Thursday, November 8, 2007
One of the specific tools that Studer describes is HOURLY ROUNDING. In the hospital setting, this means that every hour the nurse makes a quick visit to each of his/her patients, and runs through some variation of this script: (1) How are you feeling? Are you in pain? (2) Let's change your position. (3) Do you need to use the restroom? (4) Is there anything else you need? I HAVE THE TIME!?! (That last bit was tacked on because patients are usually reluctant to ask a nurse to do something for them if they perceive the nurses as being rushed). So pain, position, and potty are what you're addressing in these hourly rounds. You're also making sure that nobody's fallen (On a side note, it's becoming pretty well recognized that no matter what or how much you do, you really can't prevent falls. All you can do is screen for risk and reduce hazards as much as possible. But more on that later). So what's keeping your facility's CNAs from doing hourly rounding? Rounds q2h are already the norm (and in Tennessee, the law). Can you find some way to reorganize the status quo so that patients are being looked in on more frequently? If the status quo isn't all about the patient, then the status quo must go. If this sounds like something you want to adapt, I would recommend starting on your skilled units first and then crossing over to the intermediate care units as well. And it's not necessary to do rounds hourly from 10P to 6A; every 2 hours or so have been found to be just as effective.