Intentional Rounding With Certified Nursing Assistants in Long-Term Care: A Pilot Project.

Area of Science:

• Gerontological Nursing
• Healthcare Quality Improvement
• Patient Safety

Background:

• Intentional rounding (IR) is a proactive nursing strategy to address patient needs.
• Its application with certified nursing assistants (CNAs) in skilled nursing facilities (SNFs) has not been extensively studied.
• Improving quality of care and patient safety in SNFs is a critical healthcare objective.

Purpose of the Study:

• To pilot the use of intentional rounding (IR) with CNAs in an SNF setting.
• To measure the impact of IR on patient falls, lost possessions, and CNA knowledge of IR principles.
• To assess CNA perceptions and the uptake of IR over a 10-week implementation period.

Main Methods:

• A pre-post intervention design was employed within a 60-bed unit of a 120-bed SNF.
• The Plan-Do-Study-Act (PDSA) framework guided the implementation and evaluation.
• Key metrics included knowledge of IR's "4Ps" (potty, position, possessions, pain), fall incidence, and lost possessions.

Main Results:

• The pilot demonstrated positive outcomes across all five measured aims.
• A notable increase in CNA knowledge of IR principles was observed.
• Data indicated a reduction in falls and lost possessions, alongside positive CNA perceptions of the intervention.

Conclusions:

• Intentional rounding (IR) implemented with CNAs in an SNF setting shows promise for enhancing quality, safety, and patient satisfaction.
• The intervention was well-received by CNAs and appeared to shift practice patterns.
• Replication in other SNFs is recommended, acknowledging the current study's limitations.