14 December 2012
Intentional rounding, sometimes known as hourly rounding, helps frontline teams to organise ward workload and ensure all patients receive attention on a regular basis. In the UK this approach has been found to significantly reduce pressure injuries and falls, and improve pain management. It can also reduce nurse calls, improve employee satisfaction and reduce costs.
Impressed by the potential benefits, Acting Nurse Director Jane Lees and her team at Auckland DHB decided to trial it and in July 2012 intentional rounding was introduced to Auckland City Hospital’s Older People’s Health Remuera and Rangitoto wards.
Intentional rounding involves nurses and healthcare assistants carrying out regular checks with individual patients at set intervals. The round begins with opening words, in which carers introduce themselves and explain why they are there. This connection is designed to build patients’ trust and confidence. A series of questions relating to each patient’s pain, comfort, toileting and ability to access the call bell or other important items are asked at each interval and the results recorded on a patient status form kept at the bedside. The patient is asked about any other requirements he or she may have. The information remains at the bedside ready to be added to when the nursing shift changes over.
Auckland DHB Charge Nurse Richard Benfell shared with attendees at First, Do No Harm’s Learning Session 2 that even though it was very early days intentional rounding was offering measurable benefits in some key areas.
“Since intentional rounding was introduced initially it appeared that call rates had risen on the Remuera ward, but further analysis showed that over 800 call bells for the month of August were made by just two patients. Once we were aware of this we were we were able to manage the ward more effectively.
“Reduced call rates reflect increased patient satisfaction. They also mean less interruption for nurses, allowing them to focus more on the delivery of clinical care. A reduction in falls demonstrates that we are improving the quality of nursing care.”
Waitemata DHB has more recently introduced intentional rounding and Head of Division Nursing for Medicine and Health of Older People Shirley Ross says it has been great to be able to learn from Auckland DHB’s experiences with intentional rounding under the First, Do No Harm patient safety programme. Waitemata has adapted Auckland’s patient status forms to suit their own requirements and benefitted from sharing experiences to date.
Click here to view Richard Benfell’s presentation on intentional rounding at Learning Session 2.