I am a new ADON in an LTC center and am the unit manager for the Skilled/Rehab unit. In the month I have been there, I have found that serious care issues are falling through the cracks and changes in condition are being missed.
In an effort to stay on top of these changes and improve the quality of care, I have been working with my assistant nurse coordinator in developing a plan to implement DAILY NURSING ROUNDS. He and I plan to review 8-10 patients each day from 0900-1000 on Monday-Friday. This way each patient would be reviewed once by the end of the week (full house is 42 patients).
We plan to review nurse notes, weights, nursing assistant documentation, compare the MARs with the orders, the treatment records, changes in continence, mental status, labs, pain, and general appearance of the patient's room. Unfortunately, this allows only 6-7 minutes per patient if we are hoping to round in one hour or less. Daily rounds on each patient would be ideal but that's just not realistic.
Does anyone have any suggestions on either improving this system or implementing another system that would address the same problem but possibly in a different way? Thanks for your assistance!