PURPOSEFUL ROUNDING

Coming around to better way of caring Naomi Foote RN BSN

OBJECTIVES
Discuss why rounding is important to our patients Analyze differences between task rounding & purposeful rounding Discuss benefits of purposeful rounding for patients and staff List the 6 Ps during rounding Discuss purposeful documentation Identify staff roles in rounding Practice patient scenarios using purposeful rounding

ROUNDING ..
Positively influences patient care Positively influence patients perception of their care Wait, havent we tried rounding already?

I remember coming round this way before!

WE ALREADY DO ROUND! WHAT IS DIFFERENT THIS TIME?

Task driven rounding Purposeful rounding

Round hourly Ask How are you doing? Is everything OK? Check off sheet hourly

Rounding schedule determined by patient need Ask ALL of the 6Ps Use the words Hourly Rounding Document purposefully in EMR & on patient whiteboards Consequences of not rounding = 1:1 mentoring

WHAT CAN PURPOSEFUL ROUNDING DO FOR PATIENTS?

Hourly rounding benefits:

Need to call for pain medication = pain control Decreased Falls Skin breakdown

35% 50% 14%

WHAT CAN PURPOSEFUL ROUNDING DO FOR BTMC NURSES & TEAM MEMBERS?
Hourly rounding benefits:

Decreased call light use

38%

Decreased toileting calls

40%

Decreased equipment alarms

14%

WHAT CAN PURPOSEFUL ROUNDING DO FOR BTMC?

Hourly rounding benefits:
Increased patient satisfaction scores 12% Decreased patient complaints 326 hours/week nursing time saved Cost reduction $143,546 in facilities that Round

SO IF THIS ONE ACTION COULD DO ALL THAT?

Would you do it?

I ______, do hereby commit to purposefully round on all my patients, be a purposeful rounding role model, and will hold my coworkers accountable for rounding. Signed ____YOU!_________

PURPOSEFUL ROUNDING: WHAT IT IS

Pain

Potty
Position Proximity Pump Personal

needs

PAIN
Purposeful questions & responses for nurses
What is your pain level now? What pain level is acceptable? Please let me know if these medications/therapies are not keeping your pain controlled at an acceptable level. Provide pain meds/ complemetary therapy Record pain level/acceptable level on whiteboard Your next pain med is due at 6PM Record time of next pain med on whiteboard

BTMC Team Members

You look concerned/upset, is

something wrong I will (call) let your nurse know that you are in pain.

POTTY
Purposeful questions & responses for nurses
Do you need to use the BR/urinal/commode now

BTMC Team Members

You look concerned/upset, is something wrong I will let your nurse know that you need to use the BR/urinal/commode Please do not try to get out of bed by yourself Do you need to use the restroom before we get started? Do you need to use the restroom before we get you back to your (bed/wheelchair)?

I will call for another person to assist us. (if 2 person assist needed)

POSITION
Purposeful questions & responses for nurses
You dont look comfortable, can I help you reposition? Do you know how to use the bed controls?

BTMC Team Members

Are you comfortable? Tell patient you will get repositioning help if they answer NO. Are you warm enough? Can I get you some warm blankets? Can I get you some pillows under your knees to take pressure off your back?

PROXIMITY
Purposeful questions & responses for nurses
Observe the room, ask yourself, Can the patient reach everything they need? Can the patient open their food containers? Is the urinal on the bedside table next to the food tray?

BTMC Team Members

Observe the room, ask yourself, Can the patient reach everything they need?

Can the patient open their food containers?

Is the urinal on the bedside table next to the food tray? With gloves, move urinal into BR, do not empty

PROXIMITY CAN ALSO A BE BAD THING

Would you eat at this restaurant?

WOULD YOU EAT HERE?

Original cartoon by Ctexter.com

PUMP
Purposeful questions & responses for nurses
Observe the room, ask yourself, Are alarms beeping now? Will they beep soon? Will they beep during report?

BTMC Team Members

Observe the room, ask yourself, Are alarms beeping now? I will let your nurse know about that alarm. Is there equipment in the patients way?

Is the IV bag about to run out?

Is there equipment in the patients way? Are there old IV bags, unused equipment lying around

Let nurse know about equipment in the way.

PERSONAL NEEDS
Purposeful questions & responses for nurses
Ask EVERY time! I have time, is there anything else I can get you?

BTMC Team Members

Ask EVERY time! I have time, is there anything else I can get you?

HOW TO SAY THE MESSAGE

Body language is key! On Stage all the time It is up to YOU to remind peers about Purposeful Rounding!

WHAT DID WE LEARN ABOUT PURPOSEFUL ROUNDING?

Why is rounding important to our patients? What is the difference between the old task rounding , and the new Purposeful rounding? Can anyone name 2 benefits for patients, 2 benefits for staff? Who can name the 6 Ps? Explain the different roles in rounding (nurses role and other BTMC team members roles)

REFERENCES
Ford, B. (2010). Hourly rounding: a strategy to improve patient satisfaction scores. MEDSURG Nursing, 19(3), 188-191. Leighty, J. (2006) Hourly rounding dims call lights. Nursing Spectrum. Dec. 2006 Meade, C., Bursell, A., Ketelsen, L., (2006). Effects of nursing rounds: on patients call light use, satisfaction, and safety. AJN, 106(9), 59-70. Shea, K. (2010). The rap on rapport. CE Direct. Retrieved May 01, 2010.

SCENARIOS Now.. We will practice what weve learned with 2 short scenarios. Nursing scenario BTMC Team members scenario