A Brief Note On Hourly And Rounding And Patient Satisfaction

Safety is an essential factor in the creation of the healing environment and this is dependent on the role of the caregiver and the patient when it is possible. “Safety is a basic component of professional nursing and Caritas Processes. Safety concerns affect all of the nurse’s activities related to supporting, protecting, and correcting the environment for healing at all levels, To feel safe and protected is a basic need” (Watson, 2008, p. 13). Many factors impede the safety of patients in a healing environment such as Risk of falls, Pressure ulcers, and close calls. Ford’s literature (as cited in Woolley et al, 2012) found that “hourly rounding resulted in a 52% reduction in call light use, giving nurses more time to provide patient care and prevent patient calls” and in Bourgault et al.’s study conducted in 2006 (as cited in Woolley et al, 2012) “expected outcomes of hourly rounding included increase

Hospitals nationwide are experiencing nurse shortage and increased workloads because of shorter hospital stays, fewer support resources and higher acuity in patients (Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D., 2004). Higher nurse workloads are directly associated with job burnout and job dissatisfaction which in turn causes more voluntary nurse turnover and relates to the increased nursing shortage. According to the Missouri Hospital Association the turnover rate of nurses has increased by fourteen percent in the last five years (Browning M., 2012). Nursing shortage is a real threat to the patient population. According to the Quality Health Outcomes Model by the American Academy of Nursing by Donabedian, effects of the healthcare interventions are characterized by the environment the staff works in (Vahey et al., 2004). Donabedian describes that quality metrics can be divided into three broad categories, structural, process, and clinical.

An hourly rounding is an excellent precaution strategy to make sure that patients’ alarms, call lights, and personal belongings are within reach. One benefit of hourly rounding is that it is pro-active. It reduces patients’ need to get up, thus reduced falls. In Kamehameha Nursing Home, hourly round is required, but because nurses are most of the time busy, they often forget to implement it. This needs to be addressed in order to reduce the number of falls in the facility (Agency for Healthcare Research and Quality, 2013). If Universal Precautions is effectively implemented, Kamehameha Nursing Facility’s fall incident will decrease.

A study conducted by Young, Minnick, and Marcantonio (1996) compared the opinions of more than a thousand staff nurses, numerous nurse managers, and more than two thousand patients from 17 hospitals regarding certain aspects and perceptions of patient care needs. Interestingly, staff nurse and managers

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

A common goal all healthcare providers share, is the desire to provide excellent patient care. The delivery of care is constantly changing in healthcare, however, the patient will continue to remain the focus of care. The success of nursing care thrives off the ability to fulfill patient needs and to maintain patient safety and satisfaction. When patients are admitted to the hospital, their need for an increase in their level of care and attention, due to the decline in their health status, and inability to preform normal daily activities of daily living. The loss of independence places the patient in a vulnerable state of mind, causing the individual to rely on members of the healthcare team to assist with basic self-care needs while in a stable and well-organized environment. A structured environment can be accomplished through the practice of hourly rounding on all patients.

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.

Additionally, the study found that a high patient to nurse ratio resulted in greater emotional exhaustion and greater job dissatisfaction amongst nurses. Each additional patient per nurse was associated with a 23% increase in the likelihood of nurse burnout, and a 15% increase in the likelihood of job dissatisfaction. Moreover, 40% of hospital nurses have burnout levels exceeding the normal level for healthcare workers, and job dissatisfaction among hospital nurses is four times greater than the average for all US workers. 43% of nurses involved in this study that reported job dissatisfaction intended to leave their job within the upcoming year. (Aiken et al.)

Another strength of interprofessional rounding is that it has shown to decrease medical errors, increase positive patient outcomes, and decrease length of stay. For effective patient-centered care it requires all team members to have effective communication, teamwork, and a culture of safety. Patient privacy comes to mind when coming up with a weakness of interprofessional rounding because if family members are being involved they may not know all of the pertinent information that may be shared during rounds and the patient may not want the family members to know. Interruptions during rounds can also be considered a weakness, whether it is call lights, ventilator or cardiac monitor alarms, other patient and/or family members. Being distracted during interprofessional round can cause ineffective communication, which could lead to medical errors or negative patient

We also implement hourly rounds and we do it very similar to your facility. Nurses and techs take turns and while rounding we make sure to address the 3Ps (pain, potty, and position). Also before we leave the patient’s room we asking a key question “is there anything else I can do for you before I leave?” this really makes a big difference. On the other hand, we are making from the hourly rounds one collaborative effort, because it is not only limited to nurses and CPs, but we getting everyone involved, physicians, MSWs, PTs, OTs, speech therapists, dietitians, etc. Everyone is accountable and responsible for our patients’ care and wellbeing. This has absolutely had a positive outcome in patient’s safety and satisfaction by not only meeting

Patients in a hospital and/or healthcare facilities have to be cared for all day and all night, everyday of the week by nurses. The usual way to fulfill this need is to divide up the day into three 8-hour shifts. Different shifts have been put into place to help improve nurse satisfaction, decrease the nursing shortage and save the hospital money. The 24-hour day is made up of two 12-hour shifts; 12 hours in the day and 12 hours at night. There has been quite an ongoing debate over the years regarding this issue of nurses working over 8 hours in a single day. Many people, such as hospital nursing administrators, have reason to believe that working long hour shifts causes more errors in

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.

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

Previous research has shown that those hospitals with high levels of nurses experiencing burnout have a lower score for patient satisfaction. In studies performed by Russell (2016) and Stimpfel et al. (2012), there is corresponding data to reveal that those nurses who are burned out do not

Barry Hill (2017) performed studies related to the quality of care that patients receive and what factors are associated with those perceptions. One area that was noted to be of importance and directly related to quality of care provided to patients is staff dissatisfaction and burnout. This study also found that longer shifts contributed to increased amounts of emotional exhaustion leading to decreased quality of care for patients. Addressing staffing needs early and intervening can decrease the amount of nurse burnout and dissatisfaction that is often seen. This study has shown that hiring additional competent nurses reduces medication errors, falls, infections, wounds, and decreases hospital litigation costs, while improving staff morale, patient experience and care, and cost-effectiveness for the hospital.