Abstract
Hourly rounding is aimed to improve the patients’ outcomes through addressing needs proactively. It offers nurse practitioners more time to carry out patient care tasks. Due to the various medical conditions that require frequent checkups as well as treatment procedures from physicians, patients are placed in a state of dependency where they become emotionally and socially vulnerable. The paper aims to research on evidence that exist on the importance of hourly rounding to reduce patient falls. The research involved review and analysis of a variety of article. Finally five articles are chosen that contains the information on the effectiveness of hourly rounding. The aspect is associated with patient satisfaction as well as quality care. The article also provides existing limitations a well as suggestions and recommendations for improving the nursing practice.
Impact of Hourly Rounding on Hospitalized Patients
Hourly rounding is the practice of where assistive personals, as well as nurses, make scheduled visits to various patient rooms to carry out specific medical interventions after every hour. Hourly rounding is aimed to improve the patients’ outcomes through addressing needs proactively. The practice has been linked to various benefits apart from improving patient experience. These benefits include reduced patient falls, improved patient perception of care, reduced skin breakdown, and reduced call lights for improved nurse satisfaction and efficiency.
Additionally, it offers nurse practitioners more time to carry out patient care tasks. The practice should be considered a critical aspect in an organization’s commitment to patient-centered excellence. Compared to no hourly rounding, hourly rounding has many benefits in the health sector, with the reduction of fall incidences being the key benefit of the practice.
Importance to the Science of Nursing
Due to the various medical conditions that require frequent checkups as well as treatment procedures from physicians, patients are placed in a state of dependency where they become emotionally and socially vulnerable. Additionally, they are forced to seek assistance with necessities such as elimination, eating, and repositioning. Falls are critical problems across all grounds locally, regionally, nationally, and globally.
According to a research report in 2015, there were 1,330 falls which amounted to 418 injuries across over 27,000 hospital admissions in Australia. In the US, the hospitals reported more than 700,000 patient fall in a year half of these cases resulted in an injury. The results show the global trend in the number of falls experienced, making falls a global concern. The highest percentage of falls experienced occur in older patients aged 60years and above. Patients who are 8p years or older are at the highest risk of falling. In 2008 the CMS deemed the evidence of falls meaning that there should be more occurrences of falls. CMS also declined to pay for any cost incurred by patient falls. Therefore, incidences of falls have become expensive for healthcare institutions.
Evidently, inpatient falls and injuries are a complicated phenomenon that involves various factors that can be intrinsic and extrinsic. Therefore, a lack of knowledge on the risks of falls, such as the procedures followed in case of a fall, of extrinsic factors that risk a patient’s health. Due to these numerous cases of falls, it is imperative for health care practitioners to come up with an intervention that could assist reduce instances of falls. Hourly nursing rounds are the most appropriate practices that could mitigate the issue.
Literature search
To get comprehensive answers to this research question, a search for relevant articles on the topic was done on different websites. Most of the research literature was retrieved from PubMed. During the literature search, the use of keywords such as hourly rounding, patient safety, and patient falls. Moreover, the research relied on articles published in the past ten years to obtain recent literature about the question. After the search, a total of 105 articles were gathered and critically analyzed the titles and the abstracts to ensure that they were relevant to the question. A final list consisting of the five most relevant recent publications that mainly focused on hourly rounding and its advantage in reducing the rate of falls among hospitalized patients. All the articles reviewed were written in English.
Key Findings
In the study conducted by Matthew et al. (2014), he has synthesized evidence concerning hourly rounding programs’ effect on patients. Patient satisfaction is key to a metric that influences an institution’s ratings.
Hourly and timely rounding improves patient outcomes and also prevents cases of falls and patient injuries.
The research is carried out through a systematic review of the evidence available regarding the effectiveness of hourly rounding. According to the article, the evidence available supporting the use of hourly rounding in inpatient care was of both low and moderate strength. However, sustaining an hourly rounding emerges as a strain on the nurses’ resources (Mitchelle et al., 2014). Although the effect could be cost-effective and help the nurses fulfill the four Ps, it is not determined whether the patient will feel the same impact.
In a research study conducted on implementing purposeful and timely rounds of inpatient care, the intervention is concluded to be the best practice that reduces light calls and fall injuries. The project aims to improve patient satisfaction by implementing purposeful and hourly rounding in nursing. Every nurse practitioner has an obligation to improve patient safety and patient satisfaction by using round interventions which improve staff responsiveness and communication—having an organized approach and supportive infrastructure responsiveness. Having a supportive infrastructure and an organized approach surrounding all the staff levels to meet the patients’ needs when hospitalized is crucial for success.
Hourly rounding is key to patient and nurse satisfaction.
Currently, the implementation of hourly rounding is a crucial component that evaluates the excellent performance of Healthcare institutions, and it has been ranked as the best practice that forester quality patient care. However, there is little evidence that shows the effect of hourly rounding on patient satisfaction. In a research study, the researchers aim at determining the effect of hourly nursing rounds. The study is conducted by observing a sample group of hospitalized patients (Daniels, 2016). The study provides evidence that hourly rounds improve patients’ satisfaction as well as the quality of care; as a result, health policymakers should consider the implementation of hourly rounds to improve overall quality care in health care facilities.
Limitations of the Current Research
Several studies outlined various limitations on current research. For instance, in the research article that aimed to investigate the perceptions and perspectives of the frontline nursing staff on hourly rounding, the researchers did not reach the recommended 50% response rate. In order to have valid results of a survey, the majority of the sources recommend that there should be at least 50% response rates ( Fabry, 2016). In the same study, the registered nurses were 37 more than the PCAs. As a result, it was challenging to classify and categorize the responses with regard to the shift since the nurses worked for 12 hours while PCAs worked for 8 hours alone. The study concerning reducing patient falls using hourly rounding faced the challenge of low daily patient volume (Malungeta, 2020).
Additionally, the 30-day evaluation caused a limited data analysis. In the research study to evaluate patient satisfaction through hourly rounding in Ethiopia, the use of quasi-experimental design was considered a limitation since it does not assure equality between groups. Additionally, the study did not assess the perception of nurses on hourly rounds, which is a crucial aspect. Other limitations included familiarity with issues of bias, generalizability as well as publication bias.
Discussion – Suggestions for a change in nursing practice
According to the evidence provided by the research articles, hourly rounding is a critical practice that is associated with both patient and nurse satisfaction, reducing the number of falls in hospitals, among other benefits. Particularly, hourly rounding assists in reducing light calls and patient falls. The benefits of satisfaction support the hypothesis shows there is an impact of hourly rounding.
Regarding the various limitations provided during the search, there is not much to be changed in hourly rounding nursing practices. However, more research should be conducted to determine the effects of hourly rounding on patients’ and nurses’ satisfaction. There exists little evidence that describes the effects of hourly rounding.
The availability of more evidence concerning hourly rounding will ensure smooth applicability of the practice in the majority of healthcare institutions to improve patient outcomes. On recommendations, hourly rounding could be improved by building a positive patient-centric culture. This initiative will help n yielding favorable patient care outcomes. The implementation of the patient-centric increases patient satisfaction by over to percent. Generally, purposeful rounding promotes patients’ safety by regularly checking equipment, creating a safe working n environment, and also preventing numerous cases of patient falls, pressure ulcers, and infections.
Conclusion
Patient falls are a consistent problem that is witnessed during nursing practice. Some of them lead to fatal injuries that could lead to death. However, the problem could be mitigated by the use of hourly rounding. Research studies have shown the effectiveness of using hourly rounding and the numerous benefits associated with the practice. Effective employment of purposeful and timely rounding has shown a positive impact on health care patient outcomes.
Additionally, hourly rounding benefits both patients and nurses and also improves satisfaction and quality care. The five selected articles have shown evidence of the usefulness of hourly rounding in nursing practice. The practice changes the perceptions of nurses towards nursing practice. However, there are various limitations to studies that may leave gaps concerning hourly rounding. For instance, despite the numerous benefits of timely rounding, there is little evidence showing the effect of hourly rounding on patient satisfaction and the quality of care. Therefore, more research should be conducted on hourly rounding. However, it is evidently clear that hourly rounding effectively reduces patient falls compared to no hourly rounding.
References
Daniels, J.F. (2016) ‘Purposeful and timely nursing rounds: a best practice implementation project,’ JBI Database of Systematic Reviews and Implementation Reports, 14(1), pp. 248–267. doi:10.11124/jbisrir-2016-2537.
Fabry, D. (2014). Hourly rounding: Perspectives and perceptions of the Frontline Nursing Staff. Journal of Nursing Management, 23(2), 200–210. https://doi.org/10.1111/jonm.12114
Mitchell, M. D., Lavenberg, J. G., Trotta, R. L., & Umscheid, C. A. (2014). Hourly rounding to improve nursing responsiveness. JONA: The Journal of Nursing Administration, 44(9), 462–472. https://doi.org/10.1097/nna.0000000000000101
Mulugeta, H., Afenigus, A. D., Wagnew, F., Haile, D., Tadesse, A., & Kibret, G. D. (2020). The effect of hourly nursing rounds on patient satisfaction at Debre Markos Referral Hospital, Northwest Ethiopia: A non-randomized controlled clinical trial. International Journal of Africa Nursing Sciences, 13, 100239. https://doi.org/10.1016/j.ijans.2020.100239
Savage, A. (2020). Reducing Patient Falls Through Purposeful Hourly Rounding. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https://doi.org/10.46409/sr.UOZB3951
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