Running head: HOURLY ROUNDS

Hourly Rounds Promoting Quality Nursing Practice Katie D. VanderVelde Ferris State University

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Hourly Rounds Promoting Quality Nursing Practice Hourly rounding is a skill in nursing care that relates to taking care of the patient every hour. It is a collaborative approach that includes both the nurses and health care staff. As described in one article hourly rounding includes nurses and unlicensed assistive personnel making visits to the patients room to make specific nursing interventions. These interventions include pain management, elimination needs, offering nourishment, and correct positioning (Shepard, 2013). Having these interventions performed each hour significantly improves patient outcomes. It is proven that hourly rounding is considered evidence based practice and enhances patient safety and satisfaction. Time Management Time management is the key in order for patients to be taken care of efficiently. Many patients cannot perform activities on their own and have to rely on others to help. When a nurse is not on time to change a patients brief or give a medication patient satisfaction is lowered. Nurses have many things to do at one time and having a set plan can improve time management. This is why hourly rounding can benefit both the patient and nurse. When a patient understands that a healthcare provider will visit their room every hour, they are less likely to request services between nursing rounds. Less interruption allows time for nurses to work more productively (Shepard, 2013, p. 13). In order for nurses to manage their time they need to first serve the patient in an efficient manner. Hourly rounding creates a routine that allows nurses to have more time without a call light going off or a patient complaining of back pain.

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Some might say that hourly rounding interferes with the more important needs of the patient like medication or treatments. For example, a nurse who has to take care of six or more patient on a medical surgical unit with high care needs (Shepard, 2013). If they manage their time correctly most of the time management problems will be solved. Many of their needs may be included in the hourly rounds. For instance, one patient might have severe pressure ulcers and need to be turned every 2 hours. One of the requirements in hourly rounding is proper positioning, so a nurse should not have to worry about turning the patient every two hours. Not to mention as hourly rounding is a collaborative approach nursing assistants can help. Time management and hourly rounding is a skill that is required for nurses to be successful and for patients to be satisfied. One Hour Compared to Two Evidence shows that checking up on a patient every one hour instead of two increases patient satisfaction. The effectiveness of hourly rounds compared to every two hours was studied by the Alliance for Health Care Research. As stated in one article a study was conducted on a medical surgical unit where one hour rounds were from 6 a.m. to 10 p.m. and two hour rounds from 10 p.m. to 6 a.m. Results showed that patient use of call lights, patient dissatisfaction, and patient falls decreased (McCartney, 2009). The more the nurse or staff member is checking up on the patient the less care they may need later. Many patients put their call lights on because they have to use the restroom. However if it is checked during hourly rounding this should be less of a problem. Some nurses say that hourly rounding is one more thing to do with no time to do it

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(McCartney, 2009, p. 327). If hourly rounds are done they are saving more time rather than chasing after call lights. It may seem a hassle at first but research shows that it does save time in the long run. Satisfaction Not only does hourly rounding increase patient satisfaction but also nursing satisfaction. In order to succeed in the best practice staff priorities and attitudes need to be improved. The nurses first priority should be the needs of the patient followed by documentation. Hourly rounding makes sure that the patients needs are met before the nurse proceeds on their other priorities. In order to increase the satisfaction of the nurses they should realize how important they are to the patient. It was stated in one article patients commented positively on hourly rounding to the staff members (Kessler, Claude-Gutekunst, Donchez, Dries, & Snyder, 2012). This should improve the nurses satisfaction because they are succeeding in their job and making the patient happy. In addition some patients do not know when they are wet or when they need to go to the bathroom. With hourly rounding the patient will already be changed and soiled briefs should not be a problem. A patients dignity and self-esteem is satisfied when they are changed on time. Satisfaction comes with the proper care and hourly rounding enhances this.

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Evidence As found in many studies hourly rounding is highly supported through evidence based practice. Results show throughout a six year study that the protocol achieves positive patient outcomes. A recent study on the medical surgical at Lehigh Valley Hospital-Muhlenberg in Pennsylvania assessed hourly rounding and concluded it is required for success. Careful planning, implementation, communication, and evaluation can all be achieved during hourly rounding and this is what leads to nursing success (Kessler, Claude-Gutekunst, Donchez, Dries, & Snyder, 2012). Nurses should be the number one staff member that communicates with the patient most often. As results show hourly rounding improves communication in order to satisfy the patients holistic being. Also the fall rate has decreased since hourly rounding has been implemented at the Lehigh Valley Hospital. In 2006 when hourly rounding was first being performed the fall rate was at a 5.46 percent. Throughout the years it has decreased about one percent and in 2011 it is at 2.19 percent (Kessler, Claude-Gutekunst, Donchez, Dries, & Snyder, 2012). This proves that hourly rounding is the best practice and improves patient care. Conclusion Throughout the past six years hourly rounding has been performed in most hospitals. Evidence has shown that the new protocol has increased both patient and staff satisfaction. Patients are receiving the care they need at the right time and no longer have to wait an extra hour to receive special care. Hourly rounding enhances the nurses time management and puts the correct priorities in pace. No longer do nurses spend half of their time running back and forth across the floor to answer call lights. The protocol makes sure the patients are receiving pain

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management, proper positioning, and voiding needs on time. It also reminds nurses to care for the most prominent needs of the patient. Hourly rounding provides a holistic aspect when caring for the patient. It enhances the patients dignity, self-esteem, and self-care needs.

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References Kessler, B., Claude-Gutekunst, M., Donchez, A. M., Dries, R. F., & Snyder, M. M. (2012). The merry-go-round of patient rounding: assure your patients get the brass ring. MEDSURG Nursing, 21(4), 240-245. McCartney, P. (2009). Hourly rounds: an evidence-based practice. MCN: The American Journal of Maternal Child Nursing, 34(5), 327. doi:10.1097/01.NMC.0000360428.36980.56 Shepard, L. H. (2013). Stop going in circles! Break the barriers to hourly rounding. Nursing Management, 44(2), 13-15. doi:10.1097/01.NUMA.0000426147.98903.ae