Kelli Flowers1, Kylie Wright2, Rachel Langdon3, Maureen McIlwrath4, Craig Wainwright5, Maree Johnson6. 1. Liverpool Hospital, Sydney, NSW, Australia. 2. Neurosurgery, Liverpool Hospital, Sydney, NSW, Australia. 3. Centre for Applied Nursing, South Western Sydney Local Health District, Affiliated with the Ingham Institute, Sydney, NSW, Australia. 4. Clinical Governance Unit, Liverpool Hospital, Sydney, NSW, Australia. 5. Respiratory and Sleep Medicine, Liverpool Hospital, Sydney, NSW, Australia. 6. Faculty of Health Sciences, Australian Catholic University, Affiliated with the Ingham Institute, Sydney, NSW, Australia.
Abstract
AIMS AND OBJECTIVES: To describe the implementation, practice and sustainability of Intentional Rounding (IR) within two diverse settings (aged care and maternity). BACKGROUND: The profile of patients in hospitals has changed over time, generally being more severe, placing heavy demands on nurses' time. Routine non-urgent care is often provided only when there is time. IR has been found to increase both patient and staff satisfaction, also resulting in improved patient outcomes such as reduced falls and call bell use. IR is also used as a time management tool for safe and reliable provision of routine care. METHODS: This descriptive qualitative research study comprised of three focus groups in a metropolitan hospital. RESULTS: Fifteen nurses participated in three focus groups. Seven main themes emerged from the thematic analysis of the verbatim transcripts: implementation and maintenance, how IR works, roles and responsibilities, context and environment, benefits, barriers and legal issues. CONCLUSION: IR was quickly incorporated into normal practice, with clinicians being able to describe the main concepts and practices. IR was seen as a management tool, facilitating accountability and continuity of management support being essential for sustainability. Clinicians reported increases in patient and staff satisfaction, and the opportunity to provide patient education. While patient type and acuity, ward layout and staff experience affected the practice of IR, the principles of IR are robust enough to allow for differences in the ward specialty and patient type. However, care must be taken when implementing IR to reduce the risk of alienating experienced staff. Incorporation of IR charts into the patient health care record is recommended. RELEVANCE TO CLINICAL PRACTICE: Engaging all staff, encouraging ownership and stability of management are key factors in the successful implementation and maintenance of IR. IR is flexible and robust enough to accommodate different patient types and acuity.
AIMS AND OBJECTIVES: To describe the implementation, practice and sustainability of Intentional Rounding (IR) within two diverse settings (aged care and maternity). BACKGROUND: The profile of patients in hospitals has changed over time, generally being more severe, placing heavy demands on nurses' time. Routine non-urgent care is often provided only when there is time. IR has been found to increase both patient and staff satisfaction, also resulting in improved patient outcomes such as reduced falls and call bell use. IR is also used as a time management tool for safe and reliable provision of routine care. METHODS: This descriptive qualitative research study comprised of three focus groups in a metropolitan hospital. RESULTS: Fifteen nurses participated in three focus groups. Seven main themes emerged from the thematic analysis of the verbatim transcripts: implementation and maintenance, how IR works, roles and responsibilities, context and environment, benefits, barriers and legal issues. CONCLUSION: IR was quickly incorporated into normal practice, with clinicians being able to describe the main concepts and practices. IR was seen as a management tool, facilitating accountability and continuity of management support being essential for sustainability. Clinicians reported increases in patient and staff satisfaction, and the opportunity to provide patient education. While patient type and acuity, ward layout and staff experience affected the practice of IR, the principles of IR are robust enough to allow for differences in the ward specialty and patient type. However, care must be taken when implementing IR to reduce the risk of alienating experienced staff. Incorporation of IR charts into the patient health care record is recommended. RELEVANCE TO CLINICAL PRACTICE: Engaging all staff, encouraging ownership and stability of management are key factors in the successful implementation and maintenance of IR. IR is flexible and robust enough to accommodate different patient types and acuity.