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Hourly Rounding: Give “PEAS” a Chance
Neeta Shrestha RN, BSN Mani Murugavel DNP NE-BC, CSSGB RN-BC
Introduction
Evidence-based Model
Discovery Research
Increased volume of call bell and decreased patient satisfaction
Lean Methodology
• A3 thinking and PDCA (Plan, Do, Check, Act) was used to identify root cause
• Based on 5 why exercise, the root cause was identified
• Lack of standardized hourly rounding process was identified as the key contributor
• Other factor: Lack of staff accountability and patient education
A3 THINKING
Clinical Program Proposal
Hourly rounding
• Purposeful • Being proactive • Anticipate needs
Evidence Summary
Patient Satisfaction A)Round
with Purpose
E)Stop going in circles! Break the barriers to hourly
rounding B) Hourly Patient
Rounding
C) Hourly Rounds: An Evidence- based
practice
D) Transforming Care at the
Bedside
F)How is patient education linked
to patient satisfaction
Rationale A)Round with
Purpose
B) Hourly Patient Rounding
C) Hourly Rounds: An Evidence- based practice
D) Transforming Care at the
Bedside
↓se hospital acquired pressure ulcer, falls and call light volume, health care cost (Sherrod, Brown, Vroom, & Sullivan, 2012, p. 33- 38).
•Use of script
•Universal inquiries
•Consistently available staff
•↓se call volume (Davies, 2010).
•Study by Studer group (Studer Group, 2011).
•↓se call light use
•↓se fall (McCartney, 2009, p. 327).
• rounding in partnership
•Laminated card
•14 days rounding
•36 days without fall (Stefancyk, 2009, pp. 70- 71).
Rationale E)Stop going in circles! Break the
barriers to hourly rounding F)How is patient education linked to
patient satisfaction
• Buy in
•Acuity
•Time management
•Unexpected Interruptions (Shepard, 2013, pp. 13-15).
• education begins from the moment patient steps in the hospital
•Patients who feel well informed, trust the healthcare system
• Patient whose time is respected and are kept informed have more patience which in turn increase patient satisfaction (Murdock & Griffin, 2013, pp. 43-45).
Translation To Guidelines
Practice Integration
• Commitment / pledge form
• Staff education of the model using a simulation methodology
Outcome/Evaluation • Comparison of
HCAHPS scores pre and post implementation of hourly rounding
• By June 2014, score for call button response increased to 70% and 83% overall patient satisfaction score.
References 1. Davies, K. E. (2010, August 17). Hourly Patient Rounding. Retrieved 04
29,2013,from Advance for Nurses: http://nursing.advanceweb.com/continuing-education/ce-articles/hourly- patient-rounding.aspx
2. McCartney, P. R. (2009). Hourly Rounds: An Evidence- based practice. The American Journal of Maternal/Child Nursing, 327.
3. Murdock, A., & Griffin, B. (2013). How is patient education linked to patient satisfaction? Nusing2013, 43- 45.
4. Shepard, L. H. (2013, February). Stop going in circles! Break the barriers to hourly rounding. Nursing Management, pp. 13- 15. Retrieved from Nursing Management.
5. Sherrod, B. C., Brown, R., Vroom, J., & Sullivan, D. T. (2012, January). Round with purpose. Nursing Mangement, pp. 32-38.
6. Stefancyk, A. L. (2009). Transforming Care at the Bedside. American Journal of Nursing, 70-71.
7. Studer Group. (2011). About Studer Group. Retrieved 10 02, 2013 from Studer Group: https://www.studergroup.com/who-we-are/about-studer-group/
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