Working the Process

In 2010, Medical Center Hospital implemented focused nursing rounds to increase patient satisfaction. Education was provided to the nurses related to a 2-5 minute “sit down” to discuss with the patient goals for the day, bedside report, proper entrances and exits to a patient’s room, and assessing the four “R”s prior to leaving the patient’s room.  Three Press-Ganey patient satisfaction scores were monitored pre and post implementation to evaluate the effect of focused nursing rounds. Four clinical units were examined three months post implementation. Two units showed poor results of decreased patient satisfaction scores; however, the other two units had up to 9% increases in patient satisfaction. Variables affecting the data include difficulty to sustain change, director support and encouragement is essential along with variable staffing, and staffing turn over-rates.   Nurses completed a questionnaire form post education on the concept of focused nursing rounding and four weeks post implementation. Four weeks post implementation, 100% of the nurses stated they felt knowledgeable to carry out nursing rounds. However, the next review showed a decline in patient satisfaction scores represented the inability to maintain the momentum of the change despite the education. The decrease in patient satisfaction scores suggested that nursing rounds were not completed despite the nurses stating they felt knowledgeable to perform nursing rounds. This also suggests a compliance issues/enforcement from nursing leadership versus an education issue.  Leadership buy-in is essential in the success of focused nursing rounds. The post implementation survey completed by the nurses showed a 10% increase in the number of nurses who did not feel supported in their efforts to implement nursing rounds. These two units also had a change in leadership pre and post implementation of the focused nursing rounds.