This document discusses hourly rounding, which involves nurses checking on patients on an hourly basis. It presents national averages for HCAHPS scores and outlines several improved outcomes associated with hourly rounding such as patient satisfaction, safety, and reduced call light usage. The 6P protocol is described which involves greeting the patient and addressing their pain, personal needs, positioning, bathroom needs, and environment. Benefits of hourly rounding include increased HCAHPS scores, hospital reimbursement, and nurse satisfaction and efficiency.
This document discusses three topics for nursing units to consider implementing: bedside report, hourly rounding, and team huddles. Bedside report involves developing a standardized process for nurses to conduct shift change at the patient's bedside. Hourly rounding focuses on checking patients every hour on key tasks like pain, positioning, and bathroom needs. Team huddles are short, scheduled meetings called by any staff member to facilitate fast communication and collaboration. The document provides references for further information on implementing these approaches.
This document discusses hourly rounding, a quality improvement project to improve patient satisfaction and outcomes. It describes who can perform hourly rounding, which involves assessing patients' pain, bathroom needs, possessions, mobility, and other needs every hour. Studies show hourly rounding can increase patient satisfaction scores, decrease call light usage and falls, and improve the work of nurses and other staff. Proper staff training and support is needed to successfully implement hourly rounding.
Wood County Hospital scored 72.3% on patient responsiveness according to HCAHPS surveys, below the 80% CMS requirement. A study was conducted to analyze call light response times, who answers call lights, and hourly rounding adherence. Recommendations include implementing individual nurse communication devices to improve response times and patient satisfaction scores, helping the hospital meet CMS standards and increase reimbursement. Changing to a new communication system requires using the Transtheoretical Model of behavior change to successfully adopt the new approach.
Hourly rounding was initiated at Deer Lodge Centre to further reduce falls among older adult patients. Previous efforts had reduced falls but not achieved the anticipated results. A working group examined restarting hourly rounding by identifying barriers and facilitators. They changed the rounding method with a new policy and documentation. An action plan for long-term sustainability was created, outlining steps, timelines, responsibilities and monitoring. Lessons showed that change takes time, staff buy-in requires involvement, and ongoing audits and feedback are needed to address issues and engage staff in the new approach. The initiative aims to establish consistent understanding of hourly rounding benefits for quality care, safety and satisfaction.
This document summarizes evidence on the impact of bedside nursing handoffs on patient satisfaction. It finds that 9 out of 10 studies reported increased patient satisfaction when bedside handoffs were implemented instead of handoffs outside the patient room. Bedside handoffs also improved nurse satisfaction in some studies and reduced handoff time in others, though the type of handoff tool used did not impact outcomes. Successful implementation of bedside handoffs depended on leadership strategy across all studies.
This document discusses the benefits of bedside nurse reporting to improve patient care. It begins by noting that traditional handoff reporting takes nurses away from patient care and can lead to missed information. Bedside reporting allows for a more organized transfer of information between nurses and increases patient involvement and satisfaction. Research supports the use of bedside reporting in improving outcomes such as increased patient satisfaction, decreased delay in starting nurse shifts, and improved nurse satisfaction. The document provides an example of a bedside reporting form and addresses some common concerns with implementing bedside reporting.
This document discusses the benefits of implementing bedside shift reporting compared to reporting at the nurse's station. It identifies increased patient and nurse satisfaction as key outcomes of bedside reporting. Benefits for patients include feeling more involved in their care, safer, and more comfortable. Benefits for nurses include improved accountability, communication, and teamwork. The literature review found evidence that bedside reporting improves satisfaction scores, reduces errors and costs, and improves the nurse-patient relationship. Recommendations are made for hospitals to adopt standardized bedside reporting formats to realize these benefits.
The document discusses implementing bedside shift report on a medical-surgical unit. It proposes collecting data on patient and nurse satisfaction surveys, patient fall rates, length of stay, and call light usage before and after the change to evaluate outcomes. A cost-benefit analysis found initial costs of $1,676 with annual costs of $3,060, but cost savings of $14,000 per prevented fall with injury. Staff will be educated through an online module and in-person demonstration on conducting SBAR-formatted bedside shift reports with patients.
This document discusses three topics for nursing units to consider implementing: bedside report, hourly rounding, and team huddles. Bedside report involves developing a standardized process for nurses to conduct shift change at the patient's bedside. Hourly rounding focuses on checking patients every hour on key tasks like pain, positioning, and bathroom needs. Team huddles are short, scheduled meetings called by any staff member to facilitate fast communication and collaboration. The document provides references for further information on implementing these approaches.
This document discusses hourly rounding, a quality improvement project to improve patient satisfaction and outcomes. It describes who can perform hourly rounding, which involves assessing patients' pain, bathroom needs, possessions, mobility, and other needs every hour. Studies show hourly rounding can increase patient satisfaction scores, decrease call light usage and falls, and improve the work of nurses and other staff. Proper staff training and support is needed to successfully implement hourly rounding.
Wood County Hospital scored 72.3% on patient responsiveness according to HCAHPS surveys, below the 80% CMS requirement. A study was conducted to analyze call light response times, who answers call lights, and hourly rounding adherence. Recommendations include implementing individual nurse communication devices to improve response times and patient satisfaction scores, helping the hospital meet CMS standards and increase reimbursement. Changing to a new communication system requires using the Transtheoretical Model of behavior change to successfully adopt the new approach.
Hourly rounding was initiated at Deer Lodge Centre to further reduce falls among older adult patients. Previous efforts had reduced falls but not achieved the anticipated results. A working group examined restarting hourly rounding by identifying barriers and facilitators. They changed the rounding method with a new policy and documentation. An action plan for long-term sustainability was created, outlining steps, timelines, responsibilities and monitoring. Lessons showed that change takes time, staff buy-in requires involvement, and ongoing audits and feedback are needed to address issues and engage staff in the new approach. The initiative aims to establish consistent understanding of hourly rounding benefits for quality care, safety and satisfaction.
This document summarizes evidence on the impact of bedside nursing handoffs on patient satisfaction. It finds that 9 out of 10 studies reported increased patient satisfaction when bedside handoffs were implemented instead of handoffs outside the patient room. Bedside handoffs also improved nurse satisfaction in some studies and reduced handoff time in others, though the type of handoff tool used did not impact outcomes. Successful implementation of bedside handoffs depended on leadership strategy across all studies.
This document discusses the benefits of bedside nurse reporting to improve patient care. It begins by noting that traditional handoff reporting takes nurses away from patient care and can lead to missed information. Bedside reporting allows for a more organized transfer of information between nurses and increases patient involvement and satisfaction. Research supports the use of bedside reporting in improving outcomes such as increased patient satisfaction, decreased delay in starting nurse shifts, and improved nurse satisfaction. The document provides an example of a bedside reporting form and addresses some common concerns with implementing bedside reporting.
This document discusses the benefits of implementing bedside shift reporting compared to reporting at the nurse's station. It identifies increased patient and nurse satisfaction as key outcomes of bedside reporting. Benefits for patients include feeling more involved in their care, safer, and more comfortable. Benefits for nurses include improved accountability, communication, and teamwork. The literature review found evidence that bedside reporting improves satisfaction scores, reduces errors and costs, and improves the nurse-patient relationship. Recommendations are made for hospitals to adopt standardized bedside reporting formats to realize these benefits.
The document discusses implementing bedside shift report on a medical-surgical unit. It proposes collecting data on patient and nurse satisfaction surveys, patient fall rates, length of stay, and call light usage before and after the change to evaluate outcomes. A cost-benefit analysis found initial costs of $1,676 with annual costs of $3,060, but cost savings of $14,000 per prevented fall with injury. Staff will be educated through an online module and in-person demonstration on conducting SBAR-formatted bedside shift reports with patients.
Colin Jones presented a case study on his client Eileen, a 68-year-old woman diagnosed with Guillain-Barré syndrome. Eileen was dependent on others for activities of daily living and mobility following her illness. The occupational therapy process included assessments, goal setting to improve independence, and recommending Eileen for rehabilitation. Interventions targeted improving upper limb function and mobility to allow Eileen to return safely to her two-story home.
Hospital-acquired pressure injuries are a significant issue, costing $11 billion annually in the US. A fishbone diagram was used to identify multiple factors that influence pressure injury development, including patient characteristics, materials, staff, processes, environment, and methods. Evidence shows that involving patients in their own care through education on positioning, mobility, and prevention can help reduce injuries. Evaluating prevention strategies and pressure injury rates through staff meetings and assessing staging can help hospitals improve processes and decrease injuries over time.
Ts wo es_validation+of+braden+sub+scale+scoresLaurie Crane
This document discusses validating the use of individual subscale scores from the Braden Scale for pressure ulcer risk assessment rather than just the cumulative score. It provides opinions from staff that the current use of the Braden Scale and Skin Bundle focuses more on documentation than interventions. The document recommends enhancing the Braden Scale in the EPIC electronic health record to flag low individual subscale scores and provide specific intervention recommendations tailored to each subscale. Examples are provided for interventions aimed at low friction/shear and nutrition subscale scores. Overall, the goal is to improve pressure ulcer prevention by guiding intervention selection based on assessment of individual risk factors.
This document provides information on a fall prevention evidence-based practice project conducted by nursing students at Alvernia University. It includes background information on the problem of falls in hospitals, learning objectives of comparing individual versus multi-component interventions, and a review of literature showing that multi-component programs are more effective at reducing falls than individual interventions. The document also outlines specific fall prevention interventions in place at Good Samaritan Hospital, including a fall risk letter, signage, alarms, and post-fall assessment. It emphasizes the importance of continuous re-evaluation of interventions to improve outcomes.
To coincide with NHS Change Day 2014, this slideset contains ideas for pledges in line with the #stopthepressure campaign.
Pressure ulcers affect nearly 700,000 people every year, at all points of the healthcare journey, and research suggests between 80 - 90% could be avoided.
Pledge on the NHS Change Day wall to stop the pressure - either directly, or indirectly through nutrition and hydration.
Application of relatively simple & rapid test to a large number of apparently healthy people in order to classify them as likely or unlikely to have the disease.
This document provides information about a clinical research study on low back pain being conducted by the NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health at the University of Queensland. It seeks volunteers aged 18-65 who experience low back or leg pain to undergo assessments of movement, balance, trunk muscle activity and pain measures. Participation involves two session lasting 1.5 hours each at UQ. The purpose is to improve physiotherapist assessment and treatment of low back pain. There are minimal risks and no costs to participants, who may benefit from learning about movements that ease symptoms.
The document discusses the use of SBAR (Situation, Background, Assessment, Recommendation) as a communication tool for nurse shift reports. Research shows that using SBAR improves nurse-to-nurse communication, decreases report time, and improves patient outcomes by reducing errors and deaths. The document recommends expanding the use of SBAR for all nurse shift reports and providing training to ensure effective implementation.
This document describes a community-based aquatic therapy program for people with multiple sclerosis (MS) led by an MS specialist physiotherapist. The program aimed to improve balance and function for those with MS through exercises in cooler water under supervision. Outcome measures showed significant improvements in areas like balance, mobility, and confidence after participants completed a 5-week course. Nearly 30% of participants continued attending independently. Feedback was positive, with many enjoying the social and functional benefits of the aquatic exercises.
1) A long-term acute care hospital tested the use of specialty beds that could tilt clients to standing positions to increase mobility and improve outcomes for medically complex patients.
2) The study evaluated 5 beds over 120 days, comparing outcomes for clients who received traditional therapy plus upright tilting in the specialty beds versus traditional therapy alone.
3) Preliminary findings suggested clients who used the tilt beds had shorter hospital stays, greater functional gains, fewer delirium days, and were more likely to be discharged home or to acute rehabilitation than those receiving only traditional therapy.
“A STUDY TO ASSESS THE EFFECTIVENESS OF INDIVIDUAL STRUCTURED TEACHING PROGRAMME (ISTP)ON THE USE OF BRADEN SCALE FOR PREDICTING PRESSURE SORE RISK FOR BED FAST PATIENT AMONG STAFF NURSES AT SELECTED HOSPITAL OF BIJAPUR”
A standardized handoff tool was implemented between the operating room and pediatric post-anesthesia care unit (PACU) at a hospital to improve communication. Prior to the tool, a review found miscommunication was responsible for up to 85% of hospital errors. Nurses analyzed various handoff methods and created a questionnaire to evaluate current practice. Data collected before and after implementing the tool showed completion of handoff elements increased, particularly around patient allergies, procedures, medications and history. The standardized tool improved interdisciplinary communication within one month and helps ensure efficient, safe and quality patient care during handoffs.
Prehabilitation refers to physical therapy treatment in the pre-operative setting, with the goal of reducing post-operative complications and costs. Studies have found that prehabilitation can reduce hospital stays and complication rates for cardiac and abdominal surgeries through inspiratory training. For joint replacements, prehabilitation is associated with a 29% reduction in post-acute care services. Limitations include a lack of supportive research and physician referrals, but future programs aim to expand prehabilitation's benefits.
A needs assessment of 498 nurses found that over half had never attended preceptor training. Nurses reported difficulties with inconsistent orientation experiences and knowing when an orientee was struggling. In response, a hospital developed a new multi-pronged preceptor education program including online modules, workshops, department-specific classes, articles, and simulations. Participation increased significantly after making the program mandatory for a pay increase. A Preceptor Committee was also formed to support preceptors and standardize practices.
Palliative Patient Journeys—providing services in a regional and rural settingCancer Institute NSW
Griffith is a multicultural city in south-western NSW, with a population of 16,972, with a greater population living in the surrounding rural and remote areas. Palliative Care & End of Life [EOL] Services, were being provided by a wide range of service providers, in both acute and community sectors. Despite Strategic Planning and Model of Care directives, variation in the integration of services and a lack of resources meant that patients and carers were subject to variations in methods of service delivery.
At Chester, simulated patients called Associate Clinical Educators (ACEs) are used for teaching and assessing students. ACEs role play patients for students to practice clinical skills like physical exams. They are used for scenarios in areas like emergency medicine. Students find the experience with ACEs extremely valuable for developing skills and preparing for assessments. Potential threats to the continued use of ACEs include financial constraints, measuring student outcomes, expanding training for ACEs, and ensuring they do not replace clinician resources. Future research could explore how ACEs and simulated patients impact student performance compared to traditional teaching methods.
Guidelines article review 1) please select one article from thsimba35
This document provides guidelines for writing a paper on menstrual hygiene management (MHM) in humanitarian emergencies. It instructs the student to select a peer-reviewed article on MHM, summarize it in 2 pages, identify which UN Sustainable Development Goals it addresses in 1 page, discuss implications for achieving those goals in 2 pages while citing at least 2 sources, and format the paper according to APA style over 5 pages excluding the cover page and references. The guidelines specify the expected structure, formatting, and length for the assignment.
1) The document discusses the public perception of nursing and initiatives to improve the understanding of nursing roles.
2) It highlights that nursing is a highly trusted profession and that nurses have degrees, run clinics, and conduct research.
3) The document presents findings from research showing lower patient mortality and failure rates in hospitals with more bachelor's degree nurses and lower nurse patient ratios.
This document discusses strategies for standardizing handoff processes throughout healthcare organizations. It explains that standardizing handoffs is challenging but important for patient safety, as ineffective handoffs can lead to medical errors and other issues. The document outlines some key steps for organizations to take, such as developing and implementing a standardized process, obtaining leadership and staff buy-in, and addressing hierarchical relationships among staff that can hinder communication. Standardizing handoffs requires significant cultural change across an entire organization.
Evidence based practice hourly rounds power point bettershannic99
Hourly rounding involves nurses proactively checking on patients on an hourly basis to address any needs related to pain, bathroom use, positioning, and proximity of items. Studies have shown that hourly rounding can reduce call light usage by 38%, falls by 50-60%, pressure ulcers by 14%, and improve patient satisfaction scores. Hospitals that implemented hourly rounding also saw increased nursing satisfaction and efficiency due to answering fewer call lights and having more time for other tasks.
Utilize the 8 "Vital Behaviors" to integrate Purposeful Hourly Rounding into our daily clinical practice. Anticipated to improve our current practice of hourly rounding to be more purposeful with intention.
Colin Jones presented a case study on his client Eileen, a 68-year-old woman diagnosed with Guillain-Barré syndrome. Eileen was dependent on others for activities of daily living and mobility following her illness. The occupational therapy process included assessments, goal setting to improve independence, and recommending Eileen for rehabilitation. Interventions targeted improving upper limb function and mobility to allow Eileen to return safely to her two-story home.
Hospital-acquired pressure injuries are a significant issue, costing $11 billion annually in the US. A fishbone diagram was used to identify multiple factors that influence pressure injury development, including patient characteristics, materials, staff, processes, environment, and methods. Evidence shows that involving patients in their own care through education on positioning, mobility, and prevention can help reduce injuries. Evaluating prevention strategies and pressure injury rates through staff meetings and assessing staging can help hospitals improve processes and decrease injuries over time.
Ts wo es_validation+of+braden+sub+scale+scoresLaurie Crane
This document discusses validating the use of individual subscale scores from the Braden Scale for pressure ulcer risk assessment rather than just the cumulative score. It provides opinions from staff that the current use of the Braden Scale and Skin Bundle focuses more on documentation than interventions. The document recommends enhancing the Braden Scale in the EPIC electronic health record to flag low individual subscale scores and provide specific intervention recommendations tailored to each subscale. Examples are provided for interventions aimed at low friction/shear and nutrition subscale scores. Overall, the goal is to improve pressure ulcer prevention by guiding intervention selection based on assessment of individual risk factors.
This document provides information on a fall prevention evidence-based practice project conducted by nursing students at Alvernia University. It includes background information on the problem of falls in hospitals, learning objectives of comparing individual versus multi-component interventions, and a review of literature showing that multi-component programs are more effective at reducing falls than individual interventions. The document also outlines specific fall prevention interventions in place at Good Samaritan Hospital, including a fall risk letter, signage, alarms, and post-fall assessment. It emphasizes the importance of continuous re-evaluation of interventions to improve outcomes.
To coincide with NHS Change Day 2014, this slideset contains ideas for pledges in line with the #stopthepressure campaign.
Pressure ulcers affect nearly 700,000 people every year, at all points of the healthcare journey, and research suggests between 80 - 90% could be avoided.
Pledge on the NHS Change Day wall to stop the pressure - either directly, or indirectly through nutrition and hydration.
Application of relatively simple & rapid test to a large number of apparently healthy people in order to classify them as likely or unlikely to have the disease.
This document provides information about a clinical research study on low back pain being conducted by the NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health at the University of Queensland. It seeks volunteers aged 18-65 who experience low back or leg pain to undergo assessments of movement, balance, trunk muscle activity and pain measures. Participation involves two session lasting 1.5 hours each at UQ. The purpose is to improve physiotherapist assessment and treatment of low back pain. There are minimal risks and no costs to participants, who may benefit from learning about movements that ease symptoms.
The document discusses the use of SBAR (Situation, Background, Assessment, Recommendation) as a communication tool for nurse shift reports. Research shows that using SBAR improves nurse-to-nurse communication, decreases report time, and improves patient outcomes by reducing errors and deaths. The document recommends expanding the use of SBAR for all nurse shift reports and providing training to ensure effective implementation.
This document describes a community-based aquatic therapy program for people with multiple sclerosis (MS) led by an MS specialist physiotherapist. The program aimed to improve balance and function for those with MS through exercises in cooler water under supervision. Outcome measures showed significant improvements in areas like balance, mobility, and confidence after participants completed a 5-week course. Nearly 30% of participants continued attending independently. Feedback was positive, with many enjoying the social and functional benefits of the aquatic exercises.
1) A long-term acute care hospital tested the use of specialty beds that could tilt clients to standing positions to increase mobility and improve outcomes for medically complex patients.
2) The study evaluated 5 beds over 120 days, comparing outcomes for clients who received traditional therapy plus upright tilting in the specialty beds versus traditional therapy alone.
3) Preliminary findings suggested clients who used the tilt beds had shorter hospital stays, greater functional gains, fewer delirium days, and were more likely to be discharged home or to acute rehabilitation than those receiving only traditional therapy.
“A STUDY TO ASSESS THE EFFECTIVENESS OF INDIVIDUAL STRUCTURED TEACHING PROGRAMME (ISTP)ON THE USE OF BRADEN SCALE FOR PREDICTING PRESSURE SORE RISK FOR BED FAST PATIENT AMONG STAFF NURSES AT SELECTED HOSPITAL OF BIJAPUR”
A standardized handoff tool was implemented between the operating room and pediatric post-anesthesia care unit (PACU) at a hospital to improve communication. Prior to the tool, a review found miscommunication was responsible for up to 85% of hospital errors. Nurses analyzed various handoff methods and created a questionnaire to evaluate current practice. Data collected before and after implementing the tool showed completion of handoff elements increased, particularly around patient allergies, procedures, medications and history. The standardized tool improved interdisciplinary communication within one month and helps ensure efficient, safe and quality patient care during handoffs.
Prehabilitation refers to physical therapy treatment in the pre-operative setting, with the goal of reducing post-operative complications and costs. Studies have found that prehabilitation can reduce hospital stays and complication rates for cardiac and abdominal surgeries through inspiratory training. For joint replacements, prehabilitation is associated with a 29% reduction in post-acute care services. Limitations include a lack of supportive research and physician referrals, but future programs aim to expand prehabilitation's benefits.
A needs assessment of 498 nurses found that over half had never attended preceptor training. Nurses reported difficulties with inconsistent orientation experiences and knowing when an orientee was struggling. In response, a hospital developed a new multi-pronged preceptor education program including online modules, workshops, department-specific classes, articles, and simulations. Participation increased significantly after making the program mandatory for a pay increase. A Preceptor Committee was also formed to support preceptors and standardize practices.
Palliative Patient Journeys—providing services in a regional and rural settingCancer Institute NSW
Griffith is a multicultural city in south-western NSW, with a population of 16,972, with a greater population living in the surrounding rural and remote areas. Palliative Care & End of Life [EOL] Services, were being provided by a wide range of service providers, in both acute and community sectors. Despite Strategic Planning and Model of Care directives, variation in the integration of services and a lack of resources meant that patients and carers were subject to variations in methods of service delivery.
At Chester, simulated patients called Associate Clinical Educators (ACEs) are used for teaching and assessing students. ACEs role play patients for students to practice clinical skills like physical exams. They are used for scenarios in areas like emergency medicine. Students find the experience with ACEs extremely valuable for developing skills and preparing for assessments. Potential threats to the continued use of ACEs include financial constraints, measuring student outcomes, expanding training for ACEs, and ensuring they do not replace clinician resources. Future research could explore how ACEs and simulated patients impact student performance compared to traditional teaching methods.
Guidelines article review 1) please select one article from thsimba35
This document provides guidelines for writing a paper on menstrual hygiene management (MHM) in humanitarian emergencies. It instructs the student to select a peer-reviewed article on MHM, summarize it in 2 pages, identify which UN Sustainable Development Goals it addresses in 1 page, discuss implications for achieving those goals in 2 pages while citing at least 2 sources, and format the paper according to APA style over 5 pages excluding the cover page and references. The guidelines specify the expected structure, formatting, and length for the assignment.
1) The document discusses the public perception of nursing and initiatives to improve the understanding of nursing roles.
2) It highlights that nursing is a highly trusted profession and that nurses have degrees, run clinics, and conduct research.
3) The document presents findings from research showing lower patient mortality and failure rates in hospitals with more bachelor's degree nurses and lower nurse patient ratios.
This document discusses strategies for standardizing handoff processes throughout healthcare organizations. It explains that standardizing handoffs is challenging but important for patient safety, as ineffective handoffs can lead to medical errors and other issues. The document outlines some key steps for organizations to take, such as developing and implementing a standardized process, obtaining leadership and staff buy-in, and addressing hierarchical relationships among staff that can hinder communication. Standardizing handoffs requires significant cultural change across an entire organization.
Evidence based practice hourly rounds power point bettershannic99
Hourly rounding involves nurses proactively checking on patients on an hourly basis to address any needs related to pain, bathroom use, positioning, and proximity of items. Studies have shown that hourly rounding can reduce call light usage by 38%, falls by 50-60%, pressure ulcers by 14%, and improve patient satisfaction scores. Hospitals that implemented hourly rounding also saw increased nursing satisfaction and efficiency due to answering fewer call lights and having more time for other tasks.
Utilize the 8 "Vital Behaviors" to integrate Purposeful Hourly Rounding into our daily clinical practice. Anticipated to improve our current practice of hourly rounding to be more purposeful with intention.
Nursing rounds involve a head nurse or teacher leading rounds with staff or students to understand patient conditions and the effects of nursing care. The purposes of rounds include observing patients' physical and mental states, staff work, introducing patients to personnel, carrying out care plans, evaluating treatment results, and teaching students. Rounds are conducted by discussing objectives outside patients' rooms first, then briefly visiting patients. Advantages are testing students' knowledge, benefiting informed students, orienting new nurses, and evaluating nursing activities and challenges. Disadvantages can include hampering confidentiality and distractions reducing attention. Standing orders provide emergency treatment guidance for areas without doctors by promoting temporary care until a doctor can be seen.
The document describes Rachel Gupta's capstone leadership experience at the Saint Cloud VA Medical Center. It provides details about the facilities and services at the VA, including 388 operating beds, primary medicine, mental health, outpatient services, and a 225-bed community living center. Gupta's experience involved designing and managing care for veterans in the community living center, with over 90 hours spent in leadership duties and treatment meetings coordinating care among interdisciplinary teams.
Hourly rounding was implemented in a long term care facility to reduce falls among residents. The pilot program involved education of staff on hourly rounding and use of a checklist to document rounds. Initial results showed a 43% reduction in falls during the 30 day pilot period compared to the previous year. However, compliance with hourly rounding decreased due to staffing shortages. Continuous education and supervision are recommended to sustain fall reductions through consistent hourly rounding. Direct observation of staff also improved adherence to the rounding protocol.
Goldsack et. al 2015 hourly rounding and patient falls what factorsJoya Smit
This document summarizes a study that evaluated the impact of patient-centered hourly rounding on falls in two hospital units. The study found that on the unit where staff and leadership were engaged from the start, fall rates significantly decreased during the pilot period compared to baseline. However, on the unit that did not have staff involvement in the planning, fall rates did not change significantly. The results suggest that actively involving frontline staff and leadership in program design is critical to successfully reducing fall rates.
This document discusses how bedside shift report and hourly rounding can improve patient safety and satisfaction. It defines bedside shift report as the exchange of information between nurses at the patient's bedside, which allows patients to participate and clarify information. Hourly rounding involves addressing patient needs like pain, bathroom needs, positioning and possessions every hour. Studies showed these practices reduced errors, falls and improved satisfaction scores by increasing communication and addressing issues proactively.
Hourly rounding has been shown to reduce patient fall rates in hospital settings compared to using tab or bed alarms alone. Study 1 found that implementing hourly rounding on inpatient units resulted in a 23% reduction in falls, though it was not statistically significant. Study 2 was a systematic review finding that most studies reported hourly rounding as an effective way to reduce fall rates in hospitals. Together these studies indicate that hourly rounding may help prevent falls more than other interventions alone and has been associated with reductions in fall rates in various hospital settings.
Non clinical director hourly rounding validationRachel Provau
This document outlines a validation project to assess compliance with hourly rounding processes. It will involve non-nursing leaders conducting audits using a standardized tool to check if nurses are discussing pain, bathroom needs, and positioning with patients every hour. The audits will also check if whiteboards are filled out correctly. Nursing leaders will be assigned to help non-clinical leaders with the audits. Audit results will be compared to patient satisfaction scores to identify opportunities to improve compliance and change hospital culture around hourly rounding.
This document discusses evidence-based management (EBMgt), which aims to incorporate scientific knowledge into management decision making. It outlines the EBMgt process and reasons why managers may not use it, such as lack of awareness or perception that costs outweigh benefits. Barriers to implementing evidence-based medicine are similar to those for EBMgt. Teaching EBMgt to managers involves assessing available evidence and critically evaluating its applicability to address specific management questions. The goal is to close the gap between research and practice in management.
APPLICATIONS OF SPIRITUALITY IN THERAPYKevin J. Drab
This document provides an overview of spirituality and its applications in therapy. It discusses how spirituality plays an important role in many people's lives and how failing to consider a client's spiritual beliefs can be detrimental in treatment. Some key points made include that up to 90% of patients rely on religion or spirituality during illness, spiritual interventions can help those struggling to find meaning, and competently addressing spirituality requires counselors to understand different beliefs and practices without imposing their own views. The document aims to help therapists appropriately incorporate spirituality when relevant to a client's goals and wellbeing.
A presentation given by Sue Peter at the 2012 CHA Conference, The Journey, in the 'Delivering Safety & Quality: Innovations in Clinical Governance' stream
The document provides information about rounding numbers up to 100 to the nearest ten. It gives the rule for rounding which is to round down if the number is 4 or less, and round up if it is 5 or more. An example poem is also given to help remember the rounding rule. Several examples are worked out showing how to round numbers like 36, 74, 73, and 77 to the nearest ten. Students are then asked to round 5 numbers like 19, 73, and 92 to practice the skill.
This presentation discusses a quality improvement project aimed at implementing bedside shift reporting. Data was collected and findings showed that nurses were not performing bedside shift reporting or getting to see patients in a timely manner. This increases fall risk, medication errors, and decreases patient, nurse, and physician satisfaction. Root causes identified included a lack of interest and a culture of noncompliance. Evidence supports the benefits of bedside shift reporting for improved satisfaction and safety. A timeline is proposed to educate staff, implement the change, monitor outcomes, and celebrate results. Tools are available from AHRQ to assist with successful implementation.
This document discusses the benefits of implementing bedside shift reporting compared to reporting at the nurse's station. It identifies increased patient and nurse satisfaction as key outcomes of bedside reporting. Benefits for patients include feeling more involved in their care, safer, and more comfortable. Benefits for nurses include improved accountability, communication, and teamwork. The literature review found bedside reporting can reduce errors, lengths of stay, and readmission rates while improving satisfaction scores. The recommendations are for hospitals to adopt standardized bedside reporting formats to realize these benefits.
• A study of 20 million patients
• Examining mortality in relation to NEAT
• Tracking quality indicators
Speakers: Clair Sullivan Deputy Chair Medicine Princess Alexandra Hospital, QLD & Andrew Staib Deputy Director Emergency Princess Alexandra Hospital, QLD
25Evidence-Based Practice and the Quadruple Ai.docxlorainedeserre
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Evidence-Based Practice and the Quadruple Aim
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Evidence-Based Practice and the Quadruple Aim
Evidence-based practice (EBP) and the quadruple aim both help to create improved healthcare equality, improve patient outcomes, reduce hospital cost, and improve the work life of clinicians (Malnyk, Gallagher-Ford, & Fineout-Overholt, 2016). EBP is a problem-solving approach that provides the best evidence to inform nursing practice and help to provide the best patient outcomes (Melnyk & Fine-Overhold, 2018). The quadruple aim consists of improving each patient’s experience of care, improving health population, reducing the per capita cost of healthcare, and improving the lives of the healthcare workforce (Sikka, Morath, & Leape, 2015). It is essential that both the quadruple aim and EBP are equally implemented to achieve the desired outcomes due to the fact that one cannot be fully achieved without the other.
EBP can help reach the Quadruple Aim in all four measures, which are patient experience, population health, cost, and work life of healthcare providers. The patient experience is enhanced when utilizing EBP into care delivery and decisions made by healthcare providers. For example, in my healthcare organization, we perform hourly rounding on every patient, which is backed by EBP to improve the patient experience. Integrating the best available evidence to support decisions in order to strengthen the patient’s quality and safety of the patient experience is optimized by EBP (Lavenberg et al., 2019).
Population health is driven by EBP in order to address population characteristics, needs, values, and preferences (Jacobs, Jones, Gabella, Springs, & Brownson, 2012). For example, heart failure, diabetes, and obesity have become an epidemic. Understanding and using EBP to approach new ways in helping the population who suffer from these comorbidities will help reach the Quadruple Aim. Implementing EBP approach in population health goals to develop easily accessible and time-efficient tools to improve population health will serve as a driver for success (Jacobs et al., 2012). Addressing the population health issues will ultimately affect cost measures by reducing hospitalizations, fewer test, and fewer doctor visits. EBP is proven to improve patient outcomes, which in turn, results in cost-effective care (Hrabe, 2017). Therefore, EBP helps to reach costs measures needed to reach the Quadruple Aim.
The fourth goal of the Quadruple Aim is essential to be able to meet the first three measures. The work life of healthcare providers can have a positive or negative impact on patient outcomes. Healthcare providers are experiencing burnout, increased stress, and depression, all of which are associated with decreased patient satisfaction, poor health outcomes, and increased cost (Bodenheimer & Sinsky, 2014). For example, when nurses or doctors are stressed or have a lack of empathy, they are less likely to give their fu ...
Improving NHS staff experience to improve NHS staff performance:
This session focused upon the impact staff engagement and experience has on organisational performance, specifically patient experience. The session was aimed at commissioners and policy makers, and outlined why staff experience is so important. It also offered examples from an organisation that has improved staff experience to great effect.
Sally Pezaro (Centre for Technology Enabled Health Research (CTEHR), University of Coventry) and Rhian Bishop (Staff Engagement Lead at Sheffield Teaching Hospitals Foundation Trust).
NHS staff experience, pop up uni, 10am, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Standardized Bedside ReportingOne of the goals of h.docxwhitneyleman54422
Standardized Bedside Reporting
One of the goals of healthcare is to ensure that the patients get the best service possible while not compromising on the satisfaction and goodwill of the nurses and other healthcare professionals. A key aspect of ensuring quality healthcare is the consistent handling of patient information from nurse to nurse during shifts; information handled wrongly can jeopardize the patients’ health (Baker, 2010). It is important to implement procedures that ensure consistent and smooth handling of patient information from nurse to nurse to increase patient safety and improve nurse satisfaction. This paper will explore the merits of standardized bedside reporting as opposed to board reporting in ensuring a positive outcome and consistent quality healthcare.
Change model overview
A key aspect in determining whether bedside shift reporting has any merits over board reporting is the John Hopkins Nursing Evidence-Based Practice Process (JHNEBP). The John Hopkins Nursing Evidence-Based Practice Process is a framework for guiding the translation and synthesis of evidence into valid healthcare practice. JHNEBP has three cornerstones that include research, education, and practice; the framework ensures that research evidence is the basis of clinical decision-making. (Dearholt & Dang, 2012) The implementation of the John Hopkins Nursing Evidence-Based Practice Process has three key phases, the first phase is the identification of an important question, the second phase involves the systematic review of research evidence, and the third phase is translating the results into action. Nurses should use the JHNEBP process because it provides a clear way for healthcare professionals to translate research results into healthcare practice.
Practice Question
The team includes several key stakeholders who will benefit greatly from my research. Among the team members include myself as ER nurse, charge nurse, ERT ( Emergency room tech), nurse case manager, nurse supervisor, physician and hospital manager.
The evidence-based practice question that the team members will explore is "Does the use of a standardized bedside report versus board reporting help increase patient safety, nurse satisfaction, and positive outcome?" The evidence-based practice question assesses the ability of bedside shift reporting to improve healthcare provision. The practice area of the question is clinical. The practice issue came about because of assessing risk management concerns in ensuring good health practices. To answer the question, the team members gathered evidence from patient preferences, peer-reviewed journals, and clinical guidelines. The team members searched peer-reviewed journal databases to gather relevant information from previous research that could affect the results.
Understanding the merits of bedside shift reporting as opposed to board reporting is important as most healthcare organization use either strategy in collecting and passin.
Data Collection in Patient Satisfaction Surveys Q.docxsimonithomas47935
Data Collection in Patient Satisfaction Surveys
Quality improvement is a systematic strategy “to improve practices and processes within a specific organization” (Polit & Beck, 2017b, p.741). Many quality improvement studies, specifically patient satisfaction, are measured via surveys. A survey of four different tertiary care hospitals in four different countries found that various attributes and aspects of nursing care and easy access of care were the strongest drivers of patient satisfaction as a whole, as compared to physician relations, admission process and environmental cleanliness (Al-Abri & Al-Balushi, 2014). Primary care settings may measure satisfaction through similar criteria. Various data collection aspects of patient satisfaction measurement from a suburban primary care setting population are the focus of this paper.
Scenario and Survey Questions
Employees of a suburban primary care clinic, seeing 10,000 patients annually are interested in patient satisfaction. The healthcare organization has chosen to implement a satisfaction survey focusing on the areas of ease of access, wait time, friendliness of staff, and likelihood of recommending the clinic to others. The following questions was chosen for the patient satisfaction survey in the primary care clinic
1. How satisfied were you with the ease of setting up an appointment?
1 2 3 4
Very dissatisfied Dissatisfied Satisfied Very Satisfied
2. How satisfied are you with obtaining answers to questions during off hours?
1 2 3 4
Very dissatisfied Dissatisfied Satisfied Very Satisfied
3. How satisfied are you with the wait time in the office before seeing your provider?
1 2 3 4
Very Dissatisfied Dissatisfied Satisfied Very Satisfied
4. How satisfied are you with the attentiveness of the staff to your need?
1 2 3 4
Very dissatisfied Dissatisfied Satisfied Very Satisfied
5. How would you rate the ease of entry to our office (parking, location, hours)?
1 2 .
Organisational outcomes of person centred hearing care - HEARing CRC PhD pres...HEARnet _
Research Aims:
1.According to senior management, how is ‘success’ defined and evaluated in hearing care organisations in Australia?
a)What are the organisational values used to drive clinical practice and clinical change?
b)What are the measures used to drive clinical practice and clinical change?
c)To what extent it PCC reflected in these values and measures?
2.What short and long term effects does a PCC approach have on the measures?
Erik Hollander's document discusses the history and current state of healthcare in the United States, and envisions the future state. It summarizes that healthcare has evolved from a fee-for-service model to bundled payments aiming to control costs. While access and quality have improved, the U.S. still spends far more per capita than other nations with varying results. The future likely includes population health management, value-based care, and learning from high performing systems.
This presentation explains the concept of the patient-centered medical home (PCMH), its function and its intended effects. A brief overview of the history of PCMH is also provided, as well as a discussion of its operational characteristics, its principles and outcomes, and what is expected in the future for the PCMH model.
This document summarizes a transitional care workgroup meeting held on July 12, 2013. The meeting included introductions and presentations on transitional care evidence and measuring patient-centered outcomes. Participants discussed a vignette about a patient being discharged from the hospital to identify questions patients would have about participating in a new transitional care program. The group's objectives were to understand transitional care broadly and narrow the topic by prioritizing important questions from multiple stakeholder perspectives. Breakout sessions allowed for submitted questions and discussion of proposed research topics. The meeting concluded with recapping next steps and welcoming further input.
This study aims to determine if a nurse-delivered discharge planning bundle that includes a follow-up phone call within 1 week of discharge will decrease rapid readmissions of patients with heart failure. The researchers will implement a discharge care bundle including patient education and a follow-up phone call on a hospital unit. They will compare rates of readmission before and after the intervention to see if the bundle reduces readmissions. The goal is to improve patient outcomes and lower healthcare costs for heart failure patients.
This document discusses strategies to reduce hospital wait times and avoidable hospitalizations in Saudi Arabia, the UAE, and the United States. It identifies that increased healthcare costs and patient dissatisfaction with long wait times are issues. It proposes identifying high-risk patients for unnecessary admissions and applying alternative modeling techniques. Implementing policies to address problems leading to wait times and incorporating patient preferences could help reduce costs for patients and hospitals from long waits and hospitalizations.
This document summarizes a presentation given to nurses about celebrating success, harnessing enthusiasm, and improving patient care. It discusses changes in the NHS including service reconfigurations, quality improvements, organizational changes, and moving to all degree nursing. It highlights nursing indicators and successes in the North West region. It also discusses the new mental health strategy, quality innovation productivity and prevention, and initiatives to improve patient safety such as the Safety Express program.
This document summarizes a presentation given by Chris Jeffries, Acting Director of Workforce and Education for NHS NW. The presentation celebrates nursing successes, discusses harnessing enthusiasm to improve patient care and experience. It addresses organizational changes like service reconfigurations, quality improvements, and regulatory changes from the Francis inquiry. Key nursing initiatives discussed include the move to all degree nursing, changes to health visiting, and regional nursing indicators.
Reflections on Implementing Value-based Assessment in the UK -- Towse at HESG Office of Health Economics
Value-based pricing, as originally proposed in the UK, was intended to achieve several objectives, including broadening the definition of value. This presentation reviews important issues in defining value, demonstrates how past policy aimed at value has affected the availability of some medicines, and suggests ways forward under the revised, value-based assessment approach.
The document summarizes a meeting of the FLS Champions' Summit in 2016. It discusses updates on the implementation of Fracture Liaison Services (FLS) across the UK, priorities for improving osteoporosis services, and new developments for 2016 including best practices for identifying vertebral fractures. The National Osteoporosis Society's plans for 2016 aim to increase coverage of FLS and improve their quality. The meeting provided information on tools and support available to help establish and improve FLS, including implementation workshops, clinical standards, and a cost and workforce calculator. An audit presented at the meeting found some gaps in investigating patients and shortfalls in the numbers being seen by FLS compared to expected fractures.
Rob Reid: Redesigning primary care: the Group Health journeyThe King's Fund
Rob Reid, Senior Investigator at Group Health Research Institute, explains the journey taken by Group Health in support of integrated primary care. A case study in how primary care can be delivered effectively and efficiently to a population, Rob laid out the challenges facing general practice in the States, and how Group Health worked to improve the situation for both patients and the workforce.
The document discusses the attending model of medicine and technologies that can support it. It proposes using medical assistants, medical scribes, health coaches and navigators as a "pit crew" to allow physicians to focus on patients. This team approach aims to improve efficiency and patient satisfaction. Technologies mentioned include electronic health records, secure messaging, telemedicine, wearables and various clinical tools. The attending model seeks to make primary care more scalable and sustainable for solo or small physician groups.
Similar to Susan Schwabe Hourly Rounding 2014 (20)
1. Hourly Rounding
Presenter: Susan Schwabe
HCAHPS Scores
Received Help as soon as wanted: Nurse Always Communicated Well Rated Hospital 9/10:
National Average National Average National Average
68% 79% 71%
Hourly Rounding Outcomes
Improved:
• Patient Outcomes
(Mitchell et. al, 2014; Shepard,
2013)
• Patient Satisfaction
(Mitchell et. al, 2014; Olrich et. al,
2014)
• Patient Perception of Care
(Krepper et. al, 2014; Ford, 2010,
Woolley et. al, 2012)
• Patient Safety
(Ford, 2010; Mitchell et. al, 2014;
Olrich et. al, 2014)
• Reduce Call-Light Usage (Berg et.
al, 2012; Ford, 2010; Krepper, et.
al, 2014; Mitchell et. al, 2014;
Olrich et al., 2012)
Consistent Protocol - 6P’s
(Berg et. al, 2012; Ford, 2010;
Kessler et. al, 2012, Woolley et. al
2012):
• Greet Patient
1. Pain
2. PO
3. Pump
4. Potty
5. Positioning
6. Pick up-Environmental
Check
**Bonus: Plan -Schedule Next
Rounding
(Kessler et. al, 2012; Mitchell et. al,
2014; Olrich et. al, 2012)
Benefits to Hourly Rounding
Increased:
• HCAHPS Scores
(Krepper et. al, 2014; Mitchell et.
al, 2014)
• Hospital Reimbursement
(Mitchell et. al, 2014)
• RN Satisfaction
(Kessler et. al, 2012)
• RN Efficiency
(Krepper et. al, 2014; Shepard,
2013, Woolley et. al, 2012)
• HealthCare Awards
• Staff Recognition
• Continuity of Care
(Ford, 2010; Kessler et. al, 2012)
2. Hourly Rounding
Presenter: Susan Schwabe
Accountable Care Facts. (2012). Retrieved from http://www.accountablecarefacts.org/
Berg, K., Sailors, C., Reimer, R., O’Brien, Y., Ward-Smith, P. (2012). Hourly Rounding With a Purpose. The Iowa Nurse Reporter, 12-14.
Brewer, J., Shoulders, A., Emmons, K. (2010). Mind Your Mommies! Our Hospital’s Story of Hourly Rounding on the Obstetric Patient. Journal of Obstetrics and Gynecological Nursing,
39(1), S49-S50.
Centers for Medicare and Medicaid Services. (2014). Hospital Compare. Retrieved from http://www.Medicare.gov
Ford, B. (2010).Hourly Rounding: A Strategy to Improve Patient Satisfaction Scores. MedSurg Nursing, 19(3), 188-191.
Kessler, B., Claude-Gutekunst, M., Donchez, A., Dries, R. & Snyder, M. (2012). The Merry-Go-Round of Patient Rounding: Assure Your Patients Get The Brass Ring. MedSurg Nursing,
21(4),240-245.
Krepper, R., Vallejo, B., Smith, C., Lindy, C., Fullmer, C., Messimer, S., Xing, Y., & Meyers, K. (2014, March/April). Evaluation of a Standardized Hourly Rounding Process (SHaRP).
Journal for Healthcare Quality, 36(2), 62-69.
Mitchell, M., Lavenberg, J., Trotta, R., & Umscheid, C. (2014, September). Hourly Rounding to Improve Nursing Responsiveness A Systematic Review. The Journal of Nursing
Administration, 44(9), 462-472.
Olrich, T., Kalman, M. & Nigolian, C. (2012). Hourly Rounding: A Replication Study. MedSurg Nursing, 21(1), 23-36.
Shepard, L. (2013, February). Stop Going in Circles! Break the Barriers to Hourly Rounding. Nursing Management, 13-15. Retrieved from http://www.nursingmanagement.com
University of Kansas Hospital. (2014). Magnet Redesignation. Retrieved from http://www.kumed.com
U.S. News & World Report. (2014). U.S. News Best Hospitals 2014-2015. Retrieved from http://health.usnews.com/best-hospitals/rankings
Woolley, J., Perkins, R., Laird, P., Palmer, J., Schitter, M.B., Tarter, K., George, M., Atkinson, G., McKinney, K., & Woolsey, M. (2012, May-June). Relationship-Based Care: Implementing
a Caring, Healing Environment. MedSurge Nursing, 21(3), 179-184.
WomenCertified Inc. (2014).Women’s choice award America’s Best Hospitals for Obstetrics Award methodology. Retrieved from http://www.Womenschoiceaward.com
Editor's Notes
Introduction:
Welcome to my P-Party (popcorn, Pretzels, Punch) (Woolley et. al, 2012).
How does your Hourly Rounding Effect the Big Picture?
Direct Correlation between Hourly Rounding Rates and HCAHPS Scores and Hospital Reimbursement.
Lets Start with Hospital Reimbursement:
Our current climate in healthcare reimbursement is value-based reimbursement directly tied to HCAHPS(hospital consumer assessment of healthcare providers and systems survey) patient satisfaction scores (Mitchell et. al, 2014).
The Affordable Care Act’s most significant contribution is a provision that allows Medicare to reward HC organizations with a share of the savings that would result from improving care quality and reducing cost for Medicare populations. In order to participate in this “shared savings program” a hospital must become an Accountable Care Organization. The true value of ACOs is determined by assessing improvements in quality while being cost effective. This means, ACOs are rewarded for outcomes, not volume of services. Outcomes are based on HCAHPS Scores. ACOs also receives reduced reimbursement due to HCAHPS scores below the national average. (Accountable Care Facts, 2012).
HCAHPS Scores:
Patients in the hospital are under a great deal of stress with new medical conditions an unfamiliar environment in which they are unaware of hospital routines and access the one mechanism at their disposal for getting their needs met, the call button (Mitchell et. al, 2014).
A few Key HCAHPS Scores that point to patient satisfaction are did the patient feel “they receied help as soon as they wanted,” did the “nurse always communicate well,” and would they “rate this hospital a 9/10” (CMM, 2014).
Research tells us that relationship based care based on hourly rounding improved patient satisfaction through a reduction in call light by 52%, increased efficiency of nurses by 20%, decrease in patient falls by 12%. Patients reported their pain was better managed and nurses reported more time for documentation and patient education. Hourly rounding hitting the 6 P’s. Over 2 years, HCAHPS scores increased: Patients reported Nurses treated with with courtesy and respect 100%; nurses listed to me carefully 86%; nurses explained in a way I understood 86%; communication with nurses good 90%.
Problem:
Nurses, typically have a 1:6 ratio, weighted with prioritizing complexity of care for pts with different levels of acuity and safety needs sometimes requiring an extended period of time in one patient’s room while another patient believes their own need is urgent as well resulting in a delay in response to the call light.
Consistent Protocol- The 6 P’s:
Pain-Pain Assessment, TCDB, Diversion
PO-Medications
Pump-Check, Plan
Potty-Toileting, Reassuring Presence of RN
Positioning-Comfort, Skin/Sheets/Pillows
Pick up-Environmental Check, Call light/water/phone, Bedside Table, Tissues
Any Other needs, I have time right now. I’ll be back in an hour.
Extra Info:
Mitchell et. al 2014: Structured Hourly Rounding can address the Top 5 reasons for pressing call light and help the RN provide uninterrupted, more responsive care::
Pain mgmt., personal assistance, bathroom assistance, equipment/alarms.
Olrich et. al (2012): The following items will be checked for each patient:
1. Nursing staff enter room, greet patient, and say, “Hi, Mrs./Mr. Jones, I am
here to do my rounds to check on your comfort.”
2. Pain assessment using a pain intensity scale (if staff other than RNs are
rounding and the patient is in pain, RNs will be contacted immediately by the
person rounding so the patient does not have to use the call light for analgesia).
3. An hour prior to analgesia is due, the patient will be asked if she/he is starting
to feel pain. If the answer is “yes,” the RN will schedule analgesia administration.
4. Toileting assistance will be offered.
5. A patient positioning and comfort assessment will occur, including covering
the patient if needed.
6. Environmental check
• Call light within reach
• Telephone within reach
• TV control and bed light switch within reach
• Bedside table close to bed
• Tissue box and water within reach
7. Prior to leaving the room, each staff member asks, “Is there anything I can do
for you before I leave? I have time to do it.”
8. Staff also will tell the patient when rounding next will be conducted (in 1
hour).
Consistent actions during hourly rounding:
Lehigh Valley Hospital-Muhlenberg Campus, Bethlehemn PA“Is there anything I can do for you before I leave? Right now I have the time. We’ll be back in an hour to check on you.” 6T at LVHMC researched hourly rounding for 6 years and found working together to determine the tailored protocol that worked best for their floor to improve patient satisfaction and nurse indicators. Now, they hold staff meetings on their floor for other units implementing hourly rounding and have made an overarching impact on HCAHPS Scores for the hospital on the whole (Kessler et. al, 2012).
Hourly Rounding Outcomes Based on the equivalent of 10 year of studies (Mitchell et. al, 2014):
Patient Outcomes/ Patient Satisfaction: More than 16 published studies found statistically significant evidence that hourly rounding has beneficial effects on patient outcomes and satisfaction scores on HCAHPS and NDNQI Nursing Indicators. (Mitchell et. al, 2014, Shepard, 2013, Olrich et al, 2014, Woolley et al, 2012, Krepper et al, 2014 and Ford, 2010).
Brewer et. al(2010) provided the only information pertaining to hourly rounding on the Obstetric patient and found benefits of hourly rounding in that the patients received the time and attention in clustering care, which allowed them to rest or bond with their infant. Areas of focus were pain, anticipating needs and improved patient experience, as well as receive needed education regarding self care, baby, lactation and bonding as a family unit.
Patient Perception: : Patient value RN relationship, continuity of care, trust, compassion, respect, safety, understandable instructions, service quality, reliability, responsiveness and effective communication. Hourly rounding is a key component to impacting the patient perception of quality services and satisfaction.(Ford, 2010).
Patient Safety: Key mandate of TJC is improved patient safety (Ford 2010). Nine studies reported a reduction in falls ranging from 24%-80%. (Mitchell et. al, 2014)
Reduced Call Light Usage: Ten studies of hourly rounding on effects of call light usage showed decrease in usage range from 23%-70% (Mitchell et. al, 2014). That’s an “Overall call-light usage decreased an average of 33% per patient, per day.”
Specifically, patients who used the call-light to:
request pain medication and toileting
These results support the hypothesis that providing these activities routinely reduces unnecessary steps and
decreases interruptions in work flow for RNs. Thus, implementing this activity should be considered by
healthcare facilities, as an evidenced-based practice”(Berg et al., 2012).
Benefits of hourly rounding:
HCAHPS Scores:
HCAHPS patient satisfaction scores increased almost 10 percentage points after implementation of hourly rounding (Krepper et. al, 2014).
HCAHPS scores are publically reported and are linked to Medicare reimbursement levels. They highlight 2 questions pertaining to response to call button and getting expeditious help with toileting. Proactive and regular checks decrease patient anxiety, call light use, minimizes patient uncertainty (Mitchell et. al, 2014).
Hospital Reimbursement: In our current HC climate of value based purchasing, reimbursements are directly tied to patient satisfaction scores and RN responsiveness is an important factor in patient perception of care which is captured in patient satisfaction surveys (Mitchell et. al 2014).
Staff satisfaction: Kessler et. al six year study resulted with the Hospital Staff satisfaction with increased camaraderie, benefits of taking a proactive-timely approach, having more control over the work, identifying tasks that might have been missed. They found when rounds were not done there was chaos.
Staff Efficiency: Pedometers were worn by RNs before and after implementation of hourly rounding and they found that the number of steps decreased with hourly rounding resulting from a more efficient approach to meeting patient care needs in a proactive manner (Krepper et al, 2014, Shepard, 2013, Woolley et al, 2012).
Shepard, 2013: For RNs with 1:6+ ratio on high acuity medsurg units with IV pump alarms, documentation demands, new technology, have found hourly rounding was a key to time management. When a patient understands that the RN will visit their room every hour, they are less likely to request assistance between rounds. The decrease in interruptions, allows RNs to work efficiently and productively.
Krepper et al (2014) assessed efficiency of delivery of care: nursing staff wore pedometers and were able to show decreased number of steps walked in a shift by doing hourly rounding.
Since 2005 Research has demonstrated the benefits including saving valuable time. Address pain mgmt., elimination, nourishment, ambulation/positioning (Shepard, 2013).
Staff Recognition: Unit Award, Performance Review
Consistent ProtocolContinuity of Patient Care
Facility Reputation: Community Recognition Awards and Designations (see below):
Community Recognition/Awards:
Why is it important to be seen on the radar? Patient Choice. What are patients turning to determine where they will pursue medical treatment? Research the Web….what do they find on the web rating hospitals?
-Hospital Compare, HCAHPS Scores
-American Nurses Credentialing Center-Magnet Designation
-Women’s Choice Award
-US News and World Report Best Hospitals Rankings
-Word of Mouth
Hospital Compare:
HCAHPS Scores
Magnet Recognition Program:
Recognizes the important role nurses play in hospital’s ability to provide the very best in patient care and patient outcomes. University of Kansas Hospital is a Magnet hospital which attracts nurses because nurses are encouraged and appreciated, the hospital is committed to patient care and outcomes and provides higher quality care, lower mortality rates, significantly higher levels of patient satisfaction and consumer confidence as well as greater success in recruiting and retaining the best nurses. Only 393 hospitals worldwide hold Magnet designation.
US News and World report Hospital Rankings in Cancer and gyn are based on hard data.
Gynecology:
Mayo Clinic 100/100. #1 Ranking;
Brigham and Women’s 91.4/100 Ranked #2.
Ranked #50th: scored a 69.7/100 score.
University of Kansas Hospital Ranked #38th with score of 71.1/100
In addition to reimbursement, hospitals are publically acknowledged with Women’s Choice Awards and Ranked according to HCAHPS ratings. These ratings and Awards attract future patients/clients of the medical center which impact job security, ANCC magnet recognition program which recognizes quality pt care, nursing excellence and innovations in professional nursing which in turn attracts and retains nurses at a medical center.
The greater Wichita, KS area Women’s Choice Award Recipients in OB 2014: Newton Medical Center and Via Christi St. Theresa.
Female Recommendation Rating. Award methodology in a nut shell uses HCAHPS scores(patient satisfaction) coupled with frequency of incidence of problems(errors, infections) to the Centers for Medicare and Medicaid Services for 12 measures of quality (death, collapsed lung, blood clots, wound evisceration, cuts/tears, complications, CLABSI, CAUTI, SSI: colon, SSI: Hysterectomy, MRSA, C.diff). We cannot separate clinical performance from patient experience. Female recommendation rating based on pt feedback and low rates of infection or serious complications