Background of the problem
Hourly rounding is defined as “a systematic, proactive nursing intervention designed to anticipate and address the needs of hospitalized patients.” Studies have indicated hospital stay elevate the stress experienced by patients and their families. Since the patient and their families are subjected to hospital environment where he/she is required to undergo various tests and treatment monitored by physicians, nurses, doctors and other healthcare personnel(Mitchell, et al., 2015). These conditions make the patients to be vulnerable emotionally and social. In most cases, the patients are required to use nurse call button in order to have their needs met. In extreme situations, patients experience falls, reduces satisfaction rating, skin breakdown and ulcers.
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Stakeholders
Stakeholder involved in this evidence-based practice include: patients and the nursing staff who are the crucial stakeholders. Other important stakeholders include: nursing quality staff, customer service staff, clinical nurse specialists for the unit, chief nursing officer of the main hospital, director of nursing for the unit, the nurse manager of the unit, staff nurse and other direct care givers and patient families.
PICOT questions
The PICOT question developed for this evidence-based practice, hourly rounding project was “On a medical acute care setting (P), does the implementation of the hourly rounding (I), compared to no hourly rounding (C),helps to improve patient satisfaction by reducing anxiety and decrease use of call bell (O) over one year period (T)?”
The purpose
The purpose of this hourly rounding project was to determine whether implementation of hourly roundingpromotes patients satisfaction, safety and quality of health care delivery by reduce patients falls, reduce patient use of call bells/light, reduce in pressure ulcer and skin breakdown as well as increase patient satisfaction ratings(Halm, 2009). This involves synthesizing the evidence related to the impacts of hourly rounding program on the improvement of the quality health care delivery, patients’ safety and satisfaction in acute care setting by reducing anxiety and decrease use of call bell(Blakley, et al., 2011).
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The measurement that were taken before and after the implementation of evidence-based practice were the percentage in patient satisfaction rating, the percentage of patients that experienced anxiety, the percentage of patient falls, the percentage of patient use of call light/bells and the percentage of patient with pressure ulcers and skin breakdowns.
Rationale
Many studies have indicated that intentional checking on patients at hourly interval is the core approach of improving patients’ needs as well as enhance patient satisfaction and safety. Published articles indicates that purposeful and systematic rounding by health professional especially nurse on-duty significantly improve patient satisfaction(Wood, 2009). Further studies have shown that proactive and systematic nurse rounding such as hourly rounding is the key mechanism of reducing fear and anxiety. Survey have suggested that equipment alarms, bathroom assistance, personal assistance and pain management were main cause of pushing the call bell. Statistics indicated that hourly rounding reduced the use of call bell by an average of 37 %. In addition, the hourly rounding reduce patient falls by 52 % and pressure ulcers and skin breakdowns by 14 % because the nurse rounding helps patients to change directions(Mitchell, et al., 2015). The program also increased patient satisfaction rating by 12 %. These statistics have been supported by many studies that focused on hourly rounding.
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