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Hourly rounds introduced at Cromwell Hospital

  • 15 Comments

Nurses will visit patients at hourly intervals on top of their other duties at Bupa’s Cromwell Hospital under a new system modelled on practice in the US.

“Hourly Rounding” will mean nurses visiting patients every hour between 8am to 10pm, and every two hours at night between 12am and 6am.

Studies show the system improves patient satisfaction and safety, and a higher than average nurse-to-patient ratio of 1:4 will help the hospital become the first private centre in the UK to deliver it.

US patients said they were reassured by regular updates on their care and condition and the checks cut call-bell requests by an average of 37%, leading nurses to report more controlled, productive and less stressful shifts.

Cromwell Hospital spokeswoman Philippa Fieldhouse said: “We’re always looking at how we can further improve our patients’ experience. Ensuring that our nurses are proactively supporting their patients in addition to their reactive duties is a simple but effective way of reassuring our patients that their needs are central to everything we do.”

 

  • 15 Comments

Readers' comments (15)

  • I am very much in favour of this process. However, it is not new really as I bet there are many nurses out there who remember the 2 hourly "back rounds" and checks..

    As long as this process provides holistic quality patient care and is not a task tick box, it can only be of benefit to patients.

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  • i notice that this is a BUPA hospital. this sounds wonderful, where they have the staff to do this. However in the NHS where time is wasted by the nusring staff carrying out unified assessments, and other long winded paperwork this wont get done, which is a great shame.

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  • It does get done and in the NHS. I have practiced this type of care as have my colleagues for many years. Nurses should be able to multitask and while carrying out an assessment aren't you with the patient?
    In bays and the few Nightingale wards left this type of care is easy as you should be based in the bay/ward in view of patients.

    I think it is more necessary in private/single room care where patients are 'shut away' behind doors.

    Nurses use so many excuses for not getting things done. Think of the time it takes to make excuses and use it for caring for patients.

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  • I agree with Anonymous at12.38 . This type of round was done years ago as a matter of course and Nightingale Wards are a much safer place to be if you are ill than in single rooms where you cannot be seen.

    I also agree that nurses should always be visible to their patients and with the modern trend towards single rooms patients will feel less secure. It may feel more private initially but we were always able to maintain 'privacy' years ago when it was routine and not a buzzword.

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  • Like others have said, this is nothing new, many already do 2 hour checks (or less depending on need) as much as possible. HOWEVER (also as others have said) there simply AREN'T the staff numbers to keep up this benchmark of care. That is all it boils down to at the end of the day.

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  • Yes, certainly do remember the 2 hourly/ 4 hourly back rounds, and it did make sure that the care was given. However. I don't think we really needed to be reminded it was just to make sure we had remembered. I am sure this is needed but very sad that it has to be implemented as most nurses only have to look after about 6 patients at a time now. Team nursing involved looking after at least 14 or 15 per shift. As one of those 'easily 'bashed' by nursing times readers CNS's', I have recently been made to work on the wards one day a week and I can honestly say that it is I have not found it very difficult to acclimatise myself. As an experienced nurse (yes, back to that been qualified for nearly 30 years), I seem to be able to juggle everything on a busy surgical ward and talk to the patients, liaise with Doctors, discharge plan, explain procedures, operations, drugs etc and accompany to theatre not to mention filling in the forms, assessing pain relief and other symptoms, giving drugs, administer PEG feeds, suction trachoestomies and laryngectomies and SPEAK TO RELATIVES (hmm, not something done by all nurses on our ward.) And.... I actually got a break.(Needless to say I had to go to my office and do some of my own work which I normally do anyway whilst grabbing a bite to eat. I then stayed for another 3 hours the other day to get things done for my own patients.) Please don't accuse us CNS's of being clnically inept and insinuate that we are lazy I am already covering for a vacant post as well as my own workload and now this. Hourly reminders.... not averse to it at all, but hey, I still think I knew all the patients that day and there were good comments on my care delivered from patients and the other staff. Hooray! PS I know this sounds really boastful and not trying to martyr myself honestly. I love nursing and do it gladly and was VERY worried that I would be useless and dangerous but I feel I have been very careful and accountable and I do not do anything if I am unsure.

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  • Having nursed in Australia (nights) for the last 18yrs, i find it strange to read that patients here are not routinely checked hourly!? That should be a routine. patient to nurse ratio should allow for this basic duty.

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  • rovergirl6@hotmail.com

    I feel that nurses do check their patients regularly ,but this is a way of implementing the checks into the care plan so that they can in the very near future be timed , because i feel sure that someday soon nurses will have to time every action and account for every millisecond they are on duty in order to justify their salary.just you wait and see.

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  • Any good practise to improve our care and services to the patients should be welcomed,after all we are here for them.
    Cromwell Hospital Keep it up !

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  • meg29

    Rounding seems to have formalised something many nurses have always done. We were taught to and still do always check if our patients need anything before we went on our breaks ( as we are in our 6 bed bay clearly visable till then !) and rounded at least 2/24 on night duty . However as we are soon to move to a hospital where the wards are all single rooms ( not sure how I feel about that yet ) I can see how important rounding will become.

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  • Do patients buzz less often if they know a nurse will be round regularly? anybody got any experience of this?

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  • Yes, yes, yes....we all know that we should be checking on patients regularly. The telling points here are
    1) Private hospital (so no acute admissions)
    2) RNs looking after 4 patients each
    Its not rocket science.
    Meanwhile back in the pit that is the NHS, many admissions units are staffed with an RN to look after 15 plus patients. I don't know how fast you can walk but an hour to walk around our admissions unit (assuming no relatives, phonecalls, docs etc etc) would be pretty hard going. I would suggest that our BUPA hospital mainly serves those in for elective procedures, not the acutley unwell. I have also been qualified since the dinosaurs and find it distressing that we are allowing the elderly and vulnerable members of our society to be given substandard treatment due to lack of RNs on the floor. We should hang our heads in shame. In another decade the NHS will be only for those who have no other option. Just look across the pond to the state of County hospitals to see where we are heading (having worked in one, I know what I'm talking about).

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  • This system is not new......hourly rounds is used in other private hospitals in the UK, and it was based by an amercian system, it does reduce complaints and ensure patient safety, however the nurse ratio is lower in private sectors, compare to the NHS. So maybe the NHS need to hire more reg nurses, so the nurse ratio can be 1:4 instead of 1:6 or 1:15 on nights and we will be gladly use the hourly rounds on the ward.

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  • patient rounds are part of the daily process of care so nothing new there. This is just a way of documenting what we're doing in a timely way which adds to the task. Its part of the quality process anyway and patients are safer when they see the nursing staff regularly. I would love to know where there are ratios of 1:4 RNs to patients as the norm at my workplace is 1:14 daytime and nightime. though this is improving, government willing....

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  • Regular checks are essential for all patients but hourly rounds although essential for some patients, seems excessive for others. this must be tailored to individual patient's needs, their level of dependence and seriousness of their condition otherwise for some it may be too intrusive.

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