Abstract
Purpose: There were 32 falls in our Emergency Department in 2016. In addition, there was an average of 22 formal member grievances/month. The objective of the project was to decrease falls and also to improve the patient experience. Design: This was a quality assurance project. The Management team taught a mandatory evidence based two hour course on hourly rounding. 55 courses were taught by the management team in a one month time span. Setting: The setting of the project took place in an urban Emergency Department located in the Silicon Valley. This Emergency Department is a 46 bed Emergency Department with approximately 76,000 patient visits in 2017. Participants/Subjects: Approximately 150 Emergency Department nurses, and 55 technicians were included in this project. Methods: All nurses and technicians were educated on purposeful hourly rounding. Implementation of Purposeful Hourly Rounding was initiated after education was complete. Data was collected on: -Patient falls (Data collected from Quality report) -Call bell dings (A log measured the amount of call bell dings in a 24 hour day. It was broken down by the reason for the call bells (potty, pain, medications, RN, plan of care, or other), and also reflected the name of the nurse assigned to the patient) - Member patient satisfaction scores (This data was reported quarterly by the hospital regional offices) -Hourly rounding compliance (This was measured by use of a paper hourly rounding log placed in each patient room. The log was replaced every 24 hours. The nurse or tech was responsible for signing the log each hour. The logs were turned into the charge nurse at the end of each day) -Formal member grievances (The was measured by the amount of member grievances that was sent to the management team by our Member Services) Baseline data was collected for one year prior to implementation of hourly rounding. Comparative data was reported 6 months post hourly rounding and one year post hourly rounding implementation. Results/Outcomes: One year post hourly rounding implementation, this ED experienced a: 64% reduction in falls, 48% reduction in call bell dings , 80% reduction in formal member grievances, 46% improvement in hourly rounding compliance. Significant improvement in patient satisfaction scores (Specifically 5.1 point improvement in "staff checked in on you often." Implications: Our Emergency Department has experienced significant improvements in patient safety and satisfaction after the implementation of purposeful hourly rounding. The management team taught the evidence based purposeful hourly rounding course and used videos of their own staff in the presentation to better engage staff. They also created a "Service Excellence" committee to help with the initiative. One way to hardwire the practice of hourly rounding was to validate the staff members on the eight behaviors of purposeful hourly rounding on a regular basis and provide feedback. They did this using a competency checklist.They continue to teach the hourly rounding class with each new hire onboarding session. In addition, they added a "service station" to their annual skills day to keep service excellence a priority.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Hourly Rounding, Emergency Department, Fall Prevention
Recommended Citation
Broce, Tracy A. and Lacap, Ninojoseph, "Success with hourly rounding in the emergency department" (2019). General Submissions: Presenations (Oral and Poster). 123.
https://www.sigmarepository.org/gen_sub_presentations/2018/posters/123
Conference Name
Emergency Nursing 2018
Conference Host
Emergency Nurses Association
Conference Location
Pittsburgh, Pennsylvania, USA
Conference Year
2018
Rights Holder
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Success with hourly rounding in the emergency department
Pittsburgh, Pennsylvania, USA
Purpose: There were 32 falls in our Emergency Department in 2016. In addition, there was an average of 22 formal member grievances/month. The objective of the project was to decrease falls and also to improve the patient experience. Design: This was a quality assurance project. The Management team taught a mandatory evidence based two hour course on hourly rounding. 55 courses were taught by the management team in a one month time span. Setting: The setting of the project took place in an urban Emergency Department located in the Silicon Valley. This Emergency Department is a 46 bed Emergency Department with approximately 76,000 patient visits in 2017. Participants/Subjects: Approximately 150 Emergency Department nurses, and 55 technicians were included in this project. Methods: All nurses and technicians were educated on purposeful hourly rounding. Implementation of Purposeful Hourly Rounding was initiated after education was complete. Data was collected on: -Patient falls (Data collected from Quality report) -Call bell dings (A log measured the amount of call bell dings in a 24 hour day. It was broken down by the reason for the call bells (potty, pain, medications, RN, plan of care, or other), and also reflected the name of the nurse assigned to the patient) - Member patient satisfaction scores (This data was reported quarterly by the hospital regional offices) -Hourly rounding compliance (This was measured by use of a paper hourly rounding log placed in each patient room. The log was replaced every 24 hours. The nurse or tech was responsible for signing the log each hour. The logs were turned into the charge nurse at the end of each day) -Formal member grievances (The was measured by the amount of member grievances that was sent to the management team by our Member Services) Baseline data was collected for one year prior to implementation of hourly rounding. Comparative data was reported 6 months post hourly rounding and one year post hourly rounding implementation. Results/Outcomes: One year post hourly rounding implementation, this ED experienced a: 64% reduction in falls, 48% reduction in call bell dings , 80% reduction in formal member grievances, 46% improvement in hourly rounding compliance. Significant improvement in patient satisfaction scores (Specifically 5.1 point improvement in "staff checked in on you often." Implications: Our Emergency Department has experienced significant improvements in patient safety and satisfaction after the implementation of purposeful hourly rounding. The management team taught the evidence based purposeful hourly rounding course and used videos of their own staff in the presentation to better engage staff. They also created a "Service Excellence" committee to help with the initiative. One way to hardwire the practice of hourly rounding was to validate the staff members on the eight behaviors of purposeful hourly rounding on a regular basis and provide feedback. They did this using a competency checklist.They continue to teach the hourly rounding class with each new hire onboarding session. In addition, they added a "service station" to their annual skills day to keep service excellence a priority.