This paper examines hourly nursing rounding as a proactive, evidence-based nursing intervention designed to enhance patient satisfaction and improve clinical outcomes in a healthcare facility. The paper outlines the process of obtaining organizational approval, describes the current problems—including patient falls, pressure ulcers, and excessive call light use stemming from the absence of a structured rounding framework—and proposes intentional hourly rounding as the solution. Drawing on peer-reviewed literature, the paper presents a rationale for the proposed change, details implementation logistics including staff training and resource requirements, and emphasizes the importance of stakeholder collaboration throughout the change process.
Hourly nursing rounding is regarded as one of the most suitable means for enhancing patient satisfaction and clinical outcomes. This process can be described as a proactive, systematic, nurse-centered, evidence-based intervention designed to predict and address the various needs of hospitalized patients. There is sufficient evidence to demonstrate that effective hourly nursing rounding can enhance patient safety, promote team communication, and increase the capability of staff to deliver efficient patient care. Accordingly, this approach is a suitable method to help reduce falls, prevent pressure ulcers, and decrease call light use — all of which contribute to enhanced patient satisfaction through evidence-based practice. Adopting this method in the organization to improve patient satisfaction and clinical outcomes requires the development of a comprehensive implementation plan and participation from all key stakeholders.
Adopting hourly nursing rounding in the healthcare facility to enhance patient satisfaction and clinical outcomes requires obtaining necessary approval and support from the organization's leadership and fellow staff. The process of obtaining approval and support depends on the evidence within the organization regarding the need for a new approach to improving patient satisfaction and clinical outcomes. Given the existing circumstances in the organization, the evidence is strong and the environment is increasingly open to change. Therefore, facilitating this change process would be relatively less demanding (Brosey & March, 2014, p. 2).
The method used for obtaining necessary approvals and support from the organization's leadership involved holding discussions with the leadership team about current best practices and the positive impacts of hourly nursing rounding. These discussions were held during an institutional review board meeting that examined current practices in the organization's environment. The meeting also focused on identifying an appropriate framework that would contribute to enhanced patient satisfaction and clinical outcomes through evidence-based practices. In essence, the main agenda of the institutional review board meeting was to examine context and environment, review available evidence, and determine a suitable facilitation framework. Following these discussions, the organization's leadership provided the necessary approval for this evidence-based practice project.
With regard to obtaining necessary approval and support from fellow staff, the facilitation method involved using a framework through which staff were enabled and empowered to take control of their learning and change process (Brosey & March, 2014, p. 2). Discussions were also held with fellow staff about current best practices and the positive impact of this change process. These discussions were crucial in encouraging and empowering staff to become active in decision-making and in embracing the implementation plan of the proposed project.
Nurses generally carry out their roles in patient care through communication, which is a crucial element of nurse-patient interactions. Communication is regarded as the cornerstone of the nursing profession because it is central to the quality of nursing care. Despite the significance of communication in nursing practice, there have been several incidents of unfavorable communication between nurses and patients in this healthcare facility. These poor communication levels in nurse-patient interactions have contributed to reduced patient satisfaction and negatively affected the likelihood of achieving desired clinical outcomes.
One of the major reasons for this problem is the lack of an effective framework or process for nursing rounds. Delivering patient care involves conducting regular checks on individual patients rather than waiting for them to activate a call bell when in need of assistance. In this healthcare organization, nurses do not carry out regular checks on patients in order to anticipate and provide essential care. In most cases, nurses tend to wait for patients to ring a call bell before responding to their needs. This reactive approach — stemming from the absence of an effective rounding framework — has contributed to patient falls, pressure ulcers, and increased call light use.
Patients have continued to voice dissatisfaction with the ineffectiveness of nurses in delivering patient care. The main problem for this organization is the elevated risk of falls, ulcers, and excessive call light use, all of which negatively affect patient satisfaction and clinical outcomes. This problem is largely attributable to the lack of a suitable framework for effective nursing rounds that would enable nurses to anticipate and provide essential patient care proactively, rather than adopting a purely reactive approach (Forde, 2014, p. 38).
The proposed solution to address this problem is establishing a framework for hourly nursing rounding, which will help nurses adopt a proactive rather than reactive approach in anticipating and providing essential nursing care to patients. Hourly nursing rounding can be described as a systematic, proactive nursing intervention developed to effectively predict and handle the needs of hospitalized patients (Brosey & March, 2014, p. 1). This procedure is regarded as an effective means to enhance patient satisfaction and clinical outcomes. Its suitability is attributed to the substantial evidence demonstrating the positive effects of hourly nursing rounding on patient satisfaction and clinical outcomes. In most cases, this procedure has been adopted as a standard component of nursing practice for lessening patient harm and enhancing patient satisfaction. Hourly nursing rounding is an evidence-based nursing practice because numerous studies have indicated that, when done correctly, it promotes satisfaction, quality, and safety (Timothy, 2015).
Hourly nursing rounding — commonly known as intentional or purposeful rounding — entails conducting regular checks on individual patients as a means of anticipating and providing essential nursing care based on each patient's needs (Forde, 2014, p. 38). In this approach, nurses adopt a proactive stance instead of simply responding to a patient ringing a call bell. Patients are visited by a nurse at least every one to two hours to examine their health and overall well-being. During these visits, nurses also evaluate patients' comfort and pain levels, carry out necessary repositioning and toileting, and ensure easy access to the patient's personal fluids and other necessary items.
Hourly nursing rounding is based on the structured approach of purposeful or intentional rounding and is commonly linked to the concept of "back rounds," which was an important part of patient care delivery during the 1970s and 1980s. Building on this concept, the procedure is task-centered and focuses on enhancing patient comfort and preventing patient harm such as falls, ulcers, and excessive call light use. The procedure helps prevent falls because nurses reposition patients in ways that reduce fall risk. Repositioning not only helps prevent falls but also ensures that patients remain comfortable throughout the care delivery process. Through hourly nursing rounding, patients are repositioned frequently, kept comfortable, clean, pain-free, hydrated, and regularly assisted with toileting.
With regard to the prevention of pressure ulcers, hourly nursing rounding ensures that nurses reposition patients to promote comfort and acts as a means of evaluating a patient's risk of developing pressure ulcers. This evaluation informs a care plan tailored to the patient's specific needs. Through this process, nurses effectively reduce the risk of pressure ulcers by promoting patient comfort. In relation to call light use, hourly nursing rounding decreases reliance on call bells because nurses proactively carry out regular checks on patients rather than waiting to respond to them.
"Literature support and cost-effectiveness of rounding"
"Training, resources, and cost considerations for rollout"
The healthcare organization is experiencing several challenges that affect patient satisfaction and clinical outcomes, including patient falls, pressure ulcers, and excessive call light use. These challenges have necessitated the creation and establishment of a suitable framework for enhancing the delivery of patient care through improved nurse-patient interactions. Developing such a framework requires seeking necessary approval and support from the organization's leadership and fellow staff. This will involve holding discussions with the leadership team during institutional review board meetings and collaborating with staff regarding current best practices in addressing the issue. In light of the issues facing the organization and the available evidence-based nursing practice literature, hourly nursing rounding is the most suitable solution for addressing these existing problems. The implementation of this proposed solution requires collaboration among all organizational stakeholders and the use of appropriate resources for initiating the change process.
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