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Evaluating the Impact of Nurses’ Rounding on Patient Satisfaction and Clinical Outcomes

Evaluating the Impact of Nurses’ Rounding on Patient Satisfaction and Clinical Outcomes. Margaret Redmond,BSN, OCN Rene Lavoie, RN-BC Renee DiGiovanni, BSN, RN-BC, CCTN Ochsner Medical Center, New Orleans Miro Sarac, PhD, LSUHSC School of Nursing. Background – Nursing Rounds. Purpose

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Evaluating the Impact of Nurses’ Rounding on Patient Satisfaction and Clinical Outcomes

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  1. Evaluating the Impact of Nurses’ Rounding on Patient Satisfaction and Clinical Outcomes Margaret Redmond,BSN, OCN Rene Lavoie, RN-BC Renee DiGiovanni, BSN, RN-BC, CCTN Ochsner Medical Center, New Orleans Miro Sarac, PhD, LSUHSC School of Nursing

  2. Background – Nursing Rounds • Purpose • To assess patient needs • Described as • Task oriented • Unstructured without a consistent set of standards – “a peak in the door” • Current practice • Reactive vs. proactive

  3. Literature Review • Structured rounding protocol focusing on Pain, Potty, & Positioning supported positive impact on outcomes • Reduced call light usage • Improved patient satisfaction • Decreased in fall rate 3 Ps Mead, C., Bursell, A., & Ketelsen, L. (2006). Effects of nursing rounds on patient call light use, satisfaction, and safety. AJN, 106(9),59-69.

  4. Purpose for Study • Investigate theimpact of a patientrounding protocol on outcomes associated with • Pain • Potty • Positioning

  5. Study Methods Research Design Prospective Descriptive Study IRB expedited review with waiver of documentation of informed consent Convenience Sample Patients admitted to five medical surgical units Procedure Rounding protocol over 12 weeks 3 Ps

  6. Rounding Protocol • Focus on “ 3 P’s” • Hourly during the day (6am-10pm) • Every 2 hrs at night (10pm-6am • “Is there anything else you need?”

  7. Call light use Pain Potty Position Pain management satisfaction Press Ganey Patient satisfaction Press Ganey Falls NDNQI Falls 1000/patient days Hospital acquired pressure ulcers NDNQI HAPU/1000 patient days Data Collection – Pre- & Post-Protocol 3 Ps

  8. Data Analysis • Frequency distribution for each variable • Tests for differences between & among groups • Chi- square • Paired t-test • ANOVA All tests 2-tailed, α= 0.05

  9. Distribution of Pre- & Post-Calls

  10. Distribution of Patient Call Lights Pre- & Post-Protocol * * * * * * * * * * * * * * * * * * Significant differences, Anova, *p< .05. ** p < .005, p < .0001

  11. Quality Indicators by Unit

  12. Incidental Finding Beep Beep • IV pump alarming Beep Beep

  13. Limitations • Generalizability of findings • Convenience sample at one site • Limited to 3-month study period • Unable to verify the accuracy of rounding logs • Appropriate time? • Addressed all 3 variables?

  14. Summary • Decreased patient call light volume overall • Improved outcomes on some units • Pain management • HAPU and falls • Uncertain why some units did not demonstrate improvement

  15. Relevance to Nursing • Frequent structured rounds should • Improve clinical outcomes • Reduce nurses’ burden • Additional research should address • Other foci for rounding should be studied (ie. IV pump) • Obstacles to nurses’ rounding

  16. References Castledine, G. (2002). Patient comfort rounds: A new initiative in nursing. British Journal of Nursing, 11 (6), 407. Halm, M. et al. (2003). Interdisciplinary rounds: Impact on patients, families and staff. Clinical Nurse Specialist, 17(3), 133-142. Mead, C., Bursell, A., & Ketelsen, L. (2006). Effects of nursing rounds on patient call light use, satisfaction, and safety. AJN, 106(9), 59-69. Van Handel, K. & Krug, B. (1994). Prevalence and nature of call light request on an orthopedic unit. Orthopedic Nursing, 13(1), 13-18.

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