Effects of nursing rounds on patient satisfaction and safety

¶ … 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.

How will this research benefit patients and nurses?

Interestingly, according to the American Journal of Nursing, although some interactions between nurses and patients, such as smiling, the nurse's use of humor and reassurance, touching, and anticipating patient needs increases patient satisfaction, a nurse's frequent responses to call lights, not only interrupts the continuity of patient care on the wards as a whole but may actually may decrease all patients' sense of satisfaction. The nurse's physical presence is the key variable that makes some interactions helpful and others less helpful and satisfying for patients. Rather than using call lights, researchers found that the use of periodic rounds reduced call light use for frivolous purposes, increased patient contentment, and improved patient safety. Also, the nurses commented that they were more satisfied with making more frequent rounds because the reduced patient use of call lights allowed them additional time to spend with the patients in need in an uninterrupted fashion.

What barrier to implementing evidence-based practice do you face at your workplace?

One barrier, of course, is partially logistic -- it is necessary to have greater numbers of nurses to make more frequent rounds in any setting, and the larger the setting the more difficult it is to use human beings, rather than technology in the workplace. Also, as technology is supposed to reduce workloads, there may be some managerial resistance to implementing this evidence-based finding, as it seems counterintuitive. There may be legal concerns, as the availability of a call light might be a legal 'cover' for accusations of ignoring patients, even if ward rounds are increased.

But the findings suggest that call lights and decreased nursing visitations to all patients, regardless of their use of a call light, supports the unavoidable need for human connection on the part of patients and actually improve medical care, and specifically reduces the risk of falls. Most nurses' intuitive awareness of patient psychology is supported by the findings of the article, and if quality of care improves, so will the respect given to the medical facility in question. Also, legal risks to the hospital will be reduced if falls are reduced, as falls are one of the most potentially serious risks for elderly patients in hospital settings.

Propose strategies to overcome the potential barriers

Encouraging nurses to share their input from their own personal experiences, and supporting the statistical findings of the articles with data from within the facility is vital. Doing a trial run of increasing rounds and encouraging the decreased use of call lights in controlled sections of hospital wards can demonstrate within the specific clinical care setting the merits of the study. Also, increasing patient and nursing interactions through the use of more frequent rounds in a variety of medical settings, including hospital and doctor's waiting rooms, and supporting the benefits of this with patient response cards and evidenced-based onsite research can make the findings of the article more persuasive and promote change.