Introduction
Hourly rounding is a practice designed to enhance the clients’ experience and the nurses’ professional excellence. As the name implies, it is a practice of attending a client on an hourly basis to meet their basic needs, namely: pain and stress management, feeding, hygiene, etc. (Mitchell, Lavenberg, Trotta, & Umscheid, 2014). Although the practice is widely acknowledged, a growing body of evidence suggests that hourly rounding is losing efficiency.
Moreover, the rounding is perceived in some sources as harmful for both the nurse and the client because it supposedly exacerbates the nurses’ time management quality; additionally, more experienced nurses who are skeptical in relation to rounding can promote disdain to the practice in younger staff. The proposed aim of this research, therefore, is to explore the attitudes towards hourly rounding in the nursing community, whether (if at all) they have changed over time and the advantages and disadvantages of the practice as perceived by nurses.
Background
As said, rounding is a practice of making visits to the clients at an even (hourly) time interval. The aims of the visits can be assessment, addressing the clients’ needs in terms of food, elimination, and related or non-related hygiene, preventing them from injuries, communicating with them, and many more (Shepard, 2013). The practice can seem worthwhile but still, the non-acceptance of rounding by the staff can create barriers to effective implementation.
Experienced nurses can make the younger ones think the practice is unnecessary. Indeed, because the rounding plan is too time-based, a single interruption can ruin the schedule. Besides, with acute patients, who require more time to attend to, time management becomes next to impossible (Shepard, 2013).
On the other hand, the effectiveness of hourly rounding is clinically proved. A recent study assessing the usefulness of rounding as a means of fall prevention showed a decrease in client fall rates from 3.9/1000 days at the baseline to 1.3/1000 days at the end of the pilot period (Goldsack, Bergey, Mascioli, & Cunningham, 2015). The perception of rounding among 94% of the staff was either positive or strongly positive.
The differences in perspectives and controversial tendencies demonstrated by various literature explain the relevance of the proposed study and provide the rationale.
Aims and Questions
The aim of the proposed research, therefore, is to explore the nurses’ perception of the practice of hourly rounding and assess its impact on the nurses’ schedule management. To accomplish the aim, several questions should be answered:
- What are the nurses’ perspectives on the efficiency of the practice and whether they have changed over the years;
- What is the (perceived) role of the nurse and the nurse’s time in rounding;
- What is the impact of rounding on clients’ outcomes and whether this impact is acknowledged by nurses?
Perspective and Design
Based on some preliminary literature scanning, one can predict that the practice is perceived by nurses as unnecessary while in reality, it makes difference to the clients and their outcomes. The research, therefore, will be conducted from the interpretative perspective, assessing whether the practice of rounding values the nurses’ time and work/life balance. The research will be based on existing literature from which the necessary data will be singled out and analyzed. If this stage of the exploration is successful, it is possible to further develop the subject by collecting qualitative data (from peers and colleagues) and analyzing it quantitatively.
References
Goldsack, J. M., Bergey, M., Mascioli, S., & Cunningham, J. (2015). Hourly rounding and patient falls: What factors boost success? Nursing, 45(2), 25-30.
Mitchell, M. D., Lavenberg, J. G., Trotta, R., & Umscheid, C. A. (2014). Hourly Rounding to Improve Nursing Responsiveness: A Systematic Review. Journal of Nursing Administration, 44(9), 462-472.
Shepard, L. H. (2013). Stop going in circles! Break the barriers to hourly rounding. Nursing Management, 44(2), 13-15.