Adoption of hourly rounds schedules for nurses may improve patient safety and satisfaction

Adoption of hourly rounds schedules for nurses working in acute care hospitals may improve patient safety and overall satisfaction with care provided, according to research reported in the Journal for Healthcare Quality, the peer reviewed publication of the National Association for Healthcare Quality (NAHQ, www.nahq.org).

Nursing leadership at St. Luke's Episcopal Hospital in Houston investigated whether a standard hourly nursing rounding process implemented though a formal education program would result in improved efficiencies, patient satisfaction and improved quality and safety metrics when compared to a less standardized implementation process. Two 32-bed cardiovascular surgery nursing units (serving as active and control groups) were chosen for the study. Data were collected for six months.

Variables evaluated in the study were:
•Efficient delivery of care measured by total number of call lights, steps walked in a shift as documented on pedometers and from a survey of nursing staff citing perceptions of having "enough time" to complete their work
•Quality/safety of patient care measured by weekly readmission rates and incidence of patient falls
•Patient satisfaction gauged by answers from patients for two questions added to discharge phone questionnaires.

Results showed that daily and weekly call light use differed significantly in the two units, but there was no difference in staff steps logged or perceptions of having enough time to complete work.

For the quality of care measures, there were no differences in the incidence of patient falls or weekly readmission rates between the two nursing units. For patient satisfaction, there was no significant difference in patients' answers to discharge questions related to satisfaction, although positive feedback was obtained regarding how rapidly call lights were answered.

The authors concluded that because hourly rounding was one of several quality improvement strategies employed, including workshops and in-service education programs, to help improve patient satisfaction, overall improvement in satisfaction was due to the effect of all strategies involved. "While hourly nurse rounding strategies have validity and may be instrumental in improving patient care, more research is needed to clearly define its benefits in achieving effective, efficient and patient centered outcomes," said lead author Rebecca Kreppler, MBA, RN, professor, College of Nursing, Texas Women's University, Houston.