Healthcare Essay Example: Hourly or Intentional Rounding for Patients' Safety

Staying in hospitals for a long duration of time brings pressure and stress to the patients and their families. Patients are subjected to constant treatment processes by the doctors and nurses placing them in a secondary role as they have to wait for directions and instructions from the healthcare personnel. The unfamiliar schedules at the hospitals further complicate a patient's life at the hospitals. Patients who are in critical condition, such as those who have been to the theatre have to depend on the healthcare professionals for basic needs such as feeding and relieving themselves. When a patient's bladder gets full, subjecting them to unnecessary delays from relieving themselves can create a feeling of discomfort. Intentional and regular checking on patients commonly referred to as hourly rounding is a perfect way of increasing access to the primary needs of patients hence making their stay at hospitals comfortable and safe.

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Patient Care Problem

Situation

Patient dissatisfaction in hospitals is an issue that has plagued the American hospitals for decades. Some patients remain unattended to for long periods of time, exposing them to discomfort, worsening of their existing conditions and possible contraction of other ailments.

Background

Hospitals should be a haven for the sick. When patients visit medical facilities, they hope that they will be attended to professionally and that they will be treated and heal. However, there has been an increase in cases where patients press the call button to ask for assistance, but nurses take long to respond. Patient satisfaction is important as patient satisfaction score dramatically influences reimbursements. By improving patient satisfaction through improving nursing responsiveness, patients would report a great experience of care during their stay in hospitals and record better healing rates.

Assessment

Halm (2009) conducted a survey on the relationship between hourly rounding and call light use. A call light is a bedside button in a patient's room that is used to call for assistance from the nursing station (Culley, 2008). In her survey, she asked patients how often they received support upon using the call light and if the support was timely. Halm reported that hourly rounding reduced the use of call light and contributed towards patient satisfaction. This study revealed that intentional checking on patients decreased the need for the patients to use the call lights.

Ford (2010) researched to find out if hourly rounding improved patient satisfaction score. During the research, Ford interviewed patients on the impact of intentional checking by the nurses on their satisfaction and comfort. He further inquired from the patients whether they found the use of call lights more efficient hourly rounding. In his report, the patients related hourly rounding to high satisfaction rates as the constant intentional checking helped them get basic needs. They further reported that they preferred deliberate audit to use of calls as the latter were not responded to on time.

Meade, Christine, Amy, Bursell and Lyn (2006) arrived at similar results concerning the effects of nursing rounds on patient satisfaction. They argued that if the hospitals emphasised on hourly rounding, patients would benefit from better services which translate into faster healing. They further pointed out that patient satisfaction influenced reimbursements hence was mutually beneficial to both the hospital and the patients.

Practice Change

To improve patient satisfaction, hourly rounding should be introduced in all hospitals around the country. This measure should be implemented by both the State and Federal governments to ensure full compliance. Nurses should be allocated duties that would see them visit patients every hour to monitor the performance of the patients.

According to Halm (2009), hospitals that implemented the hourly rounding process recorded improved patient performance and greater reimbursements than those that did not apply this strategy. These findings were further supported by Mitchell, Lavenberg, Trotta and Umscheid (2014) who found that patients who got frequent visits by the nurses recovered faster than those who received visits only upon use of the emergency call lights.

Alignment with Mission, Vision, and Values

The recommendation of implementing hourly rounding aligns perfectly with the mission, vision, and values of Baltimore Washington Medical Center which is the selected healthcare organisation. The purpose of the University of Maryland Baltimore Washington Medical Center is "to provide the highest quality health care services to the communities we serve," and the vision is "to be the preferred regional medical center through nationally recognized quality, personalized service, and outstanding people" (University of Maryland Medical Center, 2018). Considering the effectiveness and the benefits of a purposeful hourly rounding then it would be recommendable for it to be implemented in the Baltimore Washington Medical Center. Intentional rounding by the nursing staff marries with the mission, vision and values of Baltimore Washington Medical Center of providing high-quality medical care that is measured by customer satisfaction.

Change Model

A potty plan can be implemented as a change strategy, where nurses are trained to ask a patient the 4P's -placement, position, pain, and potty (Bachman, 2012). These four elements are all vital in the well-being of patient since patient satisfaction is primarily based on the physical well-being. Baltimore Washington Medical Center unit leaders can develop a specific potty plan for each patient, which shows a review of his or her medication. The program should ensure that a patient received a specified minimum number of visits by the medical staff every day. This model was arrived at due to its simplicity and hands-on capabilities. It ensures that patients receive regular physician visits, hence contributing towards their satisfaction.

Facilitating Change

For the healthcare Centre to promote a change of the mentioned strategy, the following steps should be followed:

• The unit leaders should inform all the medical staff of the new changes. There should be consultations to ensure that the medical staff are on-board with the changes.
• The unit leaders should announce to the patients the new changes that will see them receive hourly visits from the medical staff.
• A schedule should be developed, showing when the visits should be conducted and the nurses to make the appointments.
• A data entry platform should be developed, where nurses will record their findings for decision making, future reference and storage.
• Nurses should fill in the rounding log by check marking
• Patients should complete a satisfaction survey

Stakeholders

For this change to be implemented and for it to be effective, both nurses and patients should be willing to take the difference. Nurses should be caring and willing to help the patients whenever they have a need and the patient should be ready to receive the assistance as well. Additionally, nurses and the leaders of the healthcare center should have excellent communication skills and critical thinking when dealing with the needs of patients. The hospital's leaders should assume a supervisory role to oversee the smooth implementation of the hourly rounding process by availing all the required resources.

Summary or Conclusion

Patient satisfaction is critical to the healing process. When patients receive frequent and timely visits from the nurses, their sickness is addressed in a better and satisfactory way. The hourly rounding strategy is set to improve hospital performance by conducting intentional visits to the patients every hour to ensure that their needs are taken care of. This change process should be tailored to check on the patients' placement, positioning, pain and potty. When these four critical issues are addressed, patients will be comfortable and on the right path to recovery.

References

Bachman, D. R. (2012). Patient comfort rounding: effect on patient environment and satisfaction.

Culley, T. (2008). Reduce call light frequency with hourly rounds. Nursing management, 39(3), 50-52.

Ford, B. M. (2010). Hourly rounding: a strategy to improve patient satisfaction scores. Medsurg Nurs, 19(3), 188-191.

Halm, M. A. (2009). Hourly rounds: what does the evidence indicate? American Journal of Critical Care, 18(6), 581-584.

Meade, C. M., Bursell, A. L., & Ketelsen, L. (2006). Effects of nursing rounds: on patients' call light use, satisfaction, and safety. AJN The American Journal of Nursing, 106(9), 58-70.

Mitchell, M. D., Lavenberg, J. G., Trotta, R., & Umscheid, C. A. (2014). Hourly rounding to improve nursing responsiveness: a systematic review. The Journal of nursing administration, 44(9), 462.

University of Maryland Medical Center. (2018). UMMC's Mission and Vision. Retrieved from https://www.umms.org/ummc/about/mission-vision