Hourly Rounding in the ED

[biker momma]

The ED I work in has instituted a "policy" of hourly rounding. I understand that this is an ideal on a medical/surgical type floor and agree with the concept in the ED but......am wondering about in the ED. Do any of you work where hourly rounding in the ED is the norm. I make a point of checking my patients frequently (usually more often that q hour) and charting the interaction. Part of this new policy is an effort to improve our patient satisfaction scores. A second suggestion that is floating around is doing walking rounds at change of shift. Again I see the value but am wondering about how well it works in the ED. Any thoughts? What is your ED's policy on charting and patient rounds.

[F.E.R.N., BSN, RN]

Sometimes it just doesn't matter what you do, people will be unhappy, and any rounding won't change it. Take yesterday...I had a critical patient, was in his room every 5 minutes...in fact it seemed the only reason I ever left was to get more supplies. I had taken over this patient from another nurse who was about to be up to their eyeballs in another critical case w/intubation pending. My patient was in DKA, ARF and having an active MI to boot as he rolled to my room and I took report on the fly. I thought I was extra considerate of the family, letting more stay in the room than usual, since the docs were scarring them all with predictions of doom...working my a$$ off, along with several other staff members to make this work. Then one of the sons says, "Well, I don't like doctors or hospitals, and I don't want that other nurse in here...she called my dad an a$$hole." With the whole family starring at me, I wanted to say, "You ungrateful bast@@@. After all we've done here today...not only do you not see the work we put in to saving your dad's life, but you actually think that any of us would say any such thing to a patient????":angryfire

Oh, but my rounding sheet was properly filled out, so I'm sure our Press Ganey survey will reflect their satisfaction.

[hollysunshine]

We just started this in my ED about a month ago. I was already seeing my patients at least every hour, but now we have to document that we updated the plan of care with the patient. We only actually have to document every 2 hours. The nurses document rounds on the odd hours and the techs on the even hours. I guess we have to have documentation that someone has seen the patient every hour. I'm sure it all goes back to those precious Press Ganey scores. Sometimes I feel like more of my time is spent doing documentation than patient care.

[hollysunshine]

I think we might be at the same hospital. We got an email about the 5 P's. Can't remember the 5th one either.

[ladymedik]

I work as a nurse tech (for now, waiting to take NCLEX). Part of my job is to do the hourly rounding on all rooms in the ER. I ask each room if they need anything, blanket, drink or if they need something from their nurse. This works pretty well, and it frees up the nurses. Granted we are a small ER only 15 rooms, but it seems to make the pt's happy, and helps a great deal with Press Gainey scores.

[~'JesusRocks'~]

unfortunately i think hourly rounding is here to stay. it will prob take a few months to work out the kinks but you will find a way to do it and get your work done. just time the hourly check w/ having to be in there anyway, and the tech should take every other hour. in a 12 hr shift you prob see the pt every 2 hrs, and if you cant due to a code or crit. pt note that somewhere. if managment faults you for that forget it, you are protecting your liscense.