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While the concept of hourly rounding is not new, it is undergoing resurgence in hospitals throughout the United States. During the mid- 20th century, nurses commonly rounded on their patients. As staff - ing shortages worsened, however, rounding occurred less frequently. Hourly rounding now offers a protocol to delineate actions that result in better patient outcomes (Meade, Bursell, & Ketelsen, 2006).
The medical-surgical clinical nurse specialist (CNS) at a northeast hospital examined unit data regarding fall rates and patient satisfaction for a 15- month period and call light usage for a 4-week period. Fall rate was 1.73- 3.37 per 1,000 patient days. Call light usage data from the computerized data retrieval system showed 2,237- 4,223 individual uses of the call light within a 2-week period. Of these calls, 57.75% were related to requests for toileting, pain management, personal needs, or comfort concerns such as positioning. Post-discharge patient satisfaction data showed 25% of patients were not highly satisfied nor would they definitely recommend the hospital to others. Data demonstrated significant opportunity for improvement.
The CNS convened a team to identify interventions to improve patient fall rates, call light usage, and patient satisfaction scores. In addition to the medical-surgical CNS, the team included a geriatric CNS, two nurse managers, a nurse researcher, and a statistician. The team decided to replicate the study by Meade and colleagues (2006).
Purpose
The purpose of this study was to determine the effect of hourly rounding on fall rates, call light usage, and patient satisfaction in an inpatient medical-surgical patient population.
Literature Review
A literature search of Medline and CINAHL (1950-2007) found three studies on hourly rounding. Meade and co-authors (2006) used a quasiexperimental design and non-equivalent groups to study hourly and 2- hour rounding for 6 weeks. Nurses and nurse aides followed a specific protocol during rounding. The protocol consisted of eight actions (see Table 1). When patients were asleep, staff did not awaken them but performed environmental checks only. Reasons for call-light usage were documented by nurses in a call-light log. These data were analyzed jointly by the researchers and placed into one of 26 categories (see Table 2). Results indicated both hourly and every 2- hour rounding decreased call-light usage and increased patient satisfaction. Patient satisfaction increased significantly on...