Enhancing the

Rounding Process At

JCMC

2013

Enhanced Hourly

Rounding Process on

All Patient Care Units

Starting:

April 1st 2013

Leading the Change at JCMC:

Chief Nursing Officer (CNO)

Nursing Directors & Leaders (AVP)

Nurse Educators

Patient Care Coordinators

Staff Nurses

Patient Care Technicians

Patient Engagement Associates

Clinical Ladder Members

Purpose:

To implement Evidence-Based

Practices

To increase Patient Safety

To increase Patient Satisfaction

Establish a Systematic process

Benefits of Hourly Rounds:

Proactive Approach to Care Anticipates needs of the patient

Increase Nurse/PCT Satisfaction Enhances team work Improved work flow for Nursing staff

Promotes Care that is Patient Centered

Maintains patients and families informed Increases trust with patient and family Increases presence of the nurse Enhances communication

Reason to Implement Hourly Rounding

“2013 Year of Engagement”

Research shows that hourly patient rounding: 1. Decreases Call Light usage by 38%

2. Reduce Falls by 50%

3. Decreases Hospital Acquired Pressure Ulcers by 14%

4. Increases Patient Satisfaction by 12%

Supports nursing care

Standard for customer services

What is Hourly Rounding?

It is a purposeful and meaningful action by staff nurses and PCTs to ensure that patient’s needs are met

Rounding is consistent and systematic Teamwork between RNs and PCTs Utilizes the 4 P’s:

Pain, Position, Potty and Placement (The 4 S's: Symptoms, Side effects, Safety & Satisfaction will be used for 5W)

Using key words at key times

Pain

“How is your Pain?”

Medicate patient or schedule during up coming rounds

Update whiteboard

The 4P’s of Hourly Rounding

Positioning “Are you comfortable”

Move patient up in bed

Rearrange pillows

Offer blankets

Asses the risk of pressure ulcers

Turn patient at high risk for skin breakdown

The 4P’s of Hourly Rounding

Placement

Bed is at the correct height

Trash can at bedside

Water, urinal, tissues, phone, call light, and remote are within reach

Environmental scan for hazards etc

Potty (personal needs)

“Do you need to go to the bathroom?”

Assist patient to the bathroom

The 4P’s of Hourly Rounding

In addition:

Communicate when you will return

Close with key words

“Is there anything I can do for you?”

Communicate the Vision

Present to Nursing Councils

Ongoing agenda at Staff meetings

UPC meetings

Charge Nurse meetings

PCT’s meeting

Patient Engagement Team members / Associates

Learning module on MC strategies

Routine real time auditing of hourly rounding process

Empower Staff Nurses and

PCTs Identify barriers

Remove obstacles to change

Implement innovative strategies to address barriers

Ongoing education

Provide resources

Create Short Term Wins

Provide feedback reports

Recognize and reward nursing staff

Include Hourly rounding projects in the Clinical Ladder

“Never Underestimate the Difference you can make”

Quint Studer