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Francis calls for 'key nurse' to coordinate each patient's care

Nurses should be present at every interaction between a doctor and their patients.

This is one of the recommendations of the Francis report, which calls for patient to have a named key nurse responsible for coordinating care. 

The report suggests that:

  • Nurses involvement in ward rounds is a key part of patient care;
  • No consultant ward round should take place without the key nurse or an appointed deputy;
  • Handovers between nurses should occur at the end of shifts to ensure teams are up to date.

It also identified that ward rounds are part of a nurse’s development and should involve student nurses.

Last year the Royal College of Physicians and the Royal College of Nursing have published Ward Rounds in Medicine: Principles for best practice. This guideline recommended that ward rounds should be seen as a priority by all members of the multi-professional team.

Readers' comments (5)

  • Hmmm, do we not already have nurse to nurse handover? As for going around on the ward round with the doctors, what a fabulous idea. Presumably there will be a few more nurses employed on the wards to enable this to happen, so whilst the 'key nurse' is trundling around with the consultant for an hour, the patients aren't neglected!

    There's nothing new about these recommendations; we've been doing this for years where I've worked.

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  • Of course nurses should be present on ward rounds, but if there is ONE, or occasionally two, trained nurses for a group of patients, and the ward round takes a couple of hours, and the IV drugs need to be given on time, and anxious relatives are on the phone, and discharge liaison and social work and AHP's need to speak to this same "key nurse", and he or she is also keeping an eye on HCA's and students, making sure charts are completed, responding to other staff's concerns and assessing patients if obs are not quite right, admitting patients, making sure people get to X-ray or theatre.....how is this to be achieved? People who make these suggestions should come and spend a day on a busy ward and really understand the implications of not enough staff.

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  • Nurses involvement in ward rounds is a key part of patient care;
    No consultant ward round should take place without the key nurse or an appointed deputy;
    Handovers between nurses should occur at the end of shifts to ensure teams are up to date.

    In 40 years of nursing, I have never known these recommendations not to be the case

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  • B R 06-02-2013 9:48pm

    Agreed

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  • B R | 6-Feb-2013 9:48 pm


    I agree. for me this is standard practice but it rather indicates it was not in the Staffs if it has had to be put forward as a recommendation.

    The only thing that puzzles me is how one can be present at every dr./pt interaction as one cannot always be everywhere at once and especially if they come to see a patient unannounced. this could also be a problem if they are taking a history and doing an examination on admission as it would be too long as well as unnecessary. However, if I call a doctor to see a patient I then make every effort to be present unless called away for some reason as often happens.

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