The Effect of Hourly Rounding on Nurse Satisfaction and Productivity
Kerri Austin
Originally Submitted November 23, 2008
Revised and Resubmitted January 10, 2009
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
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When the project is a proven success, the hospital should consider implementing hourly rounds instead of odd-hour rounds. Employee satisfaction contributes to satisfied customers. Hourly rounding promotes high-quality patient care to improve patient outcomes; this is vital in healthcare delivery today (Studer, 2007).
According to Studer (2004), 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).
Hourly rounding permits the nurse give quality care to their patients and the nurse has more time to focus on other tasks, especially patient education. This greatly improves employee satisfaction and morale.
Formative Evaluation
Formative Evaluation is the method I will use to determine if hourly rounding does indeed increase productivity (and job satisfaction) of senior nursing students. According to Gallagher (2006), “[Formative evaluation’s] goals are to find out whether the program is being effective in order to change procedures to increase efficiency” (p. 122). Formative Evaluation will consider the level of which the nurses are
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).
Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.
Safety is an essential factor in the creation of the healing environment and this is dependent on the role of the caregiver and the patient when it is possible. “Safety is a basic component of professional nursing and Caritas Processes. Safety concerns affect all of the nurse’s activities related to supporting, protecting, and correcting the environment for healing at all levels, To feel safe and protected is a basic need” (Watson, 2008, p. 13). Many factors impede the safety of patients in a healing environment such as Risk of falls, Pressure ulcers, and close calls. Ford’s literature (as cited in Woolley et al, 2012) found that “hourly rounding resulted in a 52% reduction in call light use, giving nurses more time to provide patient care and prevent patient calls” and in Bourgault et al.’s study conducted in 2006 (as cited in Woolley et al, 2012) “expected outcomes of hourly rounding included increase
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.
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
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.
Healthcare just like any other type of service industry is reliant on possessing satisfied clientele. Scheduling practices help to manage the patient flow by establishing certain guidelines regarding how late a patient can arrive, and still be seen without disrupting the patient flow
Nurse staffing have an effect on a variety of areas within nursing. Quality of care is usually affected. Hospitals with low staffing tend to have higher incidence of poor patient outcomes. Martin, (2015) wrote an article on how insufficient nursing staff increases workload and job dissatisfaction, which in effect decreases total patient care over all. When nurse staffing is inadequate, the ability to practice ethically becomes questionable. Time worked, overtime, and total hours per week have significant effect on errors. When nurses works long hours, the more likely errors will be made. He also argued that inadequate staffing not only affects their patients but also their loved ones, future and current nursing staff, and the hospitals in which they are employed. An unrealistic workload may result in chronic fatigue, poor sleep patterns, and absenteeism thus affecting the patients they take care of.
Hourly rounding also known as intentional rounding or comfort rounding is an initiative that hospitals nationwide are beginning to implement. Hourly rounding should be purposeful. “Hourly rounding is a systematic proactive nurse-driven evidence based intervention to anticipate and address needs in hospitalized patients” (Deitrick, Baker, Paxton, Flores, & Swavely, 2012, p.13). “Purposeful nurse rounds encompass a practice where nurses attend to and document scheduled patient reviews at pre-determined and regular intervals (hourly or second hourly)” (Lyons, Biunero, & Lamont, 2015, p.31).
Despite many efforts to improve staffing numbers, there is often still a staff shortage among staff in hospitals and acute care settings. While the most obvious solution to short staffing is to hire more nurses, there are also other ways to make staffing more effective. A patient acuity tool is a staffing instrument that can be used to decide how much time and attention each individual patient requires. By knowing the acuity level of each patient, charge nurses can decide how many patients each nurse can be assigned to at a time. This essay describes the way a patient acuity instrument improves healthcare outcomes by promoting patient-centered care and improving on key nurse competencies including teamwork and collaboration, quality improvement, and safety measures.
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
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