
Participant will be able to distinguish the
difference between “hourly rounding”
and “rounding with purpose”

Participant will be able to identify
improved patient outcomes resulting
from rounding with purpose

Participants
oStudy
•Hourly rounding
› 14 hospitals
•Every two rounding
› 27 units, 8 met criteria
•Specified protocol used
79.9% overall satisfied before
 88.8% overall satisfied after

38.2% “Excellent” ratings before
 80.1% “Excellent” ratings post


Participants
› Patients in 27 units from 14 hospitals nationwide

Study
› Rounding hourly
› Rounding every 2 hours
› Charge Nurse rounding

Certain a care giver would come:
› 8% before hourly rounding
› 72% after hourly rounding

Participants
› 3 campuses of:
 St. Joseph Regional Medical Center, Indiana
 South Bend Plymouth, Indiana
 Mishawaka, Indiana

Study
› Hourly rounding on all inpatient units

ALL FIVE QUESTION AREAS IMPROVED

Studies Reviewed = 11
› Included hospital units
or
› telemetry, medical/surgical, orthopedic,
rehabilitation, and gerontology settings

Study
› Hourly rounding by direct caregivers,1-10
› 1 involved a charge nurse rounding Q 2 hours

(83%) call lights use reduced; 5 of 6
studies

(77%) fall rates were reduced; 7 of 9
studies

(88%), showed improvements in overall
patient satisfaction; 8 of 9 studies
Halm, 2009
•
Scores related to patient satisfaction
increased
•
Call light use decreased
•
Nurse perception of quality of care
increased
•
Patient fall reduction
•
Alleviates “uncertainty”
Bourgault, 2008; Gardner, 2009; Meade 2006; Woodard, 2009

Answering the call lights already

In the room more than 1X/hour already

Document more information!?

This will only cause more work

Formal scripting feels impersonal

Acuity of patients

Patient satisfaction measured in all 3
› 3 of the 3 showed increased patient satisfaction

2 of 3 studied call light usage
› 1 experienced reduction of call light usage

2 of 3 studied fall rates
› Both showed a decrease in falls
›
Bourgault, 2008; Meade 2006; Woodard, 2009

Meaningful interaction by clinical staff
› Address the four P’s





Pain
Positioning
Potty
Presence
All associates trained and expected to
assist PRN
 Housekeeping
 Dietary
 Maintenance
Bourgault, 2008; Woodard, 2009
o Actively engages patients and
families
o Builds Trust
o Reduces Anxiety
o Call light reduction
o Decreases nurse stress
o Decreases patient uncertainty
Evaluate structures and processes frequently
o Revise what did not work PRN through
o
• Staff evaluation
• Patient evaluation
o
o
o
o
o
o
Support from nursing leadership
Ongoing audits
Nurse manager rounding
Accountability by all involved
Educate patients/families
Be realistic
Insanity is doing
the same
thing over and
over and
expecting a
different result.
Albert Einstein
1.
2.
3.
4.
5.
6.
7.
8.
Incorporate patient position on the rounding
log
During rounding, assess pressure points
Tell patients why we are repositioning them
Use specific key words to explain our actions
Explain why specialty equipment is being used
Use wound teams proactively for prevention
Engage all employees through stories
Hourly rounding reduces pressure ulcers 14%





Involve patients as part of the team
Provide printed information on fall
precautions
Use specific words to explain what patients
can do
Set specific goals around fall reductions
Hourly rounding cuts falls in half
More information available at
www.studergroup.com/never
 View
free videos
 Learn the financial impact
 Link to prevention resources
 Find national Studer Group speakers and
coaches who can come to your
organization
View a free video
covering these topics on
studergroup.com/never
Bourgault, A.M., RN, MSc, CNCC(C), King, M.M., RN, MS, MBA, CNAA, Hart,
P., RN, MSN, Campbell, M.K., BEd, Swartz, S., RN-BC, MSN, Lou,M., MS.
(2008). Circle of excellence. Nursing Management, 39(11), 18-24.
Halm, Margo A., RN, PhD, CNS-BC. (2009). Hourly Rounds: What does the
evidence indicate? American Journal of Critical Care, 18(6), 581-584.
Meade C, Bursell A, Ketelsen L. (2006). Effect of nursing rounds on patients’
call light use, satisfaction, and safety. American Journal of Nursing, 106(9),
58–70
Woodard, J. L., MSN, RN-BC. (2009). Effects of rounding on patient
satisfaction and patient safety on a medical-surgical unit. Clinical Nurse
Specialist: The Journal for Advanced Nursing Practice, 23(4), 200-206.