our hospital recently implemented hourly rounding. but before that we have to go through a one on one teaching session with our manager so we can go through a script on how we will address our patient every time we make rounds (a script...sounds like a play!)
"is there anything else i can do for you? i have time."- this should be the exact words we are required to use before we leave patients room.
(i could bring a recorder with me and play it everytime i check on my patient...hehe! ) of course, our patient are expected to be informed of this hourly rounding. and if we don't show up in their rooms or missed the due time for rounding..patient and family can write us up and complain.
take note , we are to document this rounding in a piece of paper. if not our attention will be called for not documenting it. so my guess would be unrealistic documentation. why? most of the time you can be stuck in one patient for 45 mins to an hour esp when you have a needy patient. and they rarely provide us with nurse aide or techs.
(can i just clone myself..! maybe clone a secretary so somebody can enter doctor's order while i do my hourly rounding).
well the reason for this because they want a high score on patient satisfaction..oh yes to be recognize!
how about nurses satisfaction? nah..they don't care!
Just a thought...Scripting would most likely improve pg scores. Instead of explaining side effects to the patient in a meaningful way, we could instead say " I want to be sure you understand the side effects of your medications." Then rattle off a list the way the drug companies do in their commercials.
We all know that more frequent rounding does in fact decrease the number of times a patient uses the call light. Some patients need the extra reassurance that we are in fact paying attention. Most do not. In the past, I would round in an unobtrusive way. (Except for the patients who need the extra reassurance.) Now I often make a point of telling the patients that I'm "doing my rounds, making sure the IV is O.K. and that you are not in any discomfort." Sometimes this is more helpful than I expect. The patient sometimes can be involved in a conversation about how I know everything is O.K. and I can explain the rapid assessment that I do on entering a room and even validate that assessment with a more formal assessment. It's an interesting way to get patients involved in their own health care. But to be honest, pg does not reflect patient satisfaction and mostly leads to good scores verses good patient care. The same can be said for scripting and timed rounding.
You are so right!! Hourly rounding is linked to press ganey scores and patient/hospital satisfaction. A management strategy to improve public perception and patient satisfaction. PR....
Are you talking about INOVA. I hate that place. All that stupid stuff about -I am going to give you excellent care makes me sick. I have left that sickening place. They are happy when they see those nonsensical rounding logs completed lot of nurses go and at the end of the shift mark them off. They have no meaning and by no means reflect good or bad patient care. They like to treat nurses like waitresses so they never gather enough self esteem to stand up for thmenselves.
INOVA Health system is totally screwed up. They do not focus on patients they only focus on the jazzy paperwork.
If you are a good nurse you would check on your patients, if you do not care about your patients you would just check off the sheets and make yourself look good. I hate the way these facilities treat you. I am ready to quit nursing. I was told that I have a safety violation because my hourly rounding was not complete and I did not use the word excellent so the patient was not assured. What is this craziness? Imagine in this job market they treat nurses so badly what are they going to do when it starts getting better. I regret that I spent all this time and money to become a nurse, they shoot themselves on the foot and wonder what is wrong. Nurse quit and do not stay at one place for too long because of this kind of hostile environment. They can give people sign off bonus etc. But reality is there has to be a major shift in the way these organizations treat nurses.
I have been informed by the hospital I work that we will be going to this "Rounding with Purpose" program and it will start Set. 29th. The hospital assures me that this program will result in better pt. care, less call lights going off, and, overall, better pt. satisfaction with the nurses having more time to do their paperwork. The hospital also states they have research that shows it really does work.
Even though this looks good on paper, and looks like a good concept, I have my doubts about this as nurse who works the floor and lives in the real world.
Could I hear from those who work in a hospital which recently went to this program and relate your experiences working with it?
I still think the best approach would be a nurse/patient ratio based on a level of acuity classification system(which I know my hospital would not do).
RE: Rounding with a purpose. It has been 2 years now since we incorporated the Rounding.. As with any "rule" it is only as good as the enforcement. We also rejected the canned porgram put out by Studer. I never could get an answer from ANY of the reorted test sites about staff mix, acuity etc, I even called, emailed and wrote to the nurse author of the article, no reply!! Even the Studer group did not reply! I feel the information is bogus. Save time, not really. As usual, the better practioners rounded, did actual assessments and followed up on pain meds. The poor practioners did "door way" assessments and then sat at the desk. Studer has made a bundle on his infomertial programs and managment is buying it! I am at a for profit facility, we have a rounding sheet with vs, i/o etc on the door(HIPPA?) I know they are being checked at the beginning of the shift "I was here". It just happens we have very weak supervisors, no leadership, no follow up, the program was rolled out poorly, no initial stats as to # of call lights in order to determine if call light usage was down. The attitude was"Git'er done!" I was on the committee to roll it out, we
modified it to fit out facility and to be workable, use your own personality to follow the plan after all we promote, people caring for people. So, no, this has not worked, nothing has changed on to the next program, "Ideas to save money" complete with little paper flags as a promo. Sheesh!
When we attended the orientation for this new "Rounding with Purpose," we were told that if we came to a room, during an hourly round, and the pt. was out for a procedure, we are to place a "sorry we missed you" card in their room. After the orientation finished, we had to sign a committment paper stating we would follow this program. Why is that? Is this the Studer Group? What is the main purpose in a hospital doing this? Do they really think this program will work?
Yes, the "sorry we missed you" is part of the Studer program. Your facility wants you to sign because they have spent a great deal of $'s on this program. The program even says you have to check you rounded on EMPTY ROOMS!! As yet, I have not seen the data on their evidence based practice. Our manager checks and files a report on the data sheets taped to the pt door each 24 hours. C'mon, do they really think every one really is in the room for each check mark on the page? I calculate for the cost of this program we could have added at least one staff member/shift and really given the pt more attention. Sorry state of affairs. Do we see a manager at night verifying rounding? no. Do the managers check when they have entered the room to do pt satisfaction inquiries? no. Hear that? that was the crash of the ball dropping on Rounding With A Purpose!!
we implemented hourly rounding quite awhile ago; but it doesnt cut down on call lights I have noticed. Pts eventually become annoyed with the peeking in q hr to see if they need something; especially the younger, independent pts. for the older, more dependent pts i think it helps to a point; but most of the time no more than you leave the room the call light is on because now they have thought of something. (I actually have had pts who thought they NEEDED to come up with something that they need q hr.) It doesnt get done on my unit bc we literally have NO time do it at all! we cant hardly educate our pts properly or take time to simply talk to them outside of asking them how they are doing. we are also supposed to initial q hr when we are "in the room" on the i&o sheet, but since its not a part of the perm. record, no one marks it.
I think, w/ our charting, placing our telemonitoring strips in the charts, charting, giving medications and dealing w/ pt.s that require high levels of nursing care, that this q hr rounding is going to be difficult to do, if not near impossible.
I can understand the hospital not wanting to go to a nurse/patient ratio based on levels of acuity classification because that would mean spending more money, but I think this would provide better care for the pt.s! Plus, the labor union has wanted to get in to our hospital and has placed a nurse/patient ratio, among other things, on the table as a selling point in why we would want a union. You would think that the hospital would consider implementing this level of acuity classification if they wanted to keep out the union, rather than this q hr rounding!
Sorry if I missed it, but what do you do when the pt is asleep? I work nights, and try to "bundle" care so that the pt's get a least at couple of uninterrupted hours of sleep whenever possible. (Whicn is a good thing according to EBP). So, is it better for the pt to get through all of the stages of sleep, or be wakened every hour to see if they need anything? Can you let a sleeping pt lay? (or is it lie?)
:yeahthat::yeahthat::yeahthat:
casperx875x
129 Posts
I'd like to know, when are we not in each patient's room at least once every hour!?