Hourly Nursing Rounds - Essay Example

Quality care keeps the patient fully informed and allows the patient to retain control through active participation. Hourly nursing rounds allow nurses to provide scheduled treatments and interventions. This provides proactive patient care compared to reactive care when nurses respond to bells and lights (Dutton, 2003). During hourly shifts, incoming nurses introduce themselves to patients and define the period they will be attending to the patient (Miller, 1997). This helps create a nurse-patient relationship that is necessary when providing satisfactory intervention (Ford, 2010). During each hourly visit, the nurse assists such as visiting the bathroom, conducting repositioning to ensure the patient is comfortable and providing appropriate interventions such as ensuring the patient is not in pain (Halm, 2003). The patient gets the chance to request anything else that the nurse can do or provide. Hourly rounds decrease patient falls, increase patient satisfaction and decrease the number of call lights. Hourly care helps reduce decubitus ulcers when patients are repositioned frequently (Meade, Bursell, and Ketelsen, 2006).

In an adult patient in the acute care setting (P) what are the effects of hourly rounding (I) on patient safety and patient satisfaction (O) compared with providing scheduled treatments and responding to call lights (C)? 

This proposal aims at replacing call bells and lights with hourly nursing rounds. The nursing care facility relies on call lights and bell alerts when providing care for patients. This is a form of reactive intervention by nurses. In most cases, nurses are interrupted while attending to a patient so that they can answer a call bell. They are forced to answer call bells and call lights for patients that were not on the treatment schedule. This affects the efficiency of nurses when providing treatment and interventions. Introducing hourly rounds would improve patient satisfaction, and nurses’ efficiency, and reduce resources used by the hospital.

Hourly rounds would introduce shifts that decrease staff overtime and introduce better time management. Currently, nurses working beyond the normal working time require extra payment as per the overtime work agreement. Patients falling from beds and those who develop decubitus increase hospital costs due to the need for specialized care. Introducing hourly rounds would reduce hospital costs (Sheedy, 1989). A silent environment is required in hospitals since patients are disturbed by noise. Relying on call bells increases the noise levels within the hospital due to frequent buzzing by patients requiring assistance. Hourly rounds are shared among nursing teams, and the names of the current team are updated on the whiteboard. This introduces accountability by nurses as they assume full responsibility for patients in the hospital (Olrich, Kalman, and Nigolian, 2012).

Hourly nursing will be performed on an hourly basis between 0600 and 2300. They will be conducted every other hour between 2300 and 0600. Patients will not be woken up between 2300 and 0600 unless they require scheduled intervention such as pain management. The nursing team will be divided into two; one team will provide rounds on even hours and the other on odd hours. The nurse in charge will have a list of the nurses conducting rounds during every shift. The nursing will undergo 15-20 minute training on the basic requirements and importance of hourly rounding. The head nurse will conduct monthly reviews on the effects of the nursing rounds on patients, nurses, and management. Checklists will also be issued to assess the competency of nursing on the subject of hourly rounding. Staff members who fail the assessment will undergo further training on the importance of the hourly rounds. Patients will receive questionnaires evaluating their satisfaction during the period of their admission.

Satisfaction is a perception of a patient regarding the type of services and treatment provided. Patients require timely responses from nurses, and they have to build confidence in the nursing practices at the care facility. Hourly rounding is a proactive nursing approach aimed at improving patient satisfaction. Hourly rounds eliminate the need for overtime by nurses and reduce the number of patient falls. Nurses also have a planned schedule for treatment and intervention, which eliminates abrupt reactions when the call bell rings. These rounds reduce stress on nurses by freeing time and decreasing frustration by introducing timely shifts. Read More