Johns Hopkins Nursing Evidence-Based Practice Thrid Edition: Model and Guidelines

(^234) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition

5

Initiating Purposeful Hourly Rounding on an Inpatient

Oncology Unit to Improve Patient Safety and

Satisfaction

Laurie Bryant, MSN, RN, OCN, ACNS-BC

Irina Rifkind, MSN, RN

Sarah McCarthy, BSN, RN

The Johns Hopkins Hospital

Baltimore, Maryland, USA

Practice Question

Purposeful hourly rounding (PHR) is a patient-centered quality improvement

initiative that uses five key interventions to improve patient satisfaction and to

decrease fall rates and call bell use. Public reporting of patient satisfaction scores

to improve quality of care is a national standard and is directly correlated with

nurse responsiveness and patient safety. In addition, nurse satisfaction, work-

flow, and efficiency can be hampered by patient call bell use. Hourly rounding

literature suggests that purposeful hourly rounding can improve quality of care

and patient and nurse satisfaction. Using the tools from the JHNEBP Model, the

clinical nurse specialist was uniquely positioned to initiate an EBP project. The

outcome measures were call bell rates, fall rates, and patient satisfaction with

staff responsiveness.

The EBP question was this: How does hourly rounding affect patients’ percep-

tion of nurse responsiveness, call bell usage, and fall rates?

Evidence

An evidence search was conducted by using PubMed and CINAHL. Twenty-

seven articles were identified and reviewed. Of the 27 articles, no experimental

studies were found—6 quasi-experimental, 6 qualitative, 1 systematic review,