8 What is Hourly Rounding? What is it?A plan to proactively interact with patients every hour during the day using focused key words to assess needs (pain, position, personal needs and patient education)A care model to return care to the bedside, truly patient-centeredA plan to help achieve our goal to “always” deliver exceptional clinical quality care in a safe and compassionate environmentWhy do it?Evidence supports a decrease in patient anxiety, falls, skin breakdown, and nursing steps as well increased patient satisfactionIt allows nurses to provide more care at the bedsideIt reduces anxiety, worry and waitingIt is just good patient careThere is no other initiative that impacts the patient perception of quality care as this ONE does.No matter what the initiative we are trying to hardwire and ensure reliability, we must ensure we have consistency among all staff. … why do you do it… what results do you expect and more importantly, what results have you seen.Here are a few key words that describe hourly rounding. As you talk about it, lead with the WHY of hourly rounding first. It is a Safety initiative, it is proactive, it is how we deliver quality care…
16 Evidence-Based Quality These are the results from the largest study done on hourly rounding in This study clearly demonstrated when nurses followed the recommended eight behaviors and actions during their hourly rounds the following results are achieved:Value to the staff is the reduction of call lights and proactively addressing needs so staff take some control back of their day. This is truly an initiative for staff satisfaction.This demonstrates that hourly rounding is a quality initiative – not a patient satisfaction or HCAHPS initiative.
30 Myth #6: Scripting/Key Words Make Us Sound Robotic “Always sit down when a sick person is talking business with you, show no signs of hurry, give complete attention and full consideration… Always sit within view so that when speaking to him, he does not have to painfully turn his head around in order to look at you. If you make this act wearisome, you are doing the patient harm. You cause harm also by continuing to stand to you make him continuously raise his eyes to see you.”Florence Nightengale had it right… she was PRESENT for the patient and we need to be able to do that… No more multi-tasking – truly listen to the patient.“Notes on Nursing” Florence Nightingale 1854
32 Tell the Patient the “Why” of Hourly Rounding “On this unit, one of our care team members will be coming in to see you every hour during the day. You will see either me or Jackie, our certified nurse assistant. I have worked with Jackie for two years and she is excellent. We will be checking on your comfort such as we will make sure we are helping manage any pain you might have, help you change position, help you to the bathroom and make sure you have everything you need.” We call this hourly rounding and we do it to make sure you are safe and we are always meeting your needs.”Have you standardized the process of setting expectations of hourly rounding as part of how you deliver care?How do you know it happens every time?How do the staff explain the logs to the patient and family?When I am on site coaching for hourly rounding, one gap I see pretty consistently is setting the expectation that they do hourly rounds and why… here is an example of some key words to use with your staff in coaching. Also, I provided a sample patient card that explains hourly rounds and is included in the admissions packet. You just want to make sure that all wording is compliant with HCAHPS guidelines if you are putting something in print format. I suggest you review all written materials for any violations.
34 Pause Before Leaving “Is This Patient Safe?” Bottom line, before leaving the room, key words to ask your self are – is this patient safe? If you pause before leaving the room and do the environmental assessment for safety as well as for cleanliness, the patient will feel like they are in a safer place, because they are.
40 Bedside Shift Report (Handover) The process of handing-over care delivery from one nurse to another at change of shift at the patient bedside. This process incorporates other concepts such as “managing up”, AIDET communication, teamwork and creating a safe patient environment. All necessary patient information is exchanged in the patient room such as patient identifiers, safety checks, medications, tests etc. This addresses basic patient rights by keeping them patient informed and involved in their care. The patient, and key caregiver/family members are INCLUDED in the conversation as a partner in their care.What is it?A study outlined by the Joint Commission in 2009 found that 37% of handovers are deemed ineffective meaning the oncoming caregiver could not safely care for that patient. When we factor this in with our goal to include patients as partners in their care, it just makes sense that we would do bedside handovers.This process “transfers the trust” to the oncoming caregiver and reduces patient anxiety. Through a real-time exchange of information, the patient is involved in their care as well as teamwork and accountability are strengthened with the care-giver team. It aligns with Magnet and Baldrige criteria and National Patient Safety GoalsWhy is it important?