Hourly rounding logs

[afteralltheseyears]

Is anyone utilizing the practice of hourly rounding to assess the 4 Ps (position, pain, personal needs and potty) and if so do you have a log up in the room for staff to document it? This practice has been found by research to decrease falls, calllights and improve patient satisfaction. How is it working in your facility?

[IowaKaren]

I can't imagine how this could be done in LTC with the ratios we have, e.g. 1 nurse and 4 CNAs for 60 patients on night shift.

Or, 1 nurse and two CNA's for 60 residents on the noc shift!

[IdrilRN, BSN, RN]

We are 1 nurse and 2 LNA's to 40 at night. If I'm the RN of the night I get to take care of IV's and what not on the other units.

Some people think we should be checking on their family memebers every 15 min. Honestly, this is their home, and that has been crammed down my throught for countless years. Does someone come and check on them every hour at home????

[rntj]

Personally I think the sadists who came up with this nonsense should be drawn and quartered! I constantly check on my patient's pain, turn all my total care pt's q 2 hrs, but I refuse to use scripts or management-mandated communication as I believe it is nontherapeutic and demeaning to both pt and nurse. I sign those damn things off just so I don't get in trouble. I work on a very busy tele unit and I will not tell my patients that I will be in there every hour on the hour to take them to the bathroom, repostion them, and ask them their pain number because it would be a lie and I will not willfully lie to my patients. I have more respect for them than that and more respect for myself to not be made a pawn of management and their obssession w/ pt satisfaction (apparently they have not seen the new research that higher pt sat scores positively correlate w/ negative clinical outcomes and deaths). Sorry, nope, not this nurse, I will not drink the Kool aid.

[IowaKaren]

I can't imagine how this could be done in LTC with the ratios we have, e.g. 1 nurse and 4 CNAs for 60 patients on night shift.

That is a nice ratio, where I'm at it's one nurse, 2 CNA's for 60 and to be available for the Assisted Living Facility that is connected to the home since the care aide leaves at 8 PM and insulin still needs giving along with any 'needs' that happen. Acuity always worsens and the work/charting needs have increased fifty fold with less reimbursement than ever. It's a crying shame for these poor residents anymore and the nurse's and staff's sanity.

[gonzo1, ASN, RN]

I do work at a place where we have locator badges and admin can run off a sheet to see how often we are in the room. I love it. It has a panic button on it too. I do ICU though so log sheets aren't needed with a 1:2 ratio. Every ER I have worked in that has these sheets are pointless. Everyone just signs them at the end of shift.

Almost all of the nurses I have worked with in my career are already working as hard and thoughtfully as possible and if they didn't check on the pt in room 3 for 2 hours it's because they were coding the pt in room 2.

Management needs to come out into the real world and get a clue.

I love our director. She frequently takes patients when we are short.

[lilede15]

PPD is based on several factors and stands for patient per day. So the standard for ppd comes from a budget set by the company and what is acceptable by state to take of the residents that you have depending upon acuity. It is not unreasoanable for a nurse to take care of 20 stable residents. Or 18 stable and 2 unstable. There is not a law that states how many pts a nurse can care for. It is what duz she feel safe accepting and the area which they work. PPD per insurance companies says "oh we will pay you this much per day for your staff" based on the information that the facility has sent in. Sad as it is budget comes in to play. After all the company has to make money plus pay us and feed out residents