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Intentional ward rounds need improving, says PM forum lead


Intentional ward rounds must be carried out hourly and more paperwork should be done by the bedside, according to one of the leads of the prime minister’s nursing forum.

Salford Royal Foundation Trust nursing director Elaine Inglesby is leading the “time to care” workstream of the Nursing and Care Quality Forum.

It will focus on looking at ways of “ensuring nurses have enough time to give quality care” and will include implementation of intentional nurse rounding and identifying paperwork that should not be carried out by nurses.

She told Nursing Times that, while some teams already carried out ward rounds, they did not always follow best practice. She said rounding must be done hourly during the day and every two hours at night, unless patients required more regular visits.

But she said her main aim was to change the nature of rounding in order to improve communication, dignity and compassion.

She said: “We don’t want nurses to be saying, ‘we have been doing this for years’. Implementing intentional rounding – if you are not doing it with the right values and beliefs – is just ticking a box. It has to be about dignity and respect.”

In addition, Ms Inglesby said she would try to identify what paperwork needed to be done by nurses, what could be done by someone else and what did not need to be done at all.

She said she would also be reviewing handover practice and encouraging less use of single, large ward nursing stations – in favour of completing paperwork in bays.

One concern she said the forum would seek to address was a lack of ward clerks. She said admin support was often unavailable much of the time nurses were working, such as weekends, and there were reports of admin posts being cut.

The forum has three other workstreams covering leadership, culture and values, and patient involvement.

Speaking to Nursing Times earlier this month, health secretary Andrew Lansley said he wanted nurses to feel they “owned” the forum and hoped they would not be cynical about it.

Forum member Janet Davies, executive director of the Royal College of Nursing, said her priority was to make the forum did not just lead to “initiatives and tickbox exercises that will create more work”.

Ms Davies also said the work should look at nursing resources. She said it was “difficult” for a government-commissioner review, but said: “None of this can happen if the resources aren’t there. We can only [improve] if we have the right people in the right place at the right time.”


Readers' comments (37)

  • When did Ms Inglesby last work hands on in a ward situation. ?

    This is the problem, those advising the government havn't got a clue. it was only in a recent article that managers and NCQF members were "shocked" at the statistics proving just how many nurses were currently unable to finish necessary tasks.

    How is an hourly round going to work? Patients dont just sit there waiting for one of us to come along and ask about their needs. Caring for them is an on going process, some needing more time than others. Patients should dictate the needs not another chart that needs to be ticked every hour.

    This is yet another attempt to satisfy the powers that be and the government who all seem stubbornly blinkered to the fact that most of the problems are due to insufficient staffing levels and too much paperwork.

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  • The only way to maintain staffing levels and professionalism is by being able to clearly demonstrate what is being being done and by who.

    Much of the substandard care is a result of no clear basis for skill mix, establihsment, patient acuity or serivce delivery. Only by setting what is required will lead to what is the right level of resources and care. This is needed to challenge commissioners and providers to deliver care expected.

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  • Intentional suggests what took place before was without purpose. Just another incoherent process and one that may impose on those in need of care and those with no need of care at hourly/regular frequencies.
    The focus on paperwork suggets it may be the paperwork which is the focus. What is needed is patient focussed or patient centred care. Resources are key to ensuring that the best care is delivered to a diverse group of clients with different needs but all requiring equitable outcomes. Has anyone considered what the patients want or need.

    We create our own dilemmas by ignoring the importance of flexible approaches towards regimentation. Thats what leads to a checklist. we should focus on caring for patients. Paperwork is a distraction.

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  • This is incorrect. Hourly rounding needs to be done hourly, paricularly at night as this is when patients are most often likely to deteriorate in the acute setting

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  • Perhaps they should consider bringing back nightingale wards, at least you could see and hear all the patients.

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  • Nightingale wards - a barbaric relic of the past for the military.

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  • I wonder how many of these idiots it takes to plug in a light bulb.

    Utter, utter dross. Ms Inglesby can spout drivel about her latest silly ideas (there is nothing new here anyway). It's all been said and tried before. Until the resources exist, Ms Inglesby, Humpty simply cannot be put back together again. Fact. You don't need a committee of government 'nod-guys' to reach that conclusion.This forum is yet another waste of space and time. Go and get a proper job.

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  • what RATIO is there

    of nurses in management, administration, committees, forums, carrying out research, report writing, carrying out inspections on other nurses and any other non-jobs

    TO nurses actually caring for patients?

    Has anybody actually researched and reported on that?

    It might be an opportunity for another highly paid, lengthy and wasteful job to find out!

    as the post above and very many others say it has all been done, reported and written about before at great cost and detriment to actual patient care. nothing can improve care except more hands on care which is what nursing actually is, for those who seem to have totally lost touch with the reality of what the job really is all about!

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  • Hourly rounding is a incredibly powerful tool, designed to ensure patients physical and psychological safety are attended to. At its heart is an ambition to ensure nurses spend more time with patients. It's a great idea because I and the vast majority of my colleagues came into our profession to provide care to patients and to make a difference. Ms Inglesby's focus clearly appeals to the values of millions of Nurses and as a proud Nurse I applaud her vision and focus. If you look at what Salford Royal has achieved through its hourly rounding and Improvement programme it's hard to deny that the positive benefits described should be an incentive for all Nurses to replicate.
    Obviously with all interventions there should be accompanying documentation, but what really matters is the intent to check on patients hourly, to do this in a meaningful way and hopefully with a smile.

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  • not just checking on patients hourly but identifying and actually meeting their needs as well otherwise the whole exercise is useless!

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