Hourly Rounding In Health Care

A change I would recommend for this department is for the staff to become more aware of how rounding and pain management affects the patient experience. Another suggestion based on the objective of improving patient experience would be to continue educating staff on how patient experience plays a crucial role in the reimbursement and how it impacts not only the hospital but them as well. I also recommend that the staff should continue performing rounding and pain management as if they were still being measured so that eventually these two areas will occur automatically without even having to think about it. By doing so, it will turn into a habit and will hopefully lead to a more consistent score in these two areas. New staff should also be trained that both monitoring for pain management and rounding is standard practice for the unit. As it is a lot easier to train someone new to get into this habit earlier than it is to try and implement it later after he/she has already established a routine. Staff members that have a higher role in the department must also continue to lead by example as well, in order to instill the importance of these two areas. Lastly, I recommend that the department needs to find a way to motivate and encourage staff to do rounding and pain management effectively with more internal rewards such as staff members seeing the positive impact focusing on these two areas have on patient lives.

Providing the best care to each patient starts with providing the proper amount of staff members to each unit. Looking at the needs of different units not only allows administration to see areas for improvement, but also areas that are being handled correctly. Utilizing the indicators provided by The Joint Commission, 4 East, a pediatric medical/surgical floor, has a high rate of falls and nosocomial pressure ulcers that appears to be related to the increase overtime nurses have been working for that floor (Nightingale, 2010). Research has shown increases in adverse events have been related to nurses working over 40 hours a week (Bae, 2012).

Falls are a great health concern for hospitalized patients since it has been ranked the

(Tzeng, 2008) It would be ideal to create a fall prevention team that includes current staff who are directly involved in the care of clients. This team would include physicians, former or current staff nurses, assisting personnel, and other healthcare members since they all spend time at the patients’ bedside, and they may have insight into areas of improvement that others may not see. An interdisciplinary effort would be an overall better approach when dealing with precautions that would affect the facility’s policy and procedure changed in the facility. (Hughes, 2007) All of the members input about healthcare improvement may be highly constructive and would greatly benefit safety goals. The Joint Commission emphasizes that a better physical design of facilities may also lead to improved healthcare outcomes such as fewer patient falls. (Joint Commission, 2007)

The purpose of this article is to discuss appropriate nurse staffing and staffing ratios and its impact on patient care. Although the issue is just not about numbers as we discuss staffing we begin to see how complex the issue has become over the years. Many factors can affect appropriate nurse staffing ratios. As we investigate nurse staffing ratios we can see the importance of finding the right mix and number of nurses to provide quality care for patients.

The aim of this study was to determine whether the nurse on the acute hospital floor missing nursing care interventions leads to a greater number of patient falls, using actual fall rates gathered from the study hospitals and controlling for nurse staffing (hours per patient day) levels. The related research questions were as follows: (1) Do nurse staffing levels predict patient falls? (2) Does missed nursing care mediate the effect of staffing levels on patient falls?

Prior to the hourly rounding implementation, all the clinical staff (staff involved in patient care) will attend an hour workshop, which will cover the advantages and significance of hourly rounding to patient safety, reduction of falls, increase patient satisfaction, improved health outcomes, and financial impact to the organization. A video on how to do the hourly rounding properly and what behavior to avoid will be shown. After the workshop, the staff will do return demonstration, playing the role of the staff, while being checked off to ensure that the expectations during hourly rounding are met. This includes how to properly introduce oneself to the patients, informing the patients that the staff will be rounding every hour till 2200 then every two hours till 0600, to address their pain, possession, position, and potty needs. By performing return demonstrations, the validators (nurse managers, educators) will be able to ascertain that the staff understood and will

If there is a fall with injury, the manager has the ability to go back and check how long the call light was on prior to a fall. However, this information is not used to prevent and emphasize the relationship between the length of time a call light is on and the rate of fall. Most nurses and patient care technicians are not aware that the manager can back-track the call light and find out this information. To measure the rate of falls to the length of time a call light is answered, the nurse working on the project choose the histogram. This illustrates the length of time in the Y axis and the rate of falls in the X axis during the period of study (time frame). The histogram itself will include a control group, average answers, and delay answers to call light. This example was imported and modified from a previous study done comparing the numbers of call lights and nursing rounds by (Meade et al. 2006).

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

Rounding allows nurses to gather information in a structured way. It’s proactive, not reactive like call light responses. It’s a great way to get a handle on patient problems before they occur. It’s all about providing the best patient-driven health care… The great thing about hourly rounding is that it doesn’t benefit only the patients. (¶ 4).

Devote effort to focus on patient’s need for help with toileting, pain level, and positioning.

A fall can make wide spread consequences on the health service or can be affected seriously by the increased health care utilization. Among the fallers approximately 30% of falls result in physical injury leading to extensive hospitalization with significant hospital expenses (Tzeng & Yin 2010). Preventive care phases can support health services to regulate the spare expenditure to a greater extend. A fall in hospital consequently affects the nursing staff, which lead to impaired job satisfaction, additional work load and startling time consume. As the front line of care, nurses can prevent falls and reduce fall injury rates in acute care unit with available resources (Dykes et al. 2013). This literature review aims to assess the efficiency of planned interventions to reduce the incidence of falls in acute medical units. The discussions of the main findings of the review as well as the recommendations for further research are revealed to conclude this study.

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

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