2008-02-15 / Community

SJEH Sets New Nursing Rounds Procedure

During their hourly rounds, Telemetry Unit nursing staff (standing from left to right) Maria Ramos, RN; Myrna Otero, SA; and Vida McCue, NP-C, Nurse Manager, speak with patient Edyth Baker about her care. During their hourly rounds, Telemetry Unit nursing staff (standing from left to right) Maria Ramos, RN; Myrna Otero, SA; and Vida McCue, NP-C, Nurse Manager, speak with patient Edyth Baker about her care. Nurses at St. John's Episcopal Hospital are starting a new initiative called "hourly rounding" that aims to improve service to the patient, and improve patient satisfaction, as well as improve nursing satisfaction.

"Hourly patient rounding is a proactive approach to put nursing staff back at the bedside," says Lynore Dupiton, RN, Vice President for Patient Care Services. The initiative began this month with a pilot program on the Telemetry Unit. When patients are admitted, they are told that they will be checked every hour (every other hour at night). In addition to attending to patient requests, the staff can reposition patients with limited or no mobility, make sure things are in easy reach, attend to pain management and assist those patients who require toileting.

Putting caregivers back at the bedside supports the hospital's goal to provide both clinically excellent care based on best practice, while attending to both the physical and psychosocial needs of the patients. Vida McCue, RN, the unit's Nurse Manager, was an enthusiastic advocate for the concept and trained her staff.

How well the initiative works will be measured according to:

Patient satisfaction results on surveys. Studies have shown that patients find great comfort in knowing that they will be checked regularly by caring nursing staff.

Rate of hospital-acquired pressure ulcers. Patient rounding ensures that patients won't stay too long in one bed-prone position.

Rate of falls. Patient rounding should cut down on falls caused by patients getting up to reach for something or to go to the bathroom.

Assessment of call bell frequency. An initial baseline count of call bells was measured for comparison. Anticipating patient needs will reduce call bells to get assistance.

What has delighted Dupiton and McCue is the eagerness with which the nursing staff has taken on this new initiative. "Most nurses saw it as an opportunity to enhance care rather than as an additional burden," says Dupiton. "They really understood that this could be a way to better use their hours to have more satisfying time spent with the patient, with less interruptions from call bells when they're doing nondirect patient care tasks like paperwork."

The pilot phase of patient rounding will run one month on Telemetry, where it is then expected to be instituted permanently. In April, Tower 8 will be the next unit to adopt the method, followed by Tower 10 and Maternity in June.

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