Hello, a nursing student from the USA here.
We're looking into Releasing Time to Care, and are being asked to imagine how the modules would relate to the US's health care system, since the hospital we practice at is implementing this Programme. They need the modules adapted, and we're a low-cost problem-solving measure.
My working group was assigned the "Observations" module, and we're a little stumped as to what, exactly, Observations might be. We see that they include vital signs and a fairly basic list of questions into the patient's experience and well-being. But it's taken for granted that we'll know how often they're done and how they're used to further the patients' care.
Here in my part of the US, a more common ward (=unit) policy is:
- A full physical assessment done and charted per shift/ every 8 hours/ every 4 hours (depending on institution and unit policy)
- Vital signs done and charted every 4 hours to 8 hours in general, and at times as often as every 15 minutes if the patient has just gotten back from a major medical procedure like cardiac catheterization or surgery.
- Additional vital signs as needed, according to the judgement of nurses, doctors, and aides
- Additional focused assessments as needed
- Rounding (= visiting 2-8 patient rooms) every 1-2 hours by every individual nurse. The nurse will only be expected to round on the patients they're assigned to, unless they get asked to temporarily take on another nurse's patients while the other nurse eats lunch or does something urgent. During rounding, it is expected we will ask all questions about pain, comfort, etc.
- Call lights - patients are provided with buttons they can press to call anyone at need. Anyone who sees a call light flashing in the hallway outside the room is expected to answer it, though in practice some nurses will hurry faster if it's "their patient", while others may not hurry and may expect an aide to answer the call light for them.
Baths, oral hygiene, vital signs, weights, ambulation, and toileting are generally left to the aides to do. The nurse is responsible for all other tasks for their 2 (in the ICU) to 8 or more (in med-surg...if they're unlucky) patients.
How is this similar to, or different from, the patient assessment practices run by the NHS?
And where do Observations fit in with this picture?
Any help greatly appreciated.