Effects of Nursing Rounds on Patients Call Light Use - Essay Example

A Research Base for the Proposed Solution and A Research Base for the Proposed Solution Introduction The phenomenon of interest is patient fall reduction. A previous review of the clinical challenge has shown that this problem has adverse effects on patients’ wellbeing as well as institutional goals for the care provider. It has been suggested that hourly rounding be utilised in order to minimise or eliminate patient falls. Hourly rounding is a process of attending to patient needs every hour in order to meet their medical or personal challenges. Research studies The first study focused on how programmed rounds can minimise call light use and enhance patient satisfaction as well as patient safety. Meade et al. (2006) stated that the call light is meant to be a life line tool, but poor nursing interventions have reduced it to a problem solver for mundane issues. Excessive use of the call light may lead to burnout and even prevent nurses from addressing patient problems like falls. It is suggested that a scheduled rounding protocol can minimise the likelihood of falls. Meade et. al. (2006), therefore, studied medical and surgical units in which hourly rounding occurred. They carried out this study through a quasi-experimental design. Participants were divided into three groups; nurses who ascribed to one hour rounding; those who did two-hour rounding as well as the control group that performed no scheduled nursing activities. The researchers used several hospitals (22) in order to ascertain that they had adequate levels of participants. In order to ensure validity of the research, only reliable data elements were included. This meant that eight hospitals had to be eliminated from the study. Furthermore, the analysts did not include nurses who had not done the two hour or one hour rounds consistently. The researchers also checked to confirm that the hospitals had internal mechanisms of measuring call rate use. They collected a series of results, but the parameter of interest is what they found on patient safety. Maeade et al. (2006) compared patient fall rates between the control units as well as the experimental ones with the scheduled rounds. Through patient test comparison, it was found that patient falls did reduce in the one-hour rounding program. No significant changes were reported in the two-hour or the control group, which had no scheduled system of checking on patients. This study proves that scheduled nursing rounds done after an hour can make a positive contribution towards patient safety. Nurses who belong to such a program see patients more frequently and thus anticipate problems before they happen. The research participants, who were just about to start the program, had mentioned apprehensions about the excessive time it would take to implement such a program. This criticism has also been mentioned in other literature. Authors of the latter study found that most nurses were pleasantly surprised by how seamless the transition was. A number of them reported quieter units. Call lights were used less often and it was relatively easy to pay attention to patients when an actual emergency occurred. Therefore, instead of overwhelming the nursing, one-hour rounding actually freed up their time in order to allow them to conduct other duties in the hospital. Gutierrez and Smith (2008) carried out an evidence-based research in Scripps Mercy Hospital. The Californian institution had higher-than-average fall rates and needed an intervention that would reverse this trend. Consequently, the authors of the report felt that they had to design a project in which nurses and other medical professionals would engage in fall-prevention outcomes. The study largely focused on the Definitive Observational Unit, which consisted of cardiac and high acuity surgical patients within the respective setting. In essence, the purpose of this study was to implement practice change within a real hospital setting. It was, thus, not possible to conduct a randomised clinical trial among several institutions. Their main concern was that a fall prevention protocol already existed within the institution, although it did not seem to yield results as was desired. The authors had already established that regular rounding as well as having an educational oversight of falls was the most effective way of dealing with them. However, nurses had to anticipate potential barriers and deal with them accordingly. These were the issues that needed to be addressed in the study. Their literature review indicated that hourly rounding ensures that patients were adequately positioned. This prevented them from trying to do ambulation on their own. Alternatively, they cannot try to reposition themselves through these falls. Resources and oversights dedicated to a fall prevention program need to incorporate nursing rounds alongside a number of other interventions. Gutierrez and Smith (2008) started a project at the study location in which a clinical nurse, an advanced nurse and a bedside nurse were taken through an educational class lasting for five months. These individuals would then be fall practice change agents at their institutions. A number of nurses were recruited into the study. Those who had no falls on their floors were asked about the success strategies they used while those who did not, were informed about the approach they were meant to use. Once training was completed, the project was implemented in the hospital. Individuals were recruited by the trained nurses and interviewed about their perception of fall rounding as well as other quality improvements that can be done. They then asked the participating nurses about practice barriers that may come in the way of improving patient quality care. These fall-prevention champions, thus, surveyed the behaviours, opinions and protocol observed by members of the team. The group of nursing leaders also analysed fall trends and then compared this with falling rates. The results found in the study supported the use of hourly rounding. Most nurses, who had never experienced falls in their floors, claimed that hourly rounding contributed to the situation. They also mentioned adding adequate light and eliminating trip hazards. Participants also discussed some of the potential obstacles to successful fall prevention. Change resistances, as well as poor commitment to the project from institutional leadership, may also hamper outcomes. It was also found that fall rates reduced from 4.87 per 1000 pd to 3.59 per 1000 pd. Additionally, knowledge about fall prevention also increased. Overall, this study also supports hourly rounding; however, this must be done in conjunction with a series of other interventions such as educational training, strong leadership and resource backing. Conclusion It is possible for institutions to enhance patient safety through the use of hourly rounding. One of the researches dwelt on several institutions that had implemented the practice. These hospitals had an overall drop in falls and even reported well-managed units. Another study was more qualitative in nature and illustrated that fall rates can reduce through rounding, if augmented by other factors. References Guttierrez, F., & Smith, K. (2008). Reducing falls in a definitive observation unit: An evidence-based practice institute consortium project. Critical Care Nursing Quarterly, 31(2), 127-139. Meade, C., Bursell, A., & Ketelsen, L. (2006). Effects of nursing rounds on patients’ call light use, satisfaction an safety. American Journal of Nursing, 106(9), 58-71. Read More