perceptions of barriers and solutions to hourly rounding; while also discussing implementation of an
electronic hourly rounding system and it's effect on patient falls, call lights, and nursing work in steps.
Leadership and nursing staff investment in patient safety research is essential to successful
implementation and sustainability of changes (Brosey & March, 2014; Kessler et al., 2012; Krepper et
al., 2012; Olrich, Kalman & Nigolian, 2012). Hourly rounding is employed in many hospitals to improve
patient safety, and patient and nurse satisfaction, and when implemented successfully, can decrease
call lights and patient falls (Brosey & March, 2014; Kessler et al., 2012; Olrich, Kalman & Nigolian,
2012). Little data is available regarding nursing perceptions, barriers, and solutions surrounding hourly
rounding (Fabray, 2015; Krepper, et al., 2012). Informal interviews with nursing staff showed a
perception that hourly rounding increased work and steps.
Methods: A multi-year, IRB-approved, qualitative pre- and post- implementation research study was
used to establish nursing staff perceptions surrounding hourly rounding, including convenience,
compliance, and support; while determining verbatim barriers and solutions. Additionally, nursing staff
steps were monitored using electronic step trackers; while simultaneously assessing on-time rounds
versus patient falls and call light use. Study interventions included education on hourly rounding
purpose and benefits, and implementation of an electronic hourly rounding tool.
Results: Statistical analysis showed significant (p<0.001) improvements in staff ownership of the hourly
rounding process, as well as all categories surrounding the electronic hourly rounding tool. Staff
described fewer issues with acuity and staffing as barriers to hourly rounding, self-identifying that hourly
rounding caused no increase in work; while also reporting increased knowledge about hourly rounding.
Analysis also showed higher on-time hourly rounding correlates to fewer patient call lights, and strongly
correlates to fewer patient falls. Hourly rounding does not significantly increase day-shift nursing staff
steps (staff work), but does strongly correlate to increased night shift steps.
Conclusion: Hourly rounding is essential to help maintain patient safety, and patient and staff
satisfaction. Patients suffer fewer falls, while staff experience decreased alarm fatigue with fewer call
lights. An electronic hourly rounding system can help monitor that hourly rounds are being completed;
however, staff buy-in is crucial for the culture change necessary for the successful implementation and
maintenance of hourly rounding.
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