Hourly Rounds

The idea and practice is sound, according to studies that have been done showing improved patient satisfaction, reduced pain levels, etc. The problem comes in when nurses have too many patients and not enough help to do hourly rounds, address needs (pain medication, food, drink, blanket, pillow, etc.), and chart without feeling overwhelmed. Right now I work in a small unit and with 2 - 4 patients and the hourly rounding from 7 - 11p takes up all my time, but it is doable. When we first started hourly rounds a couple years ago, most of us would just keep our notes in our pocket and jot down what we did, then we would chart everything at the 11p full assessment. Now we have computers at the bedside which makes it easy and convenient to jot down a note and that pleases management because they don't like having to explain 4 - 5 hour old charting when the JCAHO comes to survey our hospital. I personally cannot fathom working on some of the med/surg units (like in our system) and trying to do hourly rounds on the 8 - 12 patients they usually have each shift, it has to be nightmarish!

It's a good tool, it's when it becomes mandated that it becomes a problem.

I agree with the above poster. It has it's place and works well if implemented correctly and with enough support staff. My facility has the RNs round on the even hours and the CNAs round on the odd hours. However, I have found that it seems to annoy about 50% of my pts. I've had quite a few say, "Why don't I just give you a call when I need you?" I explain our policies and why we're doing it. Most are fine with it, but there is a point where I can see that it's pointless. If the pt is stable and probably going home soon, that's when they get annoyed cuz they don't feel they need that close of observation. Oh well. It covers our bootays!