1. Evaluating the Impact of Nurses’ Rounding on Patient Satisfaction and Clinical Outcomes Margaret Redmond,BSN, OCN Rene Lavoie, RN-BC Renee DiGiovanni, BSN, RN-BC, CCTN Ochsner Medical Center, New Orleans Miro Sarac, PhD, LSUHSC School of Nursing

2. Background – Nursing Rounds Purpose  To assess patient needs Described as  Task oriented  Unstructured without a consistent set of standards – “a peak in the door” Current practice  Reactive vs. proactive

3. Literature Review  Structured rounding protocol focusing on Pain, Potty, & Positioning supported positive impact on outcomes  Reduced call light usage  Improved patient satisfaction  Decreased in fall rate Mead, C., Bursell, A., & Ketelsen, L. (2006). Effects of nursing rounds on patient call light use, satisfaction, and safety. AJN, 106(9),59-69.

4. Purpose for Study Investigate the impact of a patient rounding protocol on outcomes associated with Investigate the impact of a patient rounding protocol on outcomes associated with  Pain  Potty  Positioning

5. Study Methods Research Design  Prospective Descriptive Study  IRB expedited review with waiver of documentation of informed consent Convenience Sample  Patients admitted to five medical surgical units Procedure  Rounding protocol over 12 weeks

6. Focus on “ 3 P’s” Hourly during the day (6am-10pm) Every 2 hrs at night (10pm-6am “Is there anything else you need?” Rounding Protocol

7. Data Collection – Pre- & Post-Protocol Call light use  Pain  Potty  Position Pain management satisfaction  Press Ganey  Patient satisfaction  Press Ganey  Falls  NDNQI  Falls 1000/patient days  Hospital acquired pressure ulcers  NDNQI  HAPU/1000 patient days

8. Data Analysis Frequency distribution for each variable Tests for differences between & among groups  Chi- square  Paired t-test  ANOVA All tests 2-tailed, α = 0.05

9. Distribution of Pre- & Post-Calls

10. Distribution of Patient Call Lights Pre- & Post-Protocol ****** **** **** * * ****** **** * Significant differences, Anova, *p <.05. ** p <.005, p <.0001 **** *

11. Quality Indicators by Unit Quality Indicators by Unit tyty P o s it i o n PainPain

12. Incidental Finding IV pump alarming Beep

13. Limitations Generalizability of findings  Convenience sample at one site Limited to 3-month study period Unable to verify the accuracy of rounding logs  Appropriate time?  Addressed all 3 variables?

14. Summary Decreased patient call light volume overall Improved outcomes on some units  Pain management  HAPU and falls Uncertain why some units did not demonstrate improvement

15. Relevance to Nursing Frequent structured rounds should  Improve clinical outcomes  Reduce nurses’ burden Additional research should address  Other foci for rounding should be studied (ie. IV pump)  Obstacles to nurses’ rounding

16. References Castledine, G. (2002). Patient comfort rounds: A new initiative in nursing. British Journal of Nursing, 11 (6), 407. Halm, M. et al. (2003). Interdisciplinary rounds: Impact on patients, families and staff. Clinical Nurse Specialist, 17(3), 133-142. Mead, C., Bursell, A., & Ketelsen, L. (2006). Effects of nursing rounds on patient call light use, satisfaction, and safety. AJN, 106(9), 59-69. Van Handel, K. & Krug, B. (1994). Prevalence and nature of call light request on an orthopedic unit. Orthopedic Nursing, 13(1), 13-18.