Beartooth Billings Clinic introduced the initiative on hourly patient rounding in December of 2013. The purpose of hourly rounding is to attend to the patient's comfort, safety and environmental needs. The goal is to contribute to patient's overall satisfaction with nursing care and to reduce adverse events ( falls, pressure ulcers and unrelieved pain ). Studies have shown a 50% reduction in patient falls, 56 - 77% reduction in call light use, and 71% increase in overall patient satisfaction.
The employee benefits include more organized work flow, there is less interruption in patient care with non-urgent calls, decreased call light use which decreases the distance walked by staff, and staff has more control over their shift even during times of increased census. Even with these benefits, there was not buy-in by all staff when the idea was introduced. The topic continued to be discussed at staff meetings, with encouragement for everyone to be involved in patient hourly rounding.
In June we had a nursing leadership student from MSU Bozeman who needed a project to take on so she collaborated with an new graduate nurse who was very committed to hourly rounding - Rounding with a purpose : pain, potty, positioning, personal items and protection. At a CNA skills day in June the concept was re-introduced with education on how to complete hourly rounding and where it needed to be recorded in the electronic medical record. The CNA group accepted the challenge of infusing this into our nursing culture. In August, the initiative was presented at the licensed staff nurse meeting. Our vision is that hourly rounding be a shared responsibility of the entire nursing team. All nursing staff in Acute Care have a specific goal to actively participate in hourly rounding on their 2015 employee performance goals.
Just recently, a new CNA was asking the question regarding how often we expect the rounding to be done and an experienced night shift RN replied "no matter what patient type they are here we round on them hourly during the day and every 2 hours from 10pm - 6 am." It was certainly reaffirming to hear that this practice is being promoted by the leaders in the nursing staff in Acute Care.
We feel like we have seen a shift in our HCAHPS scores with regards to overall patient satisfaction since this initiative has been introduced but will need to follow the scores for a few more quarters to see if the scores are sustained.