Whiteboards and Hourly Rounding in Postpartum Pain Management
This literature review examines the effects of patient-facing whiteboards and hourly rounding on pain management, communication, and patient satisfaction, with a focus on postpartum and pediatric care settings. Using a PICOT framework centered on women undergoing caesarean or vaginal delivery, the paper synthesizes findings from more than a dozen studies employing quasi-experimental, qualitative, and systematic-review designs. Key themes include the role of nurse–patient communication in patient-centered care, the practical application of whiteboard tools on hospital units, and the mixed evidence surrounding hourly rounding protocols. The review identifies recurring limitations such as small sample sizes, insufficient quantitative data, and a lack of standardized measurement, while also highlighting implications for nursing research and practice.
- Introduction and PICOT Framework: Clinical problem, background, and PICOT question
- Significance of the Problem to Nursing Practice: Why postpartum communication tools matter to nurses
- Literature Search Strategy: Search terms, inclusion criteria, and databases used
- Literature Review: Individual study summaries across multiple designs
- Analysis and Synthesis: Thematic analysis, limitations, and practice implications
- Conclusion: Summary of findings and call for further research
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- The PICOT framework provides a clear, structured clinical question that anchors the entire literature review and makes its scope explicit.
- The paper synthesizes more than a dozen peer-reviewed studies across varied designs—quasi-experimental, qualitative, systematic review, and pilot studies—demonstrating breadth of evidence evaluation.
- Separate identification of limitations for each study shows critical appraisal skills rather than passive reporting of findings.
Key academic technique demonstrated
The paper demonstrates evidence-based synthesis: rather than simply summarizing each study in isolation, the author groups findings thematically (communication, pain management, hourly rounding) and evaluates the strength and consistency of evidence across sources. The explicit discussion of limitations per study, followed by broader implications for practice and research, reflects the structure expected in graduate-level nursing evidence reviews.
Structure breakdown
The paper opens with a clinical problem statement and formal PICOT question, then establishes the practice significance for postpartum nursing. A transparent search strategy section outlines inclusion/exclusion criteria and database sources. The literature review presents each study individually with design, sample, setting, and findings. The analysis synthesizes studies into three thematic areas—communication, pain management, and hourly rounding—with a numbered limitations list and an implications section before the conclusion.
Introduction and PICOT Framework
Patients in hospitals often complain of pain regardless of their diagnosis. Several aspects of a patient's life contribute to pain, including amount of sleep, daily activities, and quality of life (Alaloul, Williams, Myers, Jones, & Logdson, 2015). While healthcare expenses have increased significantly over the years, there have been meaningful improvements in increasing both family and patient involvement in medical care. Hourly rounding is one strategy that has worked well in various healthcare settings. Although hourly rounding has shown success in several areas, its use in urgent pediatric settings has not been well documented (Emerson, Chumra, & Walker, 2013). Opportunities still exist to examine pediatric family preferences and perspectives regarding the use of whiteboards (Cholli et al., 2016).
Several studies conducted in different settings are referenced in this paper. The research projects include in-patient surveys, quasi-experimental design analyses, installation of whiteboards, incorporation of hourly rounding methods, and one-on-one interviews. The study highlights the role of communication in patient satisfaction and pain management. The discussion covers various areas of concern supported by the following:
- Large quantitative data and sample sizes that yielded concrete findings.
- Highly specific implementation of whiteboard use, which increased knowledge of its effectiveness in postpartum units.
- Tracking of hourly rounding metrics, which showed reductions in fall rates, among other outcomes.
Ensuring open communication between the interdisciplinary team, the patient, and family members is one of the key components of Patient-Centered Care (PCC). For patients to arrive at informed decisions about the care they want administered, they must have an open line of communication with their healthcare providers. Physicians often meet with patients to discuss treatment plans, but it is not always the case that patients understand what is happening or what options are available to them. Nurses attend to many patients, and it is not easy to keep track of every patient's information even with the help of a patient chart. Whiteboards beside patients' beds can be used to bridge the information gap: physicians can update them with necessary information about the treatment plan, and nurses can update the patient chart accordingly. This approach can help improve patient safety, address communication needs, and significantly improve patient outcomes (Karn, 2016).
PICOT Question
Patient/Problem: Women undergoing either caesarean or vaginal delivery.
Intervention/Phenomena of Interest/Issue: Use of whiteboards and hourly rounding.
Comparison/Context: Compared to no use of whiteboards and no use of rounding.
Outcome/Evaluation: Improved pain management and patient satisfaction.
Time: A trial period of three months.
Significance of the Problem to Nursing Practice
Most of the metrics used to measure the success of postpartum hospital experiences depend on patients' interactions with nurses. The broad goal should be managing the expectations of postpartum patients and their families regarding their hospital stay — from the moment of admission to the moment of discharge — by using a whiteboard and a postpartum roadmap. Feedback from patients indicates that new families were often unsure of what to expect from their caregivers and what their own responsibilities were in learning newborn and postpartum skills required for a successful discharge. The whiteboard and postpartum roadmap are valuable tools because they allow patients and nurses to communicate effectively throughout the entire hospital stay and to manage postpartum care expectations (Horgan, Roe, Yocom-Piatt, & Cohn, 2014).
Literature Search Strategy
PICOT Question Search Terms
- Emotional, mental, environmental, physical, and associated factors linked to labor pain.
- Level of relaxation and events that represent a positively perceived delivery experience.
- Dissatisfaction with equipment, hospital staff, facilities, and expenses.
- Awareness of one's newborn and family preparation for taking the baby home, including knowledge of postpartum medical examinations and readiness for discharge.
Inclusion Criteria
Post-delivery women, regardless of income level, geography, or language, are included in the study.
Exclusion Criteria
Post-delivery women who do not accept the invitation to participate in the study are excluded.
Search Locations
Google Scholar, reputable medical journals, and research reports released by relevant organizations were considered.
Reference Review
The time and quality of publication of research articles were carefully scrutinized. References of superior quality, for the purposes of this review, refer to articles that are no more than five years old. An additional criterion was whether the research articles and citations were peer-reviewed.
The journals and databases searched include:
- Journal of Nursing Administration
- Various university thesis projects
- The Journal of Emergency Medicine
- Hospital Pediatrics
- Pain Management Nursing
- LVHN Scholarly Works — Research & Neonatal Nursing
- Journal of Obstetric, Gynecologic & Neonatal Nursing
- Journal of Nursing Care Quality
- AWHONN 2013 Annual Convention
Evidence-Based Study Types
Qualitative: Generalizable conceptual studies; descriptive studies.
Quantitative: Systematic review; meta-analysis; randomized controlled trial; cohort study.
References
Alaloul, F., Williams, K., Myers, J., Jones, K. D., & Logdson, C. (2015). Impact of a script-based communication intervention on patient satisfaction with pain management. Pain Management Nursing, 321–327.
Brosey, L., & March, K. (2015). Effectiveness of structured hourly nurse rounding on patient satisfaction and clinical outcomes. Journal of Nursing Care Quality, 153.
Cholli, P., Meyer, E., David, M., Moonam, M., Mahoney, J., Hession-Laband, E., . . . Bell, S. (2016). Family perspectives on whiteboard use and recommendations for improved practices. Hospital Pediatrics, 426–430.
Emerson, B., Chumra, K., & Walker, D. (2013). Hourly rounding in the pediatric emergency department: Patient and family safety and satisfaction rounds. Journal of Emergency Medicine, 99–104.
Horgan, J., Roe, M., Yocom-Piatt, M., & Cohn, N. (2014). Creation of a postpartum roadmap and whiteboard: A family's step-by-step guide toward their journey home. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 22–23.
Johnston, E., & Fenicle, J. (2014). Communication whiteboards: Enhancing patient, family, and care team communication. LVHN Scholarly Works.
Karn, C. (2016). The use of personalized whiteboards in the inpatient acute care setting and their effect on patient and nurse perception of communication. Theses, Dissertations, Capstones and Projects — USF Masters.
Krepper, R., Vallejo, B., Smith, C., Lindy, C., Fullmer, C., Messimer, S., . . . Myers, K. (2014). Evaluation of a standardized hourly rounding process (SHaRP). Journal of Healthcare Quality, 62–71.
Liberati, M., Altman, T., & The PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine.
Martin, L. (2015). Implementing a pain care toolkit to improve patient perception of pain care. Journal of Continuing Education in Nursing, 295–296.
Massaro, D., & Murphy, S. (2013). White boards: An innovative tool for patient-centered communication. JOGNN, 557–558.
Meade, C., Bursell, A., & Ketelsen, L. (2006). Effects of nursing rounds: On patients' call-light use, satisfaction, and safety. American Journal of Nursing, 58–70.
Mitchell, M., Lavenberg, J., Trotta, R., & Umschield, C. (2014). Hourly rounding to improve nursing responsiveness: A systematic review. Journal of Nursing Administration, 462–472.
Olrich, T., Kalman, M., & Nigolian, C. (2012). Hourly rounding: A replication study. Medsurg Nursing, 23–36.
Rondinelli, J., Ecker, M., Crawford, C., Seelinger, C., & Omery, A. (2012). Hourly rounding implementation: A multisite description of structures, processes, and outcomes. Journal of Nursing Administration, 326–332.
Tan, M., Evans, C. H., Braddock, C., & Shieh, L. (2012). Patient whiteboards to improve patient-centred care in the hospital. BMJ Journals.
Create your account
Always verify citation format against your institution’s current style guide requirements.