; because it mostly involves the decision of life and death to a human being. Hospitals, therefore, have to ensure that they work towards ensuring that their patients feel satisfied with the service that they receive upon visiting the hospital. Hospitals remain assured to improve their satisfaction scores by creating a conducive working environment that allows their employees to undergo career growth. They also align their behavior and set their minds towards the achieving the hospital’s goals and objectives. Hospital management needs to communicate with their staff and put into place measures that give priority to meeting of all the patients’ needs; so that they can successfully attain and maintain a respectable satisfaction

For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.

The results of the study showed that significant increase in patient satisfaction scores, decreased call light usage, and reduction in patients fall rates. One-hour rounding shows higher satisfaction than two hour- rounding. Hypothesis supported the study because the research shows rounding can reduce patient call light usage (Meade, Bursell, Ketelsen , 2006). The theoretical framework that forms the basis of the research is that consistent nursing rounds can meet the basic needs of patient and ultimately reduce call light use and [pic]improve management of patient care while also[pic] increasing [pic]patient satisfaction and[pic] safety.

Hourly rounding, also known as “intentional” or “comfort” rounding is essentially when the nurse or tech routinely checks on a patient at scheduled times to anticipate individual needs prior to the activation of the call bell alarm (Harrington et al., 2012). In a recent study, authors imply that hourly rounding is an effective process for improving patient satisfaction and clinical outcomes (Brosey and March, 2015). I feel that the implementation of hourly rounding will improve multiple aspects of care, including patient and nurse

An hourly rounding is an excellent precaution strategy to make sure that patients’ alarms, call lights, and personal belongings are within reach. One benefit of hourly rounding is that it is pro-active. It reduces patients’ need to get up, thus reduced falls. In Kamehameha Nursing Home, hourly round is required, but because nurses are most of the time busy, they often forget to implement it. This needs to be addressed in order to reduce the number of falls in the facility (Agency for Healthcare Research and Quality, 2013). If Universal Precautions is effectively implemented, Kamehameha Nursing Facility’s fall incident will decrease.

Hourly rounding is a strategy involving nurses and other health care staff to regularly “check in” on patients every hour. Because nursing staff is not reacting to call lights, patients are more content and happy; therefore nurses feel they are doing a better job helping their patients (Studer, 2007). Research has shown that rounding every hour lowers patient’s use of call lights and resultantly decreases the workload of the nurse (Leighty, 2007; Meade, Bursell, & Ketelsen, 2006; & Tipton, 2008). Performing hourly rounds has contributed to 20% less walking per shift

Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.

A study conducted by Young, Minnick, and Marcantonio (1996) compared the opinions of more than a thousand staff nurses, numerous nurse managers, and more than two thousand patients from 17 hospitals regarding certain aspects and perceptions of patient care needs. Interestingly, staff nurse and managers

For nurses, the workload and patient assignments are the most significant factors in their perception of their ability to provide quality care to their patients. Of course, this is directly related to nursing job satisfaction. Nursing is a career in which patient satisfaction and caregiver satisfaction go hand in hand. When the nurse is happy, he or she provides high quality care to the patient, which in turn makes the patient happy. In addition, when the patient is pleased with the care they are receiving, this makes the nurse happy and improves nurse job satisfaction.

Patients in a hospital and/or healthcare facilities have to be cared for all day and all night, everyday of the week by nurses. The usual way to fulfill this need is to divide up the day into three 8-hour shifts. Different shifts have been put into place to help improve nurse satisfaction, decrease the nursing shortage and save the hospital money. The 24-hour day is made up of two 12-hour shifts; 12 hours in the day and 12 hours at night. There has been quite an ongoing debate over the years regarding this issue of nurses working over 8 hours in a single day. Many people, such as hospital nursing administrators, have reason to believe that working long hour shifts causes more errors in

We also implement hourly rounds and we do it very similar to your facility. Nurses and techs take turns and while rounding we make sure to address the 3Ps (pain, potty, and position). Also before we leave the patient’s room we asking a key question “is there anything else I can do for you before I leave?” this really makes a big difference. On the other hand, we are making from the hourly rounds one collaborative effort, because it is not only limited to nurses and CPs, but we getting everyone involved, physicians, MSWs, PTs, OTs, speech therapists, dietitians, etc. Everyone is accountable and responsible for our patients’ care and wellbeing. This has absolutely had a positive outcome in patient’s safety and satisfaction by not only meeting

Another strength of interprofessional rounding is that it has shown to decrease medical errors, increase positive patient outcomes, and decrease length of stay. For effective patient-centered care it requires all team members to have effective communication, teamwork, and a culture of safety. Patient privacy comes to mind when coming up with a weakness of interprofessional rounding because if family members are being involved they may not know all of the pertinent information that may be shared during rounds and the patient may not want the family members to know. Interruptions during rounds can also be considered a weakness, whether it is call lights, ventilator or cardiac monitor alarms, other patient and/or family members. Being distracted during interprofessional round can cause ineffective communication, which could lead to medical errors or negative patient

One of the greatest challenges in healthcare, as well as the biggest threat to patient safety, is staffing and the nurse to patient ratio on hospital floors. Studies have shown that low staffing levels lead to increased mortality rates in patients, as well as multiple other adverse effects including falls and pressure ulcers. These adverse effects are all preventable, but policies on staffing must be in place to ensure safety for staff and patients.

Hospitals nationwide are experiencing nurse shortage and increased workloads because of shorter hospital stays, fewer support resources and higher acuity in patients (Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D., 2004). Higher nurse workloads are directly associated with job burnout and job dissatisfaction which in turn causes more voluntary nurse turnover and relates to the increased nursing shortage. According to the Missouri Hospital Association the turnover rate of nurses has increased by fourteen percent in the last five years (Browning M., 2012). Nursing shortage is a real threat to the patient population. According to the Quality Health Outcomes Model by the American Academy of Nursing by Donabedian, effects of the healthcare interventions are characterized by the environment the staff works in (Vahey et al., 2004). Donabedian describes that quality metrics can be divided into three broad categories, structural, process, and clinical.

Hourly rounding contributes in several key areas to achievement of high levels of patient satisfaction, including quality of care and patient safety. This puts patients at the center of care by building on the fundamental aspects of care, which are so important. Thus by checking in on patients in wards regularly to see whether they are comfortable and have everything they need can produce a number of positive results. Nurses