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Purposeful and timely nursing rounds: a best practice implementation project.
11. UCSF JBI Center for Synthesis and Implementation: an Affiliate Center of the Joanna Briggs Institute.
Implementing purposeful and timely nursing rounds significantly improved patient safety, decreasing falls by 50%. While patient satisfaction saw increases, hospital goals were not fully met, highlighting the need for sustained effort in adopting best practices.
Area of Science:
- Nursing Science
- Patient Safety Research
- Healthcare Quality Improvement
Background:
- Purposeful and timely nursing rounds are recognized as a best practice to enhance patient care and safety.
- The Institute for Healthcare Improvement (IHI) advocates for hourly rounding to reduce call lights, falls, and improve patient satisfaction.
- Effective implementation requires nurse knowledge and supportive infrastructure for consistent practice.
Purpose of the Study:
- To improve patient satisfaction and safety through the implementation of purposeful and timely nursing rounds.
- To establish goals for patient satisfaction scores and fall reduction.
- To assess baseline compliance with rounding protocols and enhance staff knowledge.
Main Methods:
- Utilized the Joanna Briggs Institute's audit tools for assessing rounding practices.
- Conducted direct observations of staff nurses on a medical-surgical unit to evaluate timeliness and protocol adherence.
- Compared pre- and post-intervention unit-level data on patient satisfaction and safety indicators.
Main Results:
- Rounding frequency nearly doubled, and protocol compliance increased to 64% from zero.
- Patient falls decreased by 50%.
- Modest improvements were observed in nurse communication (5%) and pain management (11%), with a significant increase in responsiveness for toileting (41%). Hospital goals for satisfaction were not fully achieved.
Conclusions:
- Nursing rounds are effective interventions for improving patient communication and staff responsiveness, positively impacting satisfaction and safety outcomes.
- A supportive infrastructure and organized, multi-level staff approach are crucial for successful implementation.
- Sustained effort is necessary to integrate new practices and achieve optimal patient outcomes.
