Hourly Rounding

[neneRN, BSN, RN]

Our unit (ED) is implementing hourly rounding this week; all staff has been educated in the past few weeks, but there's a lot of resistance. The research presented to us sounded great, but there's not a great staff buy-in yet......Those of you who are doing who have already implemented rounding, what differences are you seeing? Is it working for you? How did you get staff to do it? And how long until everyone is on the same page?

[Dixielee, BSN, RN]

I think hourly rounding is a great idea, but sometimes I am so busy, I realize I haven't seen a patient in 3 hours. Sometimes each of us have 7-8 patients each, and I am lucky to see them more than once or twice. I put everyone on a monitor so I can at least be sure they are getting vital signs checked.

I hate to say it, but many times, I will see them initially to start their IV, draw labs, and give meds. I put the IV on a pump so I will at least get a warning before it runs dry. I will try to get back to see how the meds worked, then usually not again until they need more meds, or I am discharging them.

If staffing was solid enough to be able to round hourly, I say bring it on!

[neneRN, BSN, RN]

Do you use CNAs/PCAs to help with rounding?...we're going to try RN rounding every 2 hours with the techs or LPNs rounding in between.

[EDValerieRN, ASN, RN]

We have this extra form that we are supposed to initial every hour that says we were in the room, and what the patient was doing. It's not a part of the chart, and I think it's a waste of time. One more piece of paper to fill out is not the best idea, and a lot of us just don't do it. However, I do round on my patients as much as I can. I never really sit during a shift, I'm in a patients room or doing something for a patient.... I don't know about the tech aspect, we don't really have techs to speak of, and if we do, they're stocking or something.

I've been hospitalized twice in the last month, about 9 days total... and I found it to be really annoying when my nurse hourly-rounded on me on the floor. I would ask them to please just come in a few times, and I would be sure to call if I needed something. They never minded that approach, as I'm sure they were busy.

[TazziRN, RN]

We're supposed to do it but in reality it isn't doable at our place when it's busy. There are times when I triage a pt and discharge them, but I haven't seen them in between.

[clemmm78, RN]

When I worked on at 34 bed unit on nights, just me and one other nurse, we did two hour rounding and that was all we had time for. Now, in my 9-bed unit, we do official every 2 hour rounds, but I almost always round every hour.

[perfectbluebuildings, BSN, RN]

LOL... they tried this at our hospital and they got complaints and one family even left AMA saying they were being bothered too much. It went along with the thing we were supposed to say "Is there anything else I can do? I have the time." I never have said that, and I know the patients and parents would think we were idiots... it sounds so scripted and most of the time is not that true anyway. There was a whole template/list of things to ask on rounds, and little cards we could leave and sign if the parents were asleep or out at the time we came by... haha.

We have to check our kids every 2 hrs anyway and parents are not at all hesitant to call out if their kid needs something else in between!! I think it was a silly idea that mostly goes along with what we (including all nurses) do anyway. Hopefully it will adapt to reality and the good things about it will stay and the unrealistic things will fade away.

[Cheyenne RN,BSHS]

to me it seems that whoever came up with this new "hourly" rounding definitely does not work on the med/surg floor with 6 to 8 patients at a time ...alone, without anyone else assigned to the group of patients.

i can get an admission and by the time i do their assessment, start their iv, insert the foley/ng tube/whatever ... and start their initial "stat" meds, i can be with them the whole 60 plus mintues.

now try that in the middle of a morning med pass and forget it. and heavens forbid you eat up time beeping and re-paging a doctor for an order on a patient going down the tubes and trying to get them transferred into icu.... it just is not physically, emotionally, mentally possible 88% of the time.

[Tweety, BSN, RN]

We've started it. Licensed nurses round qeven hour and techs qodd hour.

So far most of the staff has ignored it and there aren't good results to post after four weeks.

Change doesn't happen quickly where I work. But I'm open minded to it. It puts more control in our hands to be proactive rather than react to when they ask for something.

I imagine in the ER it wouldn't work as well. Our ER is too crazy sometimes.

[MedSurgeNewbie]

I like the idea in theory, so long as we have soild staffing- if I can use cta.stana's too - I wish in a way stna's could learn some basic charting and add to the notes - they could get more credit for all the work they do

[RN BSN 2009]

Yup.. if staffing meets the needs, then why not :)

[NicoleRN07, RN]

Hourlly rounding is a great idea! We do this in our ED (or are supposed to), so that the patient is coming in contact with someone whether it be nurse, md, or tech. It has greatly improved our patient satisfaction. We do VS q 2 hrs on every patient who has been triaged as a level 3, 4, or 5 (yes, we even do VS in the waiting room if they have been there long enough to be revitaled). This helps us provide better care to our patients.