Walking Change of Tour Rounds

  1. Hi! I work on a 40 bed General Medicine Unit. I have been asked to institute a "walking rounds" change of tour report format. Usually change of tour report is in taped form evenings to nights. It is given verbally by the Charge Nurse to the team in a conference room from Nights to Days and Days to Evenings. The patient population is generally middle adult to geriatric. The commmon dx are COPD, Cancer, TB, HIV, Pnemonia, CHF, Diabetis, Nursing Home Placement, Sepsis, etc. I have several questions. What type change of tour report do you use? Have you ever used a walking round method? What are the time lmitations or other lmitations of this type report format? What are the benefits? I am not opposed to using this type format I just need to know if you have any suggestions to assure that report can be given in 15-30 minutes on 30-40 patients? If you have any positive or negative information I would like to hear it. Also do you know of any recent acticles that I can review on this topic to support using it or that describe it in detail? Thanks for your help.

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    Irma
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  2. 11 Comments

  3. by   nsgsup
    We tried a walking rounds report several years ago with little success. It just simply took too long! The medical floor at our hospital which sounds very similar to yours, now does a written report. Nurses make short notes on each pt., with all pertinent info covered.(vitals, I&O, IVs, tests,etc.)The staff have found that shift change runs a lot smoother and less info is missed, also helps to reduce overtime due to long report.....
  4. by   TessaG
    I too am from a small 23 bed med-surg unit. Our report consists of a taped report from the previous shift with occasional live reports if they didn't have enough time to tape. The report usually lasts 45-60 min. (too long) and not all info. is being passed on shift to shift. We are also looking at changing this to either charge nurse to charge nurse or written report. We too are always looking for new suggestions on changing the infamous "long reports"....
  5. by   nancnrse18
    Over the years we have tried a variety of ways to give report, taped report took forever, giving report verbally to everyone took longer, we now give an oral report to nurses assigned to same patients this takes about 20 min. we don't have charge nurses anymore so each nurse is responsible for their assignment.
  6. by   Suzanne
    Tape is fast but often needs addits in person. Ward round handovers are beneficial in that you see the patient state. YOu combine diagnosis and handover to a person not name and it stays embedded longer for most people. You and the patient are introduced so they know who is now on duty.
    Both systems should not require diagnosis if you already have printed sheets with this on it. Care plans are devised to give you basic care guidelines so only add things that you know put the patient or staff at risk especially if new staff on.
    Goodluck. I have worked with both and found them equally valuable.
  7. by   Gerald
    I work on a 34 bed acute care medical ward. We practice primary care nursing. We used to use the old tape recorder for shift report, however, we no longer do that. Now each nurse reports verbally to the oncoming nurse for that group of patients. Of course with differences in the numbers of nurses on each shift, this means that you usualy give report to more than one nurse. It does involve some waiting time while the other nurse finishes their report, however for the most part it seems to be quite effecient. It does mean that each nurse does not hear the report for the rest of the ward, so that is where the time saving factor comes in. It is usually about 10-20 minutes, depending of course on how much "action" there was on any particular shift. We find that this works quite well.
  8. by   TunesRN
    I worked a long time ago in an eye hospital and had the misfortune of arriving home one morning in time to answer the telephone. It was the night supervisor informing me that after I left, a patient had been discovered in his BR with his wrists slashed. Fortunately he was found in time and the outcome was ok. It was determined that he had probably done this around change of shift. I have always felt a certain degree of "guilt". I think walking reports would have turned up this problem before I went home. They were instituted shortly after this incident, we continued taping the report as usual, and did a walkaround with the incoming staff before leaving. The walkaround was an adjunct to the taped report and became the format for any questions which were formerly asked at the desk. Added time was negligible.
  9. by   ecb
    My facility does NOT require walking rounds, but my unit manager recomends this in addition to the written 24 hour report, I am able to ask about potential inpactions, get Tube Feeding totals, and little stuff that gets forgotten in written report can be passed on to me (or my relief) at shift change.

    I know nurses who refuse to do them, and it is usually because they want to leave the instant their shift is over. but very few people refuse at the shift opening.

    It only takes about 15 min on my 1/2 of my floor of 32 patients, but our consist of how a day/shift went, any incidents, new orders, the diagnoses remain the same, and we have to give detailed reports only when they are already on 24' report already (or if they are dieing and a DNR)

    I prefer it, and it protects both nurses, and I feel it improves patient care, and is worth it (but you knew that)

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    *** May we all have the serenity to accept what we cannot change, and the determination to change what we cannot accept. ***
  10. by   nlls
    We are being forced into walking rounds at the hospital where I work...Please someone give me some good advice..They are also doing away with out shift end report sheets, that had all the pertinent info on the pt.'s. Help!
  11. by   litbitblack
    We started doing walking rounds with just the charge nurses and the primary nurses just gave report to the ones who had thier assignment. Now the charge nurses give report to the charge and the primaries still give report to he primaries and it seems to work better. We found on walking rounds we would have to stop and help the patients and take them to the br ect plus their wasn't much privacy when your talking out in the hallway or family is in the room for the stuff they might not need to hear. Don;t get me wrong I love helping my pts but when you have to round on 28 and everyone needs something it just takes forever and puts you behind. We also do hourly rounding and that helps since the rounds are done just before shift change so everyone seems to be taken care of. it usually only takes 10-15 minutes to give report to the other charge and if the primaries want to get out faster they make sure thier stuff is ready.
  12. by   nursynurseRN
    Quote from Irma L Westmoreland
    Hi! I work on a 40 bed General Medicine Unit. I have been asked to institute a "walking rounds" change of tour report format. Usually change of tour report is in taped form evenings to nights. It is given verbally by the Charge Nurse to the team in a conference room from Nights to Days and Days to Evenings. The patient population is generally middle adult to geriatric. The commmon dx are COPD, Cancer, TB, HIV, Pnemonia, CHF, Diabetis, Nursing Home Placement, Sepsis, etc. I have several questions. What type change of tour report do you use? Have you ever used a walking round method? What are the time lmitations or other lmitations of this type report format? What are the benefits? I am not opposed to using this type format I just need to know if you have any suggestions to assure that report can be given in 15-30 minutes on 30-40 patients? If you have any positive or negative information I would like to hear it. Also do you know of any recent acticles that I can review on this topic to support using it or that describe it in detail? Thanks for your help.

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    Irma
    I think that walking rounds sucks!.. Not completely, but it does. We giverwritten, verbal and also walking rounds. I think that when you have 5 patients with five different nurses to give report to, then it takes too long.
    It is good if you wanna see everyone quickly in the morning and introduce yourself, but it is bad if there is someting wrong with an iv or something and then you have to confront the night nurse
  13. by   RiverNurse
    Quote from sabrosura98
    but it is bad if there is someting wrong with an iv or something and then you have to confront the night nurse
    I'd fix it instead of confronting. There might be a day when that particular nurse might need to cover my back. While walking rounds may be time consuming, it is for these very reasons that I prefer them. I'd much rather catch something undone and with the 'off going' nurse - than have to find it on my own and wonder how it got that way. This way, I can brainstorm with the accompanying nurse.

    Then again, I live in an idealistic world...

    Take care,

    Shawna

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