Hourly rounding

[svorse22]

The hospital where I am doing my clinicals started hourly rounding in which the nurse or cna has to be rounding the patient hourly during the day and every two hours during the night. Every time we go in we have to ask if the patient is in pain, if they need to go potty, if they need to be repositioned, and make sure they have everything that they need near them; for example, their call light, glasses, reading book, etc. Does anyone have any opinion or experience in hourly rounding? Does it work? Is the timing appropriate to go in to their rooms to check the patients and ask all those questions?

[NursedotcomPaige]

Thanks for posting and welcome!

[Jules1969]

In the hospital where I work...we have been "doing" hourly rounds. In my opinion...they do work, however it seems to me, the only one really do them consistently is the RN. And with that being said, as many other things that we have to do, the effort is half-hearted. I do believe if everyone who is assigned to do them WOULD DO THEM, they would be effective and decrease falls immensely.

[ToddRN]

Hourly Rounding Works! We have implemented a policy on rounding which includes both RN's and Aides making rounds every hour. Now with that being said, from my experience, my staff make rounds more frequently than that and I have the data to prove it. During our pre-pilot period, we tracked the following metrics - Normal Call-Lights, Bed Exit alarms, and Bathroom Calls. We tracked pre-live rounding for 2 weeks, post-live rounding at 30 days and 60 days. I even went further and tracked 1 week, 2 week just to see the amount of call lights and to evaluate the effectiveness of rounding. Our post "go-live" data did show a slight decrease in the number of normal call lights, but relatively no change in our bed exit or bathroom lights. WHY? Our pre-data and post data were low through out each metric.

To that above, I also ran numbers from the previous year for the same time periods we collected data. To my suprise, the numbers were just as low as they were during our pre-trial period and post-trial period. One of the things we did identify is the False positive calls - Staff call for help with repositoning, Tranport needing assistance with transfering a patient to and from bed, Rehab services getting the patient out of bed without turning off the bed alarm...

As a best practice, hourly rounding does work. It keeps patient's safe, allows staff nurses to "be at" the bedside, vs documenting all the time. Great discussion. I look forward to reading more.

[svorse22]

Thanks to everyone for sharing their experience and commenting on my thread! Thanks Todd I really like the way you monitor how often your employes are with patients and how hourly rounding does work. I plan on sharing this with my clinical instructor and also with my manager at the hospital where i work in order to continue with hourly rounding to help decrease the call lights and help our patients be safe. Thanks again!

[samsauntrn]

I despise hourly rounding. When my grandchild was born I was the mom's support person. We left in less than 30 hours after she delivered because there was not one minute when there was not someone coming into the room. She was nursing and never had time to rest,even with me helping her with the baby. It was horrible. I like to say we were the victims of hourly rounding. I do see that it could be very helpful on a psych, med/surg/ elderly unit but not on a maternity unit.
I also work on a maternity unit and we consider most of our patients as "well" patients. I refuse to do hourly rounding on them but do check them about every 2 hours. This has worked very well for everyone. I work at night and when I check on them I do not wake them up if they are sleeping, how ridiculous is that when someone has been up constantly feeding a baby? Where is the common sense in our profession? I see it going right out the window. I make sure that questions are answered, pain is controlled and patient comfortable and that all is ok, and I let them know that if they need anything to call me. I have found that this approach itself has greatly decreased calls yet I am also giving them time to themselves and emphasizing the need for sleep between feedings. And to have nurses fill out check off forms for when you are in the room is such an insult that it makes me sick. And believe me, nurses are the only ones who filled out the rounds sheet. What we have found is that when patients are waken with hourly rounds they are miserable and not coping with the fatigue that a new family has.
I used to speak at my kids schools on career day about nursing but no longer. I see all this ridiculousness creeping in, the total lack of respect for bedside nurses and the work they do, the increases in tasks and charting instead of patient care and it just makes me want to leave the hospital setting. I can't imagine doing anything else but nursing, or being identified as anything other than a nurse but I am sad to say that I see a day when it is coming.