2B Roundtable: Don’t Be Square, Heart the Rounds

Project Topic:

Initiation of Nurse-Led Rounds

Hospital, City and State:

Nemours Children’s Hospital, Wilmington, Delaware

Unit:

2B Telemetry

CSI Participants:

• Maria Barish, BSN, RN, CCRN
• Maya Hargreaves, BSN, RN, CCRN
• Brianna Laske, BSN, RN, CPN
• Kathleen Nichini, BSN, RN

Project Goals/Objectives:

1. Increase participation in nurse-led rounds 80%
2. Increase the Healthy Work Environment Assessment Tool {HWEAT} True Collaboration scores to 4.73
3. Increase 2 B-specific survey scores 40%

Project Outcomes:

1. Increased HWEAT aggregate score from 3.59 to 3.80 and all other standard scores except True Collaboration and Meaningful Recognition
2. Decreased HWEAT True Collaboration score from 3.46 to 3.41
3. Improved nursing presence at daily patient care rounds
4. Improved identification of discharge barriers
5. Improved discharge teaching with patient families
6. Improved identifying gaps in patient care

Project Overview:

The healthy work environment assessment tool sadly reflected only a “somewhat healthy” work environment, with a score of 3.6 in true collaboration which prompted our nurse-led rounds initiative. The CSI team designed an online rounding tool and implemented a rounding process requiring an increased nursing presence and contribution during patient care bedside rounds.

Before kickoff, the CSI team conducted a test of change to provide baseline data to assist with the first implementation of our project. A month after kicking off the project, rounds were remodeled based on feedback. During month 10 we made additional changes to the project based on feedback and redosed the project.

While our project results were not what we had anticipated, we effectively increased the presence of nurses during rounds. We learned to identify gaps in patient care and facilitate discussion regarding education needs for improved discharge at an earlier stage of care planning. Although our survey results showed a decrease in our HWEAT True Collaboration score from 3.46 to 3.41, we received feedback from all disciplines about the positive changes that nurse-led rounds have produced.