The Effects Of Hourly Rounding On Quality Of Patient Care Essay

Providing the best care to each patient starts with providing the proper amount of staff members to each unit. Looking at the needs of different units not only allows administration to see areas for improvement, but also areas that are being handled correctly. Utilizing the indicators provided by The Joint Commission, 4 East, a pediatric medical/surgical floor, has a high rate of falls and nosocomial pressure ulcers that appears to be related to the increase overtime nurses have been working for that floor (Nightingale, 2010). Research has shown increases in adverse events have been related to nurses working over 40 hours a week (Bae, 2012).

Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.

The ability of nurses to provide a high level of care to each individual patient will cause a decrease in inpatient complications and a decrease in rates of inpatient mortality (Needleman, Buerhaus, Pankratz, Leibson, Stevens & Harris, 2011).

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

Nurse-to-patient ratios is not a new topic of debate for all of us who deliver care to patients every day. Only lately it has been a big issue that have caught the attention of many. Demands by the medical community for changes concerning staffing, asking for the government interventions in minimum staffing laws. Registered nurses have long acknowledged and continue to emphasize that staffing issues are an ongoing concern, one that influences the safety of both the patient and the nurse. (ANA, 2015) .nowadays hospitals are running for profit and the emphasis is not put on job burnout, stress, and endangerment of patients. Nursing shortages is a very pertinent problem, it will be optimum to have laws in place to help with the issue, however meanwhile leadership and management methods to the matter can help to mend the nursing situation and avoid many of the damaging effects of unfitting nurse-to-patient ratios.

The purpose of this article is to discuss appropriate nurse staffing and staffing ratios and its impact on patient care. Although the issue is just not about numbers as we discuss staffing we begin to see how complex the issue has become over the years. Many factors can affect appropriate nurse staffing ratios. As we investigate nurse staffing ratios we can see the importance of finding the right mix and number of nurses to provide quality care for patients.

Prior to the hourly rounding implementation, all the clinical staff (staff involved in patient care) will attend an hour workshop, which will cover the advantages and significance of hourly rounding to patient safety, reduction of falls, increase patient satisfaction, improved health outcomes, and financial impact to the organization. A video on how to do the hourly rounding properly and what behavior to avoid will be shown. After the workshop, the staff will do return demonstration, playing the role of the staff, while being checked off to ensure that the expectations during hourly rounding are met. This includes how to properly introduce oneself to the patients, informing the patients that the staff will be rounding every hour till 2200 then every two hours till 0600, to address their pain, possession, position, and potty needs. By performing return demonstrations, the validators (nurse managers, educators) will be able to ascertain that the staff understood and will

The results of the study showed that significant increase in patient satisfaction scores, decreased call light usage, and reduction in patients fall rates. One-hour rounding shows higher satisfaction than two hour- rounding. Hypothesis supported the study because the research shows rounding can reduce patient call light usage (Meade, Bursell, Ketelsen , 2006). The theoretical framework that forms the basis of the research is that consistent nursing rounds can meet the basic needs of patient and ultimately reduce call light use and [pic]improve management of patient care while also[pic] increasing [pic]patient satisfaction and[pic] safety.

Determining nurse-to-patient ratios in nursing facilities remains a challenge for the nursing profession. Two main staffing methods that are currently used in most nursing facilities are staffing by patient acuity using patient classification systems and staffing by mandated nurse-to-patient rations. Each method has an impact on patient outcomes, safety and overall satisfaction determined from different articles and studies done on each staffing method. There are pros and cons to each staffing methods. Nursing facilities look at many of these pros and cons when determining staffing methods that are used, cost, patient outcomes, nursing satisfaction and

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.

Rounding allows nurses to gather information in a structured way. It’s proactive, not reactive like call light responses. It’s a great way to get a handle on patient problems before they occur. It’s all about providing the best patient-driven health care… The great thing about hourly rounding is that it doesn’t benefit only the patients. (¶ 4).

Olrich, T., Kalman, M., & Nigolian, C. (2012). Hourly Rounding: A replication study. MEDSURG Nursing, Jan/Feb2012; 21(1): p23-36.

Escalating healthcare costs, decreased reimbursement rates, and increased emphasis on the patients perception of care have hospitals researching methods to improve quality metrics ad maximize reimbursement. One such intervention is multidisciplinary rounding (MDR). The research question addressed in this research summary and table is: “In hospitalized patients, will a unit’s initiation of bedside MDR increase patient satisfaction and decrease patient length of stay, within 6 months of introduction, as opposed to units who do not initiate bedside MDR?” A literature search of databases including Health Source: Nursing/Academic Edition, CINAHL Complete, Academic Search Complete, ProQuest Nursing and Allied Health Source, and

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