EVIDENCE BASED PROJECT PROPOSAL

Project Purpose Statement and Problem Statement

United States University

MSN 563

The impacts of hourly nursing rounding on the safety of the patients

Purpose Statement

The purpose of the capstone project is to find out the impacts of the hourly rounding on the safety of the patients. The rounding process involves the process of focusing on the hourly rounds in the areas of positioning, the proximity of the personal items, and pottying. The approach of explaining to the patients about the intention of the nurses on the frequent rounding is helping in making the patients to feel comfortable and meeting the needs of the patients. It also helps in reducing the stress being experienced by the patients when the nurses are away. It helps in the reduction of the need for the patient to ambulate hence avoiding the possible causes of the falls (Brosey & March 2015).

Background

The hospital stays are subjecting patients and their families to an increased level of stress. Nurses are faced with bewildering healthcare conditions that need testing and treatment processes from the healthcare providers such as nurses. These nurses are also facing dependent roles and are becoming socially and emotionally vulnerable. In the critical care units or medical-surgical hospital units, nurses are facing an increased level of responsibilities and request for helps with the basic needs that are linked to the repositioning, eating, and elimination (Goldsack et al., 2015).

Most of the patients in these units are not familiar with the hospital routines and on how to get their basic need. Therefore, they access these items and help at their disposal through a simple nurse call button. In acute inpatient settings, nurses and other healthcare providers are facing problems. This, therefore, implies that there is a need for evidence-based solutions to help in improving the safety of the patients. The functions in the critical care units make it hard to have the right nurses at the right time to help in the delivery of the compassionate and quality care to the patients (Young, 2016).

Therefore, it is important that when the conditions of the patients start to improve, nurses have to take the chance of educating the patients concerning their medical conditions and how to prevent possible re-admission. Nurses in the critical care units are also dealing with issues related to the patient falls, hospital-acquired pressure ulcers, and the low nurse-patient ratios. The adoption of the hourly round schedules for the nurses working in the acute care healthcare facilities is helping in improving the safety of the patients and the overall satisfaction of the patients. The change in practice is required to ensure that there is an improvement in inpatient experiences (Kelley, 2017).

The significance of the problem

Some of the problems that are faced by the patients in the medical-surgical healthcare units include patient falls, hospital-acquired pressure ulcers, and the low nurse-patient ratios. The problems can be prevented through the adoption of effective approaches. The solutions to these problems are not fully implemented due to the resistance to the changes by healthcare providers or management of the healthcare organizations. The barriers to the changes have to be examined to ensure that there is a successful initiation of the rapid cycle of changes to help in ensuring that patient healthcare outcome is improved. It also helps in ensuring that there is a reduction in the incidence of falls and improvement in patient satisfaction (Goldsack et al., 2015).

The problems presented in this case gives an opportunity of designing the effective approaches that can help in improving the safety of the patients. One of the approaches is involving the implementation of the hourly nurse rounding to ensure there is patient close monitoring. The problem is informing on the need for quality improvement efforts by the healthcare organizations and nurses. The organizations and healthcare providers especially nurses must therefore be prepared to ensure that there is a social change through increasing the scripted process of communication between the nurses and the patients. This helps in the promotion of the patients' needs such as pain management, positioning, pottying, and the proximity of the individual items during the hourly rounding interaction process (Young, 2016).

The potential impact of the capstone project on the anticipated outcome of the betterment of health

The implementation of the hourly nursing rounding in the medical-surgical hospital units will help in the reduction of the number of the patients' falls. It also helps in reducing the cost of caring for the patients after the events of the falls during the admission. The successful implementation of the proposed intervention is also important in increasing the reimbursement from the Center for Medicaid and Medicate (CMS) as a result of the positive patient satisfaction scores. The successful intervention of the hourly nursing rounding in the medical-surgical hospital units is also expected to cause an increase in the number of free-fall admissions as well as raising the satisfaction of the patient as a result of the incident-free hospital stays (Brosey & March 2015).

The practice of the proactive and regular check of the patients through hourly rounding approach has been considered to be helpful in the reduction of the patients' anxiety. When the patients are not able to give a prediction when the nurses will be available for the physical and emotional support as well as comprehend on the nursing workflow, they become much worried that there will be no any person will be able to care for them and respond to their immediate needs. This increases their anxiety levels thus tampering with their healing process. However, successful implementation of the hourly nursing rounding helps patients to develop appropriate coping skills that contribute to their overall healing process (Brosey & March 2015).

The act of implementing the hourly nursing rounding is a commitment by the healthcare providers in ensuring that patient safety and well-being is promoted. The process of taking such initiatives helps in addressing the basic needs of the patients that are important in promoting their safety for example bathing (potty), positioning, control of the pain, and the proximity of the personal items. The process of addressing these basic needs is achieved successfully through the use of the structured format thus helping in the reduction of the anxiety and minimization of the potential uncertainties (Brosey & March 2015).

PICOT formatted clinical project questions

Population: the population, in this case, are the patients who are admitted and are being cared for in the medical-surgical hospital unit. These are the patients who are exposed to stressful events as a result of being away from the nurses. These patients require help to meet their basic needs that are related to the positioning, control of the pain, and the proximity of the personal items as well as a bathing process. Therefore, they always press the call button to be provided with such help and when there is a delay in the response, their level of anxiety tend to increase that interfering with their overall healthcare outcome.

Intervention: this involves the implementation of the hourly nursing rounding. This is an effective approach that is considered to be useful in ensuring that nurses are always on the move to ensure that patients are provided with their basic needs such as pottying, positioning, control of the pain, and the proximity of the personal items

Comparison: non-scheduled rounding i.e. the non-existence of any form of policy to help in ensuring that nurses can respond to the immediate needs of the patients to reduce the exposure to the risk of falls and other complications.

Outcome: improvement and maintenance of patient safety

Time: six months period of implementing the proposed intervention.

References

Brosey, L. A., & March, K. S. (2015). Effectiveness of structured hourly nurse rounding on patient satisfaction and clinical outcomes. Journal of Nursing Care Quality, 30(2), 153-159. doi:15505065.

Goldsack, J., Bergey, M., Mascioli, S., & Cunningham, J. (2015). Hourly Rounding and patient falls: What factors boost success? Nursing, 45(2), 25-30. doi:107770823

Kelley, C. B. (2017). Time management strategies: Purposeful rounding and clustering care. Med-Surg Matters, 26(1), 1-3. doi:121191463

Young, H. M. (2016). The right person at the right time: Ensuring person-centered care. Generations, 40(1), 47-55. doi:115240270.