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/