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Region introduces hourly rounds


Trusts in the East Midlands are importing a US nursing model involving hourly checks on patients, in response to harrowing stories regarding poor care of the elderly.

The move follows last month’s damning report by the health service ombudsman that claimed the NHS was neglecting the “most basic” human needs of elderly patients (news, page 7, 22 February).

The strategic health authority NHS East Midlands is sending all trusts in the region information about “hourly rounding” in response to last month’s damning Health Service Ombudsman report on care of older patients.

The initiative involves nurses proactively visiting patients on an hourly basis, on top of their usual duties. US studies have shown it can slash patient buzzers use and halve falls.

Nottingham University Hospitals Trust has been piloting the model and last week demonstrated it to officials from the SHA and Department of Health.

Head and necks directorate matron Andrew Riley said: “Cynics say ‘we’ve always done this’ but we’ve not done it in a structured way before.

“Patients say the ward felt more therapeutic because there wasn’t that chaos of buzzers going off constantly.”

Over three months, buzzer usage dropped by 66% across two wards. Among ophthalmology patients, there was a 100% reduction in calls from patients needing the toilet.

The trust is spreading the model to other wards in the hope it will also help to reduce falls and pressure ulcers.

Trust assistant director of nursing Kerry Bloodworth said: “This is about having a dialogue with patients and…nursing staff becoming more visible. Nursing staff can encourage patients to drink, or to change their position to prevent pressure ulcers.”

Some wards, for example where patients are younger and do not want to be disturbed, have decided to carry out rounds every two hours.

But Ms Bloodworth said more regular rounds were reassuring to older patients, particularly those with dementia.

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Readers' comments (38)

  • is this really a new idea? I was trained in the 8o's as State enrolled nurse and this was expected of us.

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  • I second the sentiment above, Charlotte Santry is almost certainly too young to remember this but regular rounds aren’t a new fangled American innovation it’s the way care was provided in the early eighties. Now a lot was wrong about some of the things we did back then, lets not forget egg white and oxygen or Friars Balsam, but we had back rounds, Obs rounds and locker rounds; bottle/catheter rounds as well as medicine and IV rounds. It was called task allocation and whilst it didn’t always ‘allow the named nurse to develop a deep and meaningful partnership relationship with his or her particular group of patients’ it did ensure that the fundamentals of care were provided not least because all of the nurses on a ward knew something about all of the patients. Also, because of the hierarchical way in which responsibility for the various rounds was allocated it meant the more senior nurses regularly reviewed the work of the less experienced or unqualified. Did it feel like a production line... yes it often did, but remember why production lines were created? Are patients happier, better looked after and better informed today than they were then… you answer that.

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  • This is all fine but where do we get the staff in order to carry out such processes especially at night when ratio is 1:15 and only 2 nurses working! reality must set in at some point and nurses should be able to assess those most at risk of needing extra help!

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  • bull sh*t this has been done for over 30 years to this day thay oviously have not been doing their job right if this a new idea?

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  • With nursing going to all degree and more applicants coming in at that level, with leadership being an intention and progression through the ranks. Plus there will be a good number of applicants who will not have the academic ability but would make fantastic bedside nurses (the old SEN) and want to stay at that level and care for patients/clients.

    The only way to ever get back to good bedside nursing is to bring back a two tier registered nurse.

    The assistant practitioner is not the answer, as they are not regulated and would have a much wider role and none specific training.

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  • it seems with all the protocols, guidelines, directives, etc. nurses no longer have any professional autonomy and do not need to use their initiative anymore. I wonder why the NHS need to employ professionals at all if this is how they treat them - they could save themselves the money.

    Job dissatisfaction also comes as much from lack of challenge and recognition as it does from lack of pay.

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  • I thought we did that anyway, hourly checks that is.

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  • Surely it is the professional autonomy that has brought this in to the forefront!!!!!!!!!
    Professionally trained, supposedly competent nurses are obviously not providing the care they should and are putting patients at risk.

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  • "Professionally trained, supposedly competent nurses are obviously not providing the care they should and are putting patients at risk."

    yes, but why?

    concrete reasons need to be identified to see whether it is possible to remediate the problems instead of constantly pointing the finger of blame on the system, managers or anywhere else. this seems to create a vicious circle and achieve nothing. it is possible that the answers are not as simple and obvious as everybody seems to think.

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  • You want concrete reasons?
    1 A large percentage of qualified nurses are not interested in the basic bedside care of a patient, in fact the universities were not either. Thats why the NMC had to bring back essential skills training.
    2 Remediate the problem by bringing back the SEN as some one suggested earlier.
    3 Staffing levels also have an impact.
    4 Remediate by forcing the government to do a u-turn on getting rid of half the workforce!!!
    5 Sorry the answer is simple. Nurses need to nurse!!! Care for patients. Stop aspiring to be junior doctors!!!

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