Is there anything else I can do for you? I have the time. (new hourly rounding sheet)

[FireStarterRN]

We had an inservice yesterday. Now, they've instituted a new fall prevention policy that they basically expect every inpatient to be on. You have to reassess every 12 hours, plus reassess with every change such as a new narcotic or BP med, or transfer to another unit. They want the nursing staff to do hourly rounding, and have a sheet up in each room to check off that this was done, along with what the pt was doing at the time. They expect the nursing staff to ask "Is there anything else I can do for you? I have the time."

I told the woman that I wasn't going to say any canned comments like that, that it would seriously annoy many patients to be repetitivly asked the same question. I also told her that I basically already do this, but I don't want to follow a formula. She replied that many people, especially the CNAs aren't doing this, that probably most nursing staff was, and that this was more to get the CNAs to interact better, and that they would be the ones to do the check sheet. She said that they don't expect you to say the same thing each time, just use that as a guideline.

Well, since I already do this I don't have a big problem, except that the charting will be totally obnoxious and meaningless because I'll most likely hurry through it. Since I work in the ICU, it won't be to bad, but when I float to Med/Surg it will be a PITA to complete all this extra charting. The check off sheet will not be a part of the permanant chart, but will be collected each day and reviewed by the unit managers. I feel sorry for them, that sounds like a dreary task.

Honestly, there are nurses on our Med/Surg unit who sit at the nurse's station quite a bit, so I do think there is a problem that this is trying to rectify. But it's making a lot more charting for everyone. :angryfire

[NRSKarenRN, BSN, RN]

evidence based practice:

nursingcenter - library - journal issue - article-clinical rounds ...they found that during a 12-hour shift, their walking distance was reduced from 5.2 miles before hourly rounding to 4.3 miles with hourly rounding. ...

studergroup - hourly rounding dims call lights

advance for nurses | editorialhourly rounding boosts nurse morale, patient satisfaction and reduces call light ... hourly rounding plays a major role in the patient-centered health care ...

hourly rounding proved successful in other areas, as well. clinical outcomes improved, participating hospitals saw a 50 percent decrease in patient falls, and patient and employee satisfaction increased. of the 14 hospitals that participated in the study, 13 decided to expand the practice to other units or all units of the facility.

hourly rounding was the standard i practiced in the 80's. is there anything i can do for you now was a phrase i used quite often...also would round and tell patient if i'd be tied up with extensive care in another pts rooms or critical pt situation and time frame get back to them. if unable to do task xyz would give them time frame when i could......

colleagues often commented about reduced call lights and patient interruptions...i just tried to pick brains of senior staffers that i admired and made positive impact on patients lives; their tricks worked.

we also went form taped report to bedside report in early 80's cutting report time in half ---could take in more visually with sweep of an eye things unsaid on garbled tape machine.

25 years later, being reintroduced because they worked.

[celery]

That excerpt from ADVANCE is interesting. I haven't noticed the hourly rounding thing boosting nurses morale. If anything, it seems to reduce morale.

To be fair though, it's really not all that bad. It only takes about 5 minutes to run around all the rooms at the end of the shift and fill them out, lol.

[nightmare, RN]

We do hourly and sometimes half-hourly rounds.The carers have to sign off check sheets.We have a computerised call system so every time we enter a room we have to "Bleep" the reset.This registers on the computer. It is very handy for those occasions when a resident tells their relatives that "no one has been near me all day"!

[FireStarterRN, BSN, RN]

Just an update on this. It hasn't changed anything on Med/Surg when I float over there. None of the nurses are filling in the sheet, they expect the CNAs to do it. I was the only nurse who was charting on the sheets on the door. There is still a poor work ethic with several nurses in the unit. The sheets appeared to be only partially filled out.

[marie-francoise]

Hourly rounding was the standard I practiced in the 80's. Is there anything i can do for you now was a phrase I used quite often...also would round and tell patient if I'd be tied up with extensive care in another pts rooms or critical pt situation and time frame get back to them. If unable to do task xyz would give them time frame when I could......

Colleagues often commented about reduced call lights and patient interruptions...I just tried to pick brains of senior staffers that I admired and made positive impact on patients lives; their tricks worked.

We also went form taped report to bedside report in early 80's cutting report time in half ---could take in more visually with sweep of an eye things unsaid on garbled tape machine.

25 years later, being reintroduced because THEY WORKED.

But haven't nursing working conditions changed a lot since the 1980s?

For example, with managed care leading to/exacerbating high patient-nurse ratios, JCAHO requiring more and more types of paperwork and charting, more complex treatment/patient management protocols & meds, etc., etc.?

I've heard laments from nurses saying that nursing just isn't the same as it was, and were fed up with how the system has changed. Not nursing itself, but the circumstances surrounding it and affecting it.

[EmmaG, RN]

Just an update on this. It hasn't changed anything on Med/Surg when I float over there. None of the nurses are filling in the sheet, they expect the CNAs to do it. I was the only nurse who was charting on the sheets on the door. There is still a poor work ethic with several nurses in the unit. The sheets appeared to be only partially filled out.

I worked a unit that used these hourly rounding sheets posted in the patient rooms. Every morning, the NM would collect them all and examine them to make sure they were completely filled out.

If there were any gaps, she'd go to the nurses and tell them to sign and fill in the information (these forms didn't only have that rounds were made, but we also had to note where the patient was, what they were doing, etc.). Even if told that rounds were missed for whatever reason (i.e. an emergency with another patient), she would still insist the nurse fill out the sheets.

Can you say 'fraudulent documentation'? (these forms were considered part of the patient's medical record)

[EmmaG, RN]

yeah, sit down in that chair with the MRSA and God knows what else is all over it

That chair is less likely to be as contaminated as the computer keyboard, the phones, your pens, your stethoscope, the charts...

[lauramae18]

We do this at our facility. It is the worst idea - I check on my patients frequently to begin with, but now I have to document! At least ours is just a time list and you initial in the time. I work nights and we almost never have an aide ( she is pulled throughout the house to sit), but when she is on the floor she starts her shift off by initialling down all the sheets at the getgo. Yeah, that's patient satisfaction.

It seems like other shifts don't bother to do it at all.

Just another inefficient "tool" that keeps us away from doing patient care.

[jessiern, BSN, RN]

She replied that many people, especially the CNAs aren't doing this, that probably most nursing staff was, and that this was more to get the CNAs to interact better, and that they would be the ones to do the check sheet.

That really bugs me. I worked as an aide, and I really want to know how b/t vital signs every 4 hours (some 2), accu checks, baths, code browns, and everythings else they have to do they can possibly be expected to check up on every patient once an hour! That's my job, his/her job is to help me with that.

Also, "Can I help you, I have the time" is a load of bull, and much to my DON's displeasure I refuse to use that. :icon_roll

[sweetmuffin48]

I found it insulting that I need to be reminded to check on my patients. It is just another piece of paperwork that will take precious minutes of paitent care time away.

[nightmare, RN]

What it comes down to is another piece of paper to cover their butts(am I allowed that word?) with!They don't trust us to do our job so we have to prove it by signing a piece of paper.Of course no one would sign it without checking would they!:sfxpld:

(BTW this forum has the coolest smilies on the planet:bowingpur)

[jessiern, BSN, RN]

(BTW this forum has the coolest smilies on the planet:bowingpur)

That is so true my friend :dancgrp: