1. Applying the Path-Goal Theory to Increase Intentional Hourly Rounding
Marian Conde
University of Central Florida
College of Nursing

2. Background Organization instituted Intentional Hourly Rounding
Goal for Intentional Hourly Rounding is 95%
Complete Round to address the 5Ps (pain, potty, position, periphery, parting)
Nursing team trained on Intentional Hourly Rounding and use of key words
Hourly Rounding logs were placed in every patient room to be signed off by nurses and validated by the leadership team

3. Problem Statement
The organization has set a goal of 95% for nurse Intentional Hourly Rounding on patients to improve patient satisfaction and increase safety, which has not been consistently met on the unit; present IHR is 80%.

4. Significance Increase Intentional Hourly Rounding which will…
increase patient satisfaction
decrease falls
decrease the use of call bell lights
Lowe & Hodgson, 2012

5. Specific Aims
The overall aim is to ensure Intentional Hourly Rounding is accomplished with the 5Ps addressed during the nurse’s round and that upon discharge the patient and family can answer yes to the question “did a nurse round on you every hour during the day”.
Positive effects to be shown for both patients and for nurses through Intentional Hourly Rounding.
Nurses must understand that hospitals are no longer paid based on volume of services but on performance and that hourly rounding has a direct correlation (Fabry, 2014).

6. Path-Goal Theory
Originally developed by Evans in 1970 and later modified by House in 1971
A practice theory in nursing; linked to the human-environment health relationship
Designed to identify a leader’s most practiced style (i.e., directive, supportive, participative and achievement-oriented) as a motivation to get subordinates to accomplish goals
May be used by those in nursing leadership roles to help support the front-line teams

7. Application
Clear expectations and behaviors established for the nursing team
Nurses reeducated during check-off sessions on Intentional Hourly Rounding; review of the 5Ps and key words to be used (Studer, Robinson, & Cook, 2010)
Removed obstacles and ensured a charge person free of patients and staffing to meet the acuity of the patient load
Extrinsic rewards/contests put into place by leadership team to motivate nurses to increase the Intentional Hourly Rounding (Polstan, 2013)

8. Conclusion
The Path-Goal Theory reinforces the idea that motivation plays an important part in how a supervisor and subordinate interact and, based on the interaction, the overall success of the subordinate (Murdoch-Polstan, 2013).
Path-Goal Theory remains one of the most respected approaches to understanding leadership and the influence they have on employees (McEwen & Wills, 2011).
Patients and their families are much happier and perceive their care as “excellent” when nurses round hourly and address their needs in a timely manner.

9. References
Fabry, D. (2014). Hourly rounding: Perspectives and perceptions of the frontline nursing staff. Journal of Nursing Management, /jonm.12114
Lowe, L., & Hodgson, G. (2012). Hourly rounding in a high dependency unit. Nursing Standard, 27(8),
McEwen, M., & Wills, E. M. (2011). Theoretical basis for nursing (3rd ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.

10. References
Murdoch-Polstan, L. (2013). An investigation of path-goal theory, relationship of leadership style, supervisor related commitment, and gender. Emerging Leadership Journeys, 6(1), Studer, Q., Robinson, B. C., & Cook, K. (2010). The HCAHPS handbook: Hardwire your hospital for pay-for-performance success. Gulf Breeze, Florida, USA: Fire Starter Publishing.