Increasing Patient Satisfaction Through Nurse Rounding

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).

Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014).

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.

Determining nurse-to-patient ratios in nursing facilities remains a challenge for the nursing profession. Two main staffing methods that are currently used in most nursing facilities are staffing by patient acuity using patient classification systems and staffing by mandated nurse-to-patient rations. Each method has an impact on patient outcomes, safety and overall satisfaction determined from different articles and studies done on each staffing method. There are pros and cons to each staffing methods. Nursing facilities look at many of these pros and cons when determining staffing methods that are used, cost, patient outcomes, nursing satisfaction and

Nursing-sensitive indicators are defined by the American Nursing Association (ANA) as “indicators that reflect the structure, process and outcomes of nursing care” (ANA, 2014). These indicators help define how nursing care is given by measuring the amount of nursing staff, skill level of the nursing staff, and the education level of nursing staff. These indicators depict the quality of care provided to patients and the outcomes of the care provided. Careful tracking of these indicators provides evidence for keeping current practices or for implementing new policy and procedures. A formal set of indicators measuring the impact nursing interventions have on patient care was not implemented until 1998 (Montalvo, I. (2007). With the establishment of the National Database of Nursing Quality Indicators (NDNQI), hospitals and other care settings are able to assess how nursing interventions impact patient outcomes, quality of care, and the overall work environment in health care facilities. Nursing-sensitive indicators are a quality improvement measure used to determine how the quality of nursing care is evaluated in hospitals and other healthcare facilities. Nurse sensitive indicators allow healthcare facilities to evaluate how the care they are providing is following evidence-based practices and how they can improve their practices to achieve better patient outcomes. The American Nurses Association is promoting these indicators as the definitive standards for patient care

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.

Hourly rounding is something that has been around for a while. One of the first things we learned in nursing school was that you should check on your patient every hour or every 2 hours (depending on nursing aid assistance). I started my research by looking at what hourly rounding entails. From there I found the majority of articles that think hourly rounding really does affect patient care and only a few opinion articles that think the opposite.

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.

The authors recommend that the findings originating from this study can be used as a basis to initiate protocols for implementation of bedside nursing

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

Frist, I have learned that it is very important for nurses to have a bed-side report because it gives a lot of information about the patient. Second, we must ask our patients if it’s okay for family members to stay in the room while we are assessing patients. Last, I have learned that after we finished with our assessment, we need to share our finds with the patients. Also, ask if the patients have any questions before we leave the room.