Walking Rounds/Report

  1. I am curious to know how everybody feels about walking report? They are starting walking rounds or room to room report where I am working on Sep. 1. I DO NOT think it will be confidential or prudent. They are also qualifying it by saying it is JCAHO recommendation (policy). I have several problems with the concept.
    1. Confidentiality
    2. Inability to access pertinent data IE chart, Kardex, MAR
    3. Inconvienance for the Client
    4. Limitations on giving pertinent details Ex: Mentioning a Dx. HIV
    in a public access area (re:confidentiality)
    5. The simple fact that some people can not think on their feet
    6. Tired Nurses forced to make rounds will be grumpy, hurried, incomplete, and sloppy.
    7. Family members will undoubtedly interfere, interupt, ask for any number of things and be impatient to be assissted by two Nurses.


    I really don't think anyone has thought this through thoroughly. Furthermore I can't see how JCAHO could possibly condone such a breech of confidentiality.

    Anyone who has been using this method please enlighten me to your results and feelings on the method. I am anxious to hear what everybody thinks.

    CCU NRS
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  2. 6 Comments

  3. by   dhenceroth
    We do not have walking rounds at our hospital, however they do it at a SNF/LTC facility where I visit a family member frequently. I can often hear what they are saying and I think it is a definite confidentiality issue. I think the risks outweigh the benefits....besides, as you say, this may be the first time the nurse going off duty has gotten to sit down!! Good luck.
  4. by   tipitina3
    I thought that walking rounds were a HIPPA violation.
  5. by   Nanette
    Walking rounds can be of great benefit if handled positively, ther e should be nothing wrong with a patient hearing most of what you say about him/her.
    Granted, there are sometimes you may want to add a PS in the hall, most of the time they are gossip type remarks that could be better off unsaid like 'they were on the light all day'. Even that could have been said in front of the patient in the right way.

    With family, you need patient permission.
    I believe JCAHO is looking to encourage pt/family in plan of care and knowledge of care.
    HIPPA does not forbid it, just how it's done and with who's permission.

    I do agree that it takes practise and time to get used to, but those tired nurses will cut out extraneous info and staff will get done sooner.

    At first glance, there is no right or wrong way, but walking rounds are not bad, they work for some.
    just my thoughts
    nan
  6. by   live4today
    We did walking rounds at a military hospital I worked at. They were only done around 0715-0730 every morning after receiving a brief synopsis on every patient. The rounds were a way of introduction for the entire staff to the patients on the floor so the patients would know who we were and who was available for their care that shift. On the other shifts, report was given in the privacy of the nurses report room only. No rounds were made.

    At another civilian university medical center where I use to work, the oncoming nurse did walking rounds with the nurse taking over her/his patients for that particular shift. Anything that was not to be mentioned in patient or family range was spoken privately between the two nurses.

    I preferred walking rounds over any other way of getting report.
  7. by   DelGR
    We've done walking rounds for the last 10-13 years without difficulty. Generally, you can ask the patient's family to leave if you think or know that the patient doesn't want sensitive information about him/her to be shared with other than the medical/nursing people. We have private rooms and can do report in the room or outside the room. Usually, there is no one hanging around outside the room, so there is a type of privacy. You just give the diagnosis, v/s, current treatments, response to treatments and anything new coming up. All three shifts do walking rounds. We haven't had any problems with that. And, as someone stated, anything you don't want to share with the patient you can do outside of the room one-on-one.
  8. by   BadBird
    A hospital I worked in implemented walking rounds because the staff was constantly complaining about how patients were left, such as infiltrated iv's, not marking tubing, not emptying foley's, suction cannisters full, etc... The manager got tired of all the *****ing and one shift blaming the other that she made it our responsibility to check out the patient before we accept that patient. The nurses who were known slackers shapped up and some shipped out. I personally don't like report this way and I think the manager was putting her duties on us but when we pointed out what needed to be done such as simple I&O's before that nurse left although pissed off the situations did improve.

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