Improving Hourly Rounding on an Orthopaedic/Trauma Unit

Hourly rounding impacts multiple patient care outcomes. The task of rounding has several obstacles and is made more time-consuming by donning and doffing protective personal equipment kits, especially in the setting of the COVID-19 pandemic. To improve the frequency of hourly rounding performance on the unit, nurses and unlicensed assistive personnel on an orthopaedic/trauma unit at an academic hospital in the Midwest United States were introduced to potential interventions in several PDSA (Plan-Do-Study-Act) cycles using quality improvement methodology. Methods included chart auditing, repetitive interventions designed by evaluating previous iterations, creation of educational material, and changing unit policy by communication during unit huddle. Results found a 10-percentage point improvement of hourly rounding compliance, from 77.3% to 87.3%, with use of a "redline" policy for isolation precautions. The policy implementation was a success. Future research may consider the expansion of this policy to other units.