Compassionate Care Through Intentional Rounding
Andrew S. Eberhart, Lorretta Gail Hutchings, Mary Al-Khazraji, Katie Ellingson, & Jocelyn Nitzkorski
University of Mary
Compassionate Care Through Intentional Rounding Every day, individuals are admitted to hospitals experiencing uncertainty, fear, and anxiety. At its very core, the profession of nursing is centered around compassion, and providing meaningful care for patients. Intentional rounding is a variable system that has been created in order for nurses to assess and address the care needs of a patient. In fact, recent evidence shows that effective, intentional rounding can lead to decreased patient falls, decreased hospital acquired conditions (HAC), and increased patient …show more content…
A study cited a 12% increase in patient satisfaction along with a 38% decrease in call light usage (Forde-Johnston, 2014). Another article showed a 52% decline in call light usage (Ford, 2010). Call light usages on yet another study declined by 40% from 3416 to 2063. In this same study, patient satisfaction was listed as acceptable in-patient surveys and there was a 67% positive indication staff always responded promptly to a call light (Helwick, 2016). “I love it there, someone is always checking on me,” is a quote given from a patient during a survey. It is listed among several similar patient satisfaction quotes in the literature (Kessler et al., …show more content…
This phase encompasses developing a thorough plan, giving this plan to employees, develop a timeline, and fully develop communication skills. Phase 2 involves communicating with those that may be affected with the change, assess driving and restraining forces, and responding to concerns about projected change. In phase 3, a change agent should be identified. Change agents do not always have to be a manager or employee of the organization. If looking at an external change agent, always take into consideration that external change agents can be more objective than internal ones, but can be costly, take more time to assimilate duties and be seen as a threat by other team members (Mitchell, 2013). Phase 4 is the planning stage. During this phase, the change is fully identified, and the final draft of the plan is developed. Each member of the change process has been assigned their responsibilities. During phase 5, the role of the change agent is identified. Communication, feedback on progress, teamwork and motivation is emphasized in phase 6. The change agent is tremendously important during this phase as they need to communicate with staff and inspire change, meet staff’s intrinsic needs and continue ongoing training regarding the change so the change can be sustained. Phase 7 is terminating the helping process, which is the evaluation and withdraw of the change agent on an agreed date. The change agent should remain available for advice
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Twenty two research articles were included in the review. Questionnaires, interviews, audits and reflections where also used to collect data. Nine research studies were found related to intentional rounding. The purpose of the study was clearly stated. The purpose was to evaluate how intentional rounding affects patient outcomes.
Bedside reporting has been shown to improve communication and quality of handoff between nurses. It is also credited to promote patient safety and improve patient satisfaction. Patient satisfaction, patient safety and nursing communication and quality of report from a 32 bed surgical hospital in Dallas, Texas is to be evaluated using various surveys, HCAHPS scores, incident reports, and call light logs. Data will be collected 2 months prior and 6 months following the implementation of bedside report. Scores and communication survey results will be reviewed in this time period to determine increases or decreases from pre-implementation results using traditional nurse-to-nurse report..
State-mandated nurse-to-patient ratios remains a controversial topic in healthcare. Sufficient nurse staffing is key to ensure adequate patient care, while scarce staffing effects patients’ safety and puts nurses at risk for burnout. Determining nurse-to-patient ratios in nursing facilities remains a challenge for the nursing profession. There are many factors to consider when determining staffing methods, such as cost, nurses’ satisfaction, patient outcomes and safety. Mandating ratios is one attempt at ensuring nurses’ workloads do not exceed what is needed for adequate patient care and safety.
Numerous research has shown evidence-based practice strategies to help reduce and prevent falls in hospitalized patients. According to Day et al. (2012), exercise is one approach used by Geriatric nurse practitioners to reduce and prevent falls in the elderly. Physical activities such as strength, gait, and coordination training which last for a minimum of 12 weeks has been effective in reducing falls in the elderly. The researcher further elaborated that a primary care provider such as a nurse practitioner can refer a patient who is at risk for falls to a Tai Chi program, an operative, and cost effective technique to encourage exercise and strength training in the elderly.
Neff, Cimiotti, Heusinger, & Aiken (2011) carried out the largest survey of registered nurses ever conducted in a large southeastern state to see what the nurses have to say about providing safe and effective care and how satisfied nurses are with their current nursing position. A survey was sent out to a random sample of 49,385 registered nurses who were working and residing in this southeastern state using a modified Dillman’s methodology. Neff et al. (2011) mailed a cover letter explaining the purpose of the survey. Then a postcard was sent out a week after the first mailing to encourage participation.
Each morning patients came in for assessment and the treatment team developed or altered existing treatment protocols. I longed to be part of this team, working to stabilize each patient so they could return home to pursue their goals. The nurses stood out to me as the team members at ground zero in the unit, working directly with patients, and advocating for them in meetings. As a Nurse Practitioner, I will provide this same standard of holistic care to my patients, taking into consideration their biological, social, psychological and cultural needs while developing and implementing treatment decisions.
Nurses' perceptions of how physical environment affects medication errors in acute care settings Introduction "Medication errors results from the interaction of multiple factors that include regulatory environment, organizational leadership and commitment, management policies and procedures, complexity of tasks involved, work culture, and physical environment" (Chaudhury, Mahmood, & Valente, 2009, p. 229). Health care services that nurses perform in the hospital environments are physically and psychologically intense, which can potentially result in burnout, stress, and medication errors. Crowded and poorly designed work spaces are factors that contribute to staff stress, resulting in the risk of increase medication errors (Chaudhury et al., 2009). Ulrich, Zimring, Quan, Joseph, and Choudhary, 2004 (as cited in Chaudhury et al., 2009) "argued that reduction of nursing staff stress and error by physical environmental dimensions (such as air quality, acoustics, lighting, and so on) can have a significant impact on staff health and efficiency" (p. 230). There is limited research on the how physical environment affects medication errors.
Ethical Issues in Nursing: Nurse-Patient Ratios Megan Harvey, Katie McKelvery, Erica Robbins & Cassandra Tingley St. Johns River State College March 2018 Ethical Issues in Nursing: Nurse-Patient Ratios Every day nurses are faced with ethical dilemmas. Challenges in these situations are becoming more and more complex due to increasing workload and sicker patients. When a nursing unit is understaffed not only are nurses more likely to become burnt out, but their patients are far less likely to receive the quality of care they deserve. The problem is that the Federal regulations require hospitals who participate in Medicare to “have ‘adequate’ numbers of licensed nurses (RN, LPN, CNA) to provide care to all patients as needed,” but the regulations
Nursing Bedside Reporting, Patient Safety, And Satisfaction Scores The American Nurses Association estimates that up to 80% of serious medical errors involve miscommunication between caregivers when patients are transferred or handed off during shift report (ANA 2012). In the nursing profession change of shifts require the successful transfer of information from nurse to nurse to prevent medical errors and adverse events (Sullivan, 2010). Research shows that when patients are included and engaged in their health care there is greater potential to lead to measurable improvements in safety and quality of care.
Moreover, several studies have been conducted to examine the effects of low nurse staffing on patients hospitalization experiences, as well as its effect on nurse careers in the long run. A recent study by Frith, Anderson, Tseng, and Fong (2012) to explore the relationship between nurse staffing and medication errors, demonstrated that medication errors were higher in a cardiac care unit and non-cardiac care unit when staffing levels were lower. In addition, Frith et al. (2012) pointed out that medication errors increase by 18% for every 20% decrease in nurse staffing below the average due to failure to follow medication administration protocol As mentioned earlier, nurses perform the last and the most important step of medication administration. Thus, having adequate time to assess each patient efficiently and following the medication rights is critical to provide safe patient care and prevent errors.
The patients experience within the hospital is collected from a survey done randomly among patients. Each hospital must have at least 300 survey responses per year. After collecting the data, the data is submitted to the survey data warehouse, where it is analyzed and adjusted to truly reflect the hospital’s conditions. The Centers for Medicare and Medicaid Services along with the Agency for healthcare research standardize the survey results with the hospital consumer assessment of healthcare providers and systems survey. This survey has only thirty-two questions which are analyzed each year.
What is the planned change process? Planned change process is a strategy where changing a condition, pattern of behavior, or situations in a way that will improve a client 's ability to interact in social settings. According to the table on page 119 of the textbook, the foundation for generalist social work practice is to engage, assess, plan, implement, evaluate, and terminate. Engagement is when they see a problem and establish communication to try resolving a problem. Assessment is when a practitioner contains a rough image of their clients ' strenghths and needs.
With a nurse shortage, patients are not getting the best quality care they should be getting. Archive stated that hospital nurse staffing, is a matter of major concern because of the effects it can have on patient safety and the quality care patients deserve. Nursing-sensitive outcomes is an indicator of the quality care and can be defined as variable patient or family caregiver state, condition, or perception responsive to nursing intervention. Some unfortunate patient outcomes potentially sensitive to nursing care are shock, urinary tract infections (UTIs), pneumonia, longer hospital stays, upper gastrointestinal bleeding, failure to rescue, and 30-day mortality. Research has focused on negative rather than the positive patient outcomes for the simple reason that adverse outcomes are more likely to be documented in the medical record.
The program can proceed if all agents pivotal to the success of the change are engaged and a clear and concise vision for the future has been developed. Once the change model is in place, it is time to define the structure of change. Senior leaders should provide a clear path for communications and responsibility at each level. At this point I have realised that Change management is not an alternative to project management.