Research Paper on "Hourly Rounding of Nurses to Eliminate Constant"

Research Paper 6 pages (1879 words) Sources: 5

[EXCERPT] . . . .

Hourly Rounding of Nurses to Eliminate Constant Patient Use of Call Bells, Reduce Patient Falls and Increase Patient Satisfaction

"Can hourly rounding of nurses in hospitals and clinics eliminate patient use of call bells, reduce patient falls and increase patient satisfaction?"

Following five articles will be analyzed to answer the above research question:

Hourly Rounding: A Replication Study

Todd Olrich, Melanie Kalman, and Cindy Nigolian

Quantitative

This article is based on a quasi-experimental study which was performed to find out how the rounding protocol improve the three variables; patient fall, call light usage and patient satisfaction.

The introductory part of the article explains that it is based on Meade, Bursell, and Ketelsen's (2006) study. The next part presents the detailed literature review which is provided to show how similar studies were conducted in the past.

This study was conducted by the medical-surgical clinical nurse specialist (CNS) staff of 506 beds, northeast hospital, in United States. Two medical surgical units of same size and fall rates were selected. One unit was considered as the experimental unit and other as control unit. Data of patient falls, patient satisfaction and call light usage before the implementation of nurse rounding study was also collected from the available sources. The sample of the study was all the patients that were released from the units during the 1 year study period, i.e. N = 4,418.

Following data was collected during the study:

1. Number of falls and level of patient satisfaction collected for 6 months before intervention and 6 months during intervention

2. Call light data was collected two weeks before the study and 4 weeks during the intervention

During the study, nurses performed hourly rounding from 6:00 A.M. To 10:00 P.M. which included eight different actions. For example; greeting patient, Offering toilet help, checking environment, inform next timing of coming etc. The leader nurses also went on round three times a week to confirm from patients if nurses were really performing rounds and filling log sheet.

Different tools were used to calculate the results. The findings showed that hourly rounding affect patient fall; call light usage and patient satisfaction positively. 23%decrease was shown in fall rates, satisfaction scores also slightly improved but call light usage did not show any significant improvement .The limitations of this study include non-randomized and small sample size but researchers suggest that more accuracy and perfection is needed in performing rounds and collecting data in order to get accurate results.

Article 2: Hourly Rounding: A Strategy to Improve Patient Satisfaction Scores

Type of Study: Quantitative

Purpose: This study is also inspired by the work of Meade, Bursell, and Ketelsen (2006) and aims to find out how the use of proactive hourly rounding strategy improves the satisfaction of patients.

Review: The introductory part of the article explains that several studies have been conducted to determine how patient satisfaction can be increased and how important it is in the health care industry.

This study was conducted by the staff at Baltimore Washington Medical Center (BWMC), which is 311-bed facility and part of the University of Maryland Medical System. The article also describes briefly about the hourly rounding and the process of performing it.

In this study, specific set of actions were decided for each rounding session, where were divided into four main areas in order to meet patient needs. These included pain, personal needs, positioning and placement.

Call light logs data was collected two weeks prior to rounding and then hourly rounding was tested on assigned 51-patients samples for 3 weeks. Quantitative call light data was recorded in this time along with the data of rounding logs and phone calls made to patients within 48 hours of discharge. Random sample of patients who were not given rounds were also checked for call light and discharge phone survey.

The results showed that the there was a 52% decline in the usage of call light after performing hourly rounding, which helped in keeping nurses free and concentrating more on patient care. No falls were recorded in this 3 weeks period due to high frequency of patient contact. Other areas were not covered in this study due to brevity of the study.

It was concluded in the study that hourly rounds helps in finding out patients needs and keeping them satisfied. The research further concluded that consistent hourly rounding is a key for increasing patient satisfaction and improving the care and safety of patients.

Article 3: The Latest Evidence on Hourly Rounding

Type of Study: Quantitative

Purpose: The purpose of this study to find out the frequency and reasons for patients to use call light and also the effects of 1 and 2-hour rounding on the use of patient's call light, patient satisfaction and the rate of patient falls.

Review: It is quasi-experiment study with three study groups; i) hourly patient rounding, ii) patient rounding every 2 hours and, iii) control with no regular rounding.

This study is conducted on a very big scale consisting of 46 nursing units in 22 different hospitals of United States. Nurses which were divided into two groups followed a specific protocol and performed hospital rounds after every hour or every two hours. Different units were assigned to different nurses for studying the three study groups.

Variables were than assessed for 2 weeks and rounding was performed for 4 weeks. After intervention, follow up assessments were performed. Nurses that were responsible for doing experimental rounding were guided to inform their patients that they will be conducting rounds to perform some important actions, which included toileting assistance, environmental check up, pain assessment etc.

Due to poor results 19 units and 8 hospitals were excluded from the study which left researchers with the data of 27 nursing units and 14 hospitals. Findings showed that hourly rounding was more helpful than 2-hour rounding and no rounding. Similarly two hour rounding was effective than no rounding on patient satisfaction as it is said that something is better than nothing.

Article 4: Measuring the effect of patient comfort rounds on practice environment and patient satisfaction: A pilot study

Authors: Gardner G; Woollett K; Daly N; Richardson B

Purpose: To determine how hourly patient comfort rounds effect on patient satisfaction and nurse practice environment by implementing a model of nursing.

Review: The starting paragraph of the article gives the introduction that the hour rounding helps in patient satisfaction and improve nurse practice environment but this area has not been researched thoroughly. Considering this issue, quasi-experimental pretest randomized parallel group trial design was used to determine how hourly patient comfort rounds effect on patient satisfaction and nursing perceptions of the practice environment.

The study also included a thorough literature review which explained the importance of nurse patient interaction and communication in patient's care. It further focused on the state of patients when a call bell response is delayed, which has become a normal nursing practice. Therefore in order to solve the complex issues that rise in result of such situations, 1 or 2 hourly nursing care rounds were recommended.

In order to study the effectiveness of these rounds, hypotheses were formulated by the researchers for this quasi-experimental pilot study using non-randomized sampling. The research was performed for 8 weeks on similar surgical wards of Royal Brisbane & Women's Hospital in Brisbane, Australia. These wards were considered as experimental and control sites as per the pilot study. A sample of 61 patients and 23 nurses were in the intervention ward while 68 patients and 16 nurses were in the control ward, after their consent. Various published surveys and scales were used for doing patient satisfaction survey and nurse practice environment survey.

The results of the study did not show any significant differences between the responses of the patients in experimental and control wards regarding satisfaction or any other issues. May be this was because of the small sample size or some other limitations.

Article 5: The Impact of Nurse Rounding on Patient Satisfaction in a Medical- Surgical Hospital Unit

Authors: Donna Blakley, Michael Kroth, and James Gregson

Type of Study: Quantitative

Purpose: The purpose of the study was to investigate if the satisfaction of patients or nurses is effected by intentional nurse rounding after every 2 hours at a medical surgical unit in a small hospital.

Review: The article starts with the introduction that patient satisfaction is very important for hospitals that are pressurized to maintain the high quality service. Literature review is also provided in the article which states what studies have been conducted in the past and what researchers say about the effect of rounding of nurses on the perceptions of patients towards nurse care and attention.

Following research questions were formulated for this study, along with the other relevant questions:

1. What is the impact of intentional, regular, and consistent nurse rounding on a patient's satisfaction with his/her hospital experience?

2. What is the impact of rounding on the delivery of patient care from the nursing staff's perspective?

Case study method was used for research design,… READ MORE

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