hourly rounding

Specialties Med-Surg

Published

Anyone doing this and if so how is it working out and how did you get the nurses on board/

I get tired of the excuse "just don't have time" do you say that about meds, assessments, dressing changes, noting orders, calling doctors ? What does one eliminate because they "just don't have time" If you are an RN your role is to delegate tasks to CNA/LPN so you can do task that require an RN. Why don't the LPN/CNA do rounding ? You say they can but just don"t Why? As far as "paperwork" that is the "prove" . You will be glad you have that "paperwork" if you have to defend yourself in a court of law or even to your supervisor. Remember if it isn't documented then it is considered not done"

Hope your Rounding gets better. Sounds like your facility has some work to do by defining who should be rounding and when. We started Rounding aprox 1 month ago. It has went well. Our Rounding sheet incorporates the IV documentation as well as the turning documentation. Our aides, lpn, and Rn's are expected to round every 2 hours day shift every 1 hour noc shift. They are expected to address the 3 P's position, potty, possessions (call light, h2o etc). Our aides do not check IV's so the nurse still goes back in to do IV check. It all gets done. The nurses have a pt. ratio up to 7:1 with many times 2-3 discharges and as many back in. In some of my earlier post on this thread I mentioned some articles re to rounding . They may be helpful.

I think the problem is that it's annoying & insulting. What do they think we do? Who doesn't round on their patient at least q1-2hrs? The call bell is not there for decoration. I know all nurses take totals into consideration...

I think when management looks at implementing plans, they look at the individual assignment. Oh cool, well all the nurse has to do is sign her name on a couple of pages...what about qthing else.

So sign a paper @ 8 to say I was in the room @ 8 although I gave a pain medication @ 8 (documented in mar & cpu) & there's a scheduled med due @ 8 and documented assessment @ 8. Well I guess they want proof...

towards the end of the shift when I'm finished charting around 8 I probably would just fill in an estimated time I was in the patient room for qhr. I guess it's okay considering that society is becoming more litigious.. That's a lot of paper to be holding on to..just in case someone may decide to sue....

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Specializes in Management, Emergency, Psych, Med Surg.

We do hourly rounding, RN's and CNA's and it has really reduced the time on the call lights. We don't wake patients up. If they are sleeping, we just check and make a note on the rounding form. As charge nurse I also make rounds on as many patients as I can during the shift. I try to see all patients that have special problems, all hospice patients, patients with demanding family members, fresh post ops. If I know there is potential for a problem I try to get involved before it gets bad and I take care of it because the nurses do not have time to get tied up with a family for a hour (I don't either but sometimes I have to). It has worked great for us and our patient satisfaction scores are wonderful and we rarely have a patient fall or use restraints. We also a a great nurse patient ratio on our floor 4:1 or 5:1. This is a 34 bed med, surg, ortho unit.

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I guess I don't understand that it cuts out on call lights. What is the difference in going to the room when the call light goes off and going to the room when you round, both are a visit to the room. You should count all the visits rounding just like you would count all of the call light visits. 5 patients, 12 hr shift, equals 60 visits plus call light visits. That does not sound like a time saver to me.

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Specializes in Orthopedics/Med-Surg, LDRP.

We also are supposed to do hourly rounding. We've done a variety of things from havng sheets we had to initial every hour and we had to assess the 3P's: position, pain, potty. I'm sorry, but i'm not waking someone up every hour who is less than 70 years old who is 3-4 days post-op and AOx3. Then we get dinged for them not getting a restful night. Now the confused patients, the fall risk patients, the fresh post-ops, absolutely. We don't have those sheets anymore and us and our aids have an agreement that we each go in q 2 hours, so that someone is in there hourly. Me, them, me, them, etc. It hasn't helped much. Maybe catching a climber in the side rails, but that's about it. I had rounded on a guy at 1am and at 145 he was on the floor. And then there's nurses intuition. You just get a gut feeling when someone is just not going to do well and it behooves to listen to it.

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our hospital has been working on AIDET and hourly rounding for a while now, and really, not seeing the success. it's frustrating to see yet another sheet of paper on the wall to sign now, and it's not unusual to have no CNA for the day and have 5 pt's. when you've got one confused pt, one w/c-diff well...hourly rounds are immediately challenging. i've also noticed that some patients just don't care to be bothered hourly! they find VS q4 to be annoying. feel like i'm pushing buttons and not letting a generally normal person get over a bad time in their life without interrupting b/c i don't trust that they are smart enough to inform me that they need to potty or that their pain is increasing. i'm smart enough to see when a pt appreciates my stopping in frequently or when they prefer the solitude and quiet. personally, i'd be hating the nurse coming in every hour while i'm ill. ugh.

we are lectured constantly about our lack of rounding, our need to please our pt's, and our "scores" on surveys. so btwn the sheer exhaustion of what our job takes and then hearing i'm still not doing it well enough, i'm pretty much done with it in general. i plan to finish my time and not look back. for me, hourly rounding was the beginning of my end not b/c i disagree. i'm in there every hour for the most part. it's the lack of trust and my superiors blaming me personally for what they have decided to not fund in their hospitals - more employees, and happy employees. that piece of paper is an attempt to stretch the dollar and it's only decreasing quality of care at our hospital.

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our hospital has been working on AIDET and hourly rounding for a while now, and really, not seeing the success. it's frustrating to see yet another sheet of paper on the wall to sign now, and it's not unusual to have no CNA for the day and have 5 pt's. when you've got one confused pt, one w/c-diff well...hourly rounds are immediately challenging. i've also noticed that some patients just don't care to be bothered hourly! they find VS q4 to be annoying. feel like i'm pushing buttons and not letting a generally normal person get over a bad time in their life without interrupting b/c i don't trust that they are smart enough to inform me that they need to potty or that their pain is increasing. i'm smart enough to see when a pt appreciates my stopping in frequently or when they prefer the solitude and quiet. personally, i'd be hating the nurse coming in every hour while i'm ill. ugh.

we are lectured constantly about our lack of rounding, our need to please our pt's, and our "scores" on surveys. so btwn the sheer exhaustion of what our job takes and then hearing i'm still not doing it well enough, i'm pretty much done with it in general. i plan to finish my time and not look back. for me, hourly rounding was the beginning of my end not b/c i disagree. i'm in there every hour for the most part. it's the lack of trust and my superiors blaming me personally for what they have decided to not fund in their hospitals - more employees, and happy employees. that piece of paper is an attempt to stretch the dollar and it's only decreasing quality of care at our hospital.

I so agree.

On normal nights, (proper staffing, available equipment, stable patients, etc) I have absolutely no problem with it. I kind of like doing it, actually.

But we have been so short staffed lately, with high acuity patients, that hourly rounding is nearly impossible - you're just reacting to situations and trying to get the essential patient care in. Today we got a nasty, condescending email from our manager, talking about our noncompliance with the policy and how "research articles prove..." blah, blah... "and she'd be happy to show us the research" blah blah...

I don't doubt the research, but wonder if she has seen any research regarding nurse-patient ratios??? I'd be more than happy to show her that!

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Anyone doing this and if so how is it working out and how did you get the nurses on board/

we do this at my hospital.....but share this with the nurse techs...so for the nurse it's q 2 hours .....for 3-11....i take the even starting at 4,6,8,10 and techs take the odd starting at 5,7,9,11....works out....:)

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