Literature Review for Nursing Researh

A. Problem Description Hourly patient rounding, according to Neville, is a preset timing, usually every hour or every two hour, in which tasks are performed by nurses as a way to check in on the patients (Neville, 2012). The concept of hourly rounding by nurses is not new. Infact, it is a way nurses organize their work and address important issues as they go about their day. There are other types of rounding in the hospitals such as interdisciplinary rounds and medical rounds, but these are done perhaps daily or a few times a week.
It is the focus of this paper to address three relevant headings related to nursing hourly rounding through research literature and review. With hourly rounding, nurses can independently initiate and perform tasks. Additionally, nurses can utilize the nursing process and apply it as frequently as every hour.
For example, after medicating (implementation) the patient with pain medication in the last hour, with this hour rounding the nurse can re-evaluate (evaluation) the effect of the medication while assessing (assessment) the patient’s vital signs and pain scale and inform the patient when the next pain medication can be given (planning).
Hourly rounding is important because in doing so, nurses address patients’ comfort, needs, and safety to prevent any adverse events. Thus, nurses are proactive by anticipating and attending to patients’ needs rather than respond to patients request in reactive mode (Halm, 2009; Hutchings, 2013).
Three most common problems related to nursing hourly rounds are: patient falls, increase use of call light, and decrease patient satisfaction (Kalman, 2012). B. List of References Berg, K. et al (2011). Hourly rounding with a purpose. The Iowa Nurse Reporter, 24(30, 12-14. Tzeng, H. and Yin, C. (2009). Relationship between call light use and response time and inpatient falls in acute care settings. Journal of Clinical Nursing, 18(23), 3333-3341. Olrich, T. , Kalman, M. , and Nigolian, C. Hourly rounding (2012). A replication study.
MEDSURG Nursing, 21(1), 23-26. Meade, C. , Bursell, A. , and Ketelsen, L. (2006). Efects of nursing rounds on patients’ call light use, satisfaction, and safety. American Journal of Nursing, 106(9), 58-70. Assi, M. et al (2008). Why making the rounds makes sense. American Nurse Today, 3(2), 12. Lowe, Hodgson (2012). Hourly rounding in a high dependency unit. Nursing Standard, 27(8), 35-40. Date of acceptance: June 25, 2012.

Hutchings, M. , Ward, P. , and Bloodworth, K. (2013). Caring around the clock: a new approach to intentional rounding. Nursing Management, 20(5), 24-30. Halms, M. (20090. Hourly rounds: What does the evidence indicate? American Journal of Critical Care, 18(6), 581-584. Moran, J. (2011). Improving care on mental health wards with hourly nurse rounds. Nursing Management, 18(1), 22-26. Blakley, D. , Kroth, M. , and Gregson, J. (2011). The impact of nurse rounding on patient satisfaction in a medical-surgical hospital unit. MEDSURG Nursing, 20(6), 327-332. Weigram, B. and Raymond, S. (2008).

Using evidence-based nursing rounds to improve patient outcomes. MEDSURG Nursing, 17(6), 429-430. Tucker, S. et al (First Quarter 2012). Outcomes and challenges in implementing hourly rounds to reduce falls in orthopedic units. Worldviews on Evidence-Based Nursing, 9(1), 18-29. Date of electronic publication: Sep. 19, 2011. Gardner, G. et al (2009). Measuring the effect of patient comfort rounds on practice environment and patient satisfaction: A pilot study.

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International Journal of Nursing Practice, 15(4), 287-293. Tea, C. , Ellison, M. , and Feghali, F. (2008). Proactive patient rounding to increase customer service and satisfaction on an orthopaedic unit. Orthopaedic Nursing, 27(4), 233-241. C. Organizational Headings i. Increased patient falls and/or decreased patient safety Patient falls are one of many challenges nurses face every day.
It is also the highest reported incidence in hospitals. As of 2013, the operational cost for patients who suffered an injury as a result of fall in the hospital was $13,316 higher than for those patients who do not fall (Ganz et al, 2013). Falls are problem of public health worldwide. Not only do they result in possible loss of function and/or mobility, falls prolonged hospital stay.

Nurses throughout the nation have develop models of care in which the goal is to decrease patient falls, thereby increasing patient safety. One of the famous model hospitals adopted is the hourly nursing rounding in which the nurses address with each rounding the 4Ps: potty, pain medication, positioning patients, and possession (Meade, 2006, Halm, 2009, Tea, 2008). In the original study done by Meade et al in 2006, report shown that the reduction in fall rate decreased by 60%. Olrich replicated the study six years later resulted in patient falls by 23% on the experimental unit (Olrich, 2012).

In one study done by Gardner et al, report shown that one of the burden resulted in the health care industry in Australia was from patient falls (Gardner,2009). In conclusion, falls are definitely a harm to patients’ safety. As a result, research on hourly rounding has been done and identified as one of the solutions. Below are articles written recently by researchers that addressed the problem of increasing patient falls in the acute care units: Olrich, T. , Kalman, M. , and Nigolian, C. (2012). Hourly rounding. A replication study.
MEDSURG Nursing, 21(1), 23-26. Meade, C. , Bursell, A. , and Ketelsen, L. (2006). Effects of nursing rounds on patients’ call light use, satisfaction, and safety. American Journal of Nursing, 106(9), 58-70. Halm, M. (009). Hourly rounds: What does the evidence indicate? American Journal of Critical Care, 18(6), 531-584.
Tea, C. et al (2008). Proactive patient rounding to increase customer service and satisfaction on an orthopaedic unit. Orthopaedic Nursing, 27(4), 233-241. Lowe, H. (2012). Hourly rounding in a high dependency unit. Nursing Standard, 27(8), 35-40. Date of acceptance: June 25, 2012. Gardner, G. et al (2009). Measuring the effect of patient comfort rounds on practice environment and patient satisfaction:
A pilot study. International Journal of Nursing Practice, 15(4), 287-293. ii. Increased use of call lights Patients’ anxiety level increased when entering the hospital due to unfamiliar surrounding, multiple tests and procedures, unpredictable and unstructured routines. Having a call light within their reach gives patients a sense of security. Thus, in this sense, it can be a lifeline for patients because they know that someone, usually a nurse, will answer the call if they need help. Sometimes they “forget” that there are other patients beside them who are just as sick or even sicker.

To nurses, answering call light takes time away from their already busy schedule as well as imposing on them (Kalman, 2012; Meade, 2006). In a report done by Meade et al, patients use the call light to summon for the nurse as often as 12 to 15 times per day per patient (Meade et al, 2006) on a typical med/surg units. The reasons for patients wanting to talk to someone, preferably the nurse, are mostly about pain medication, assistance with “potty”, and position change. However, on units such as psychiatry, use of call light is not as beneficial as med/surg floors because patients are able to ambulate to the nurses’ station (Moran, 2013).

Therefore, they do not need assistance with potty or position change. Because most patients are ambulatory, they usually walk to the nurses’ station with questions and requests. Since the implementation of hourly comfort rounding, the use of call light has been decreased down to 37% (Meade et all, 2006; Leighty, 2006). Meade, C. , Bursell, A. , and Ketelsen, L. (2006). Effects of nursing rounds on patients’ call light use, satisfaction, and safety. American Journal of Nursing, 106(9), 58-70. Kalman, M. et al (2012). Hourly rounding:
A replication study. MedSurg Nursing, 21(1), 23-26. Moran, J. (2011). Improving care on mental health wards with hourly nurse rounds. Nursing Management, 18(1), 22-26. iii. Patient satisfaction The level of patient satisfaction regarding their care while in the hospital depends on how well the staff respond when patients call for help and whether or not patients’ need are met. If patients are satisfied with their hospital stay, it is most likely that they will make recommendations to others regarding choosing a hospital for the medical care.
A study done in which Tea (2008) analyzed 40,000 patient observations concluded that the level of patient satisfaction is closely related to timely staff responsiveness (Tea, 2008). In a study done by Hutchings regarding patient satisfaction as a result of nursing hourly rounding, 88% reported an overall improvement (Hutchings, 2013). Hutchings, M. , Ward, P. , and Bloodworth, K. (2013).
Caring around the clock: a new approach to intentional rounding. Nursing Management, 20(5), 24-30. Tea, C. , Ellison, M, and Feghali, F. (2008). Proactive patient rounding to increase customer service and satisfaction on an orthopedic unit. Orthopaedic Nursing, 27(4), 233-241.

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