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Hourly Rounding In Nursing

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Change is inevitable not only in the hospital setting but also in all other organizations that put the safety of stakeholders at hand. It is, however, sometimes challenging to have all stakeholders adopting a proposed change since some individuals would rather stick to the old ways of doing things as opposed to trying out new interventions (Guse, Peterson, Christiansen, Mahoney, Laud, & Layde,, 2015). Nevertheless, positive change is essential, especially when such a change is expected to positively impact on the safety of patients (Johnson, Veneziano, Green, Howarth, Malast, Mastro, Moran, Mulligan, & Smith, 2011). The purpose of this paper is to critique the adoption of hourly rounding as a nursing intervention for preventing falls. …show more content…

During the extended hospital stay, the cost of treatment also increases, sometimes by about 61 percent of the normal charges for treatment (Guse et al., 2015). Evidence based practice has shown evidence that hourly rounding can decrease the general hospital stay significant while at the same time cutting down the cost of treatment through reduction of falls. Nurses against this change complain of increased commitment on other duties, making it difficult for them to attend to their patients within the hour (Marquis & Huston, 2015). It should, however, be understood that hourly rounding may never be successful without teamwork. The absence of one nurse during the hourly rounding should be substituted by another nurse without regular complaints about personal patients. The effectiveness of hourly rounding has been clearly outlined by various evidence based materials and nursing literature, guaranteeing its adoptability (Fagan, 2012). All the same, it is most for the healthcare organization to found out ways of making hourly rounding a policy, in order to help nurses internalize the strategy as part of normal caring

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State-mandated nurse-to-patient ratios remains a controversial topic in healthcare. Sufficient nurse staffing is key to ensure adequate patient care, while scarce staffing effects patients’ safety and puts nurses at risk for burnout. Determining nurse-to-patient ratios in nursing facilities remains a challenge for the nursing profession. There are many factors to consider when determining staffing methods, such as cost, nurses’ satisfaction, patient outcomes and safety. Mandating ratios is one attempt at ensuring nurses’ workloads do not exceed what is needed for adequate patient care and safety.

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Nurses will be assigned the even hours and nurses aids will be assigned the odd hours. The pilot trial for hourly rounding will continue for six months. On the first Monday of each month the interprofessional team will meet to discuss the results of hourly rounding as well as staff and patient feedback. With the collection of data over the next 6 months the team will evaluate if there is a decrease in patient injury and falls as well as in increase in patient

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These interventions included educating patients consistently about the important of getting assistance to get out of bed and go bathroom, providing information to increase patient knowledge about fall precaution, the reason why he or she was risk for falls and what specific actions they should avoid. The most important that, the nurse should to let the patient know that calling for help is not a bother to the nurse. They also found out that fall risk assessment, fall prevention, closer supervision of patient and hourly rounding were not performed or done as its policies. The findings in case reviews suggested that despite use of multiple fall prevention intervention, all falls are not preventable, but they also highlighted the need for consistent implementation of fall prevention intervention. In current evidence based fall prevention intervention recommendation, they mentioned a multicomponent approach to fall prevention can reduce fall rates by 30% (Miake-Lye et al., 2013).

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In a recent article published in the MEDSURG Nursing journal it discussed the effects of hourly rounding to prevent falls for patients in acute care. Falls not only cause harm to patients, they cost hospitals money. In 2012 “the Joint Commission identified reduction of harm from patient falls as a national patient safety goal” (Hicks, 2015). In attempts to reduce falls, studies have been conducted on hourly rounding. “The main components of hourly rounds include reducing anxiety by using key words, addressing the four Ps (pain, potty, position, possessions), assessing the environment for safety issues and telling the patient when staff will return” (Hicks, 2015).

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Hourly rounding is indeed anticipating and meeting the needs of patients and ensuring their safety. According to Ford (2010), evidence based practice showed that hourly rounding improve patient outcome and safety by reducing the amount of times the call bell goes off and patient falling. When the nurse does round hourly he or she can ask the patient whether they need assistance with anything. The nurse can also make sure that everything is within the patient’s reach. At times patients may feel that they are a bother to the nurses and try to get up on their own to use the bathroom and fall, for example.

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Quasi-experiment Purpose: To determine the effect of hourly rounding on fall rates, call light usage, and patient satisfaction in an inpatient medical-surgical patient population Level II Setting: Medical-surgical inpatient unit N = 4,418 (Divided into 1 experimental group and one control group) Criteria: not specified. Data concerning patient satisfaction were collected for 6 months using patient satisfaction surveys. No statistically significant differences occurred in patient satisfaction between pre-rounding and post-rounding groups based on post-discharge patient surveys. While rounding did not affect patient satisfaction on discharge surveys, anecdotal evidence from nurses’ leader rounds showed increased patient satisfaction.

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