PATIENT HOURLY ROUNDING
Yale-New Haven Hospital
2010
1
Objectives
Nursing staff will:

Verbalize an increased understanding about patient
hourly rounding goals.

List the 8 specific rounding behaviors.
2
The Facts

Nursing staff devote a lot of time responding to
unscheduled patient requests so they have less time for
more critical duties.

Patient falls and pressure ulcers are concerns to staff ,
patients and families.

How nursing staff respond to call lights plays a major role
in how patient perceive the quality of healthcare.
3
Goals:

Reduce call lights

Improve patient perceptions of care

Increase nursing satisfaction and efficiency

Reduce patient falls

Reduce skin breakdown

The Studer Group (2006). Hourly rounding. Fire Starter Publishing.
4
Studer group

Largest study to show that certain nursing staff behaviors
reduce call light and allow nursing staff to respond more
efficiently to patient requests.

27 units in 14 hospitals.

Call light usage decreased by 38%

Patient satisfaction went up from 79.9-88.8%

Meade, C.M., Bursell, A.L., Ketelsen, L. (2006). Effects of nursing rounds on patients’ call light use,
satisfaction and safety. American Journal of Nursing, 106(9), 58-70.
5
Studer group

Success in other areas.

Hospitals saw 50% decrease in patient falls.

Patient AND employee satisfaction increased.

Nurse reported more time to attend to other task because
they were answering call lights less often.

The Studer Group (2006). Hourly rounding. Fire Starter Publishing.
6
Studer says:

Rounding allows nurses to gather information,
it is proactive not reactive.

Handle patient problems before they occur.
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Specific Behaviors
1. Use opening words and/actions to introduce
yourself, your skill set, your experience.
2. Perform scheduled tasks.
3. Assess and address the:
Adult: 4P’s - pain, personal needs, position and
placement
Pediatrics: P.E.D.I.
P=parents/plan/pain
E=eating (bottles, meals, etc)
D=diapers (supplies, towels, etc)
I=interaction/ID bands

The Studer Group (2006). Hourly rounding. Fire Starter Publishing.
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Specific Behaviors
4. Assess comfort needs.
5. Conduct an environmental assessment of the room.
6. Use closing key words or actions.
7. Explain when you or others will return.
8. Document the rounding in Sunrise Clinical
Manager

The Studer Group (2006). Hourly rounding. Fire Starter Publishing.
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Explain Purpose of Hourly Rounding
Upon Admission/Transfer/Change in Caregiver
“We round every hour on our patients to ensure that you
receive “Very Good” care. We will not wake you if you
are sleeping unless we need to. If anytime during your
stay, you feel you are not receiving “Very Good” care,
please let us know immediately so that we can address
your concerns.”
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Key Words - Adult

“Hello Mr/Mrs ____ My name is___ I will be your
(Nurse/PCA) today”

“What is your pain level right now?”

“Can I assist you to the bathroom?”
(incontinence care, empty urinal, etc)

“Would you like to be repositioned?”
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Key Words - Adult

“Are you comfortable?”

“I want to place these items (call bell, telephone, tissues)
in front of you, so that they are within your reach.”

“Is there anything else I can do for you before I leave? I
have the time.”

“I (or other staff member) will be back within the hour to
round on you again.”
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Key Words - Pediatrics
 “Hello (patient/parents) ____
My name is___ I will be
your (Nurse/PCA) today”
 Are you aware of the plan for today?
 “What is your pain level right now?” or “Do you feel that
your child is comfortable?”
 “Can I assist you to the bathroom?” (check diaper, supplies,
empty urinal/hats)
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Key Words - Pediatrics
 “Are you comfortable?” (for younger children - comfort items- pacifier,
toy, book, etc.)
 “I want to place these items (call bell, telephone, tissues, trash) in front
of you, so that they are within your reach.” (age appropriate)
 “Is there anything else I can do for you before I leave? I have the time.”
 “I (or other staff member) will be back within the hour to round on you
again.”
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SUCCESSFUL ADULT ROUNDING
The 4 “Ps”, vital for successful rounding consists of:
Pain: asking patients to describe their pain level on scale of zero to 10
Positioning: making sure the patient is comfortable and assessing the risk
of pressure ulcers
Placement: making sure the items a patient needs are within easy reach
(call bell, phone, water)
Personal Needs: scheduling patient trips to bathroom to avoid unsafe
conditions
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SUCCESSFUL PEDIATRIC ROUNDING
To help you remember, successful pediatric patient rounding
includes:
P = parents/plan/pain
E = eating (bottles, meals, etc.)
D = diapers (supplies, towels, etc.)
I = interaction/ID bands
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Procedure
Responsible
Time Frame
1. Use opening key words to introduce yourself and
explain your role.
Nurse , PCA,BA
Initial
Introduction
2. Write names and phone numbers of caregiver
staff on whiteboard.
Nurse and PCA
Each Shift
3. Address the 4 Ps for adult areas
Nurse and PCA
Hourly Minimum
4. Address the PEDI list for pediatric areas
Nurse and PCA
Hourly Minimum
5. Assess additional comfort needs
Nurse and PCA
Hourly Minimum
6. Conduct an environmental assessment
Nurse and PCA
Hourly Minimum
7. Prior to leaving the room ask “Is there anything
else I can do for you? I have the time.”
Nurse and PCA
Hourly minimum
8. Tell each patient when you and others will return.
Nurse and PCA
Every time you
exit the room
9. Nurses will round on the even hours
Nurse
Even Hours
10. PCAs will round on the odd hours
PCA
Odd Hours
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Procedure- Continued
Responsible
Time Frame
11. Rounding will be documented at the end of the shift on
SCM Flowsheet – Vital Signs: Adult or Pedi (Non-ICU) (See
next slide)
Nurse and
PCA
Hourly
12. Rounds will continue throughout the night; patients
do not need to be awakened.
Nurse and
PCA
Hourly
18
Document at
end of shift
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EVERY PATIENT
EVERY TIME
EVERY HOUR
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