Nurses at a large hospital trust have changed ward rounds to prevent consultants from leaving bedsides until they have discussed a series of questions about the patient with nurses.
The change has been brought in by respiratory nurses at Nottingham University Hospitals Trust following complaints about large variations in the way consultants carried out ward rounds.
A questionnaire identified that only four out of 25 nurses – mostly in senior positions – believed information or questions discussed during consultants’ ward rounds were “standardised”.
Just 11 said they felt involved in consultants’ ward rounds, with five saying they did not feel involved and nine that they were only “sometimes” involved. The vast majority said registered nurses did not attend all of the ward rounds.
As a result, consultants have been issued with a checklist of questions to discuss with nurses about every patient.
The questions include whether venous thromboembolism risk assessments have been carried out, whether the patient can move from intra venous to oral antibiotics, and whether their discharge can be nurse-led.
Consultants are not permitted to move on to other patients until each question has been discussed with a senior nurse.
The trust’s specialist receiving unit matron John Gray said: “Standardising consultants’ ways of working is a very big step forward. Their ward rounds were so variable before – some took 45 minutes, others three-and-a-half hours. This has been very empowering for nurses.
“For more junior nurses who don’t feel as confident to challenge a consultant on a canula or on antibiotics, this has given them a way to do that,” he told Nursing Times.
The scheme has also ensured that all consultants start their rounds by 9.30am on each of the three fixed days that they carry out them out, enabling earlier discharges.
Developed by the trust as part of work on the Productive Respiratory programme, it is hoped it will be spread beyond the current three wards it is operating in.