A nurse should be present at the bedside during every hospital ward round as a key aspect of inpatient care, clinical leaders have stated.
Ward rounds should be the “cornerstone” of care but pressures on staffing and capacity have led to them often being “neglected”, according to the Royal College of Nursing and the Royal College of Physicians.
There remains considerable variation between hospitals in how they are conducted and their clinical importance is often underestimated, they warned last week.
The colleges argue that multi-disciplinary ward rounds are a “key vehicle” for coordinating the care of patients, improving both safety and continuity.
In a joint statement, they said: “Reinstating ward rounds will facilitate the delivery of compassionate care, enabling doctors and nurses to plan for care jointly.”
They also published best practice guidelines (see attached document, right), which call for a nurse to be present at every bedside as part of the ward round.
The guidance recommends that a pre-round briefing should take place with the entire multi-disciplinary team, that a locally adapted checklist be used and that ward rounds should be undertaken during the morning to minimise patient anxiety and aid discharge planning.
Steve Jamieson, head of the RCN’s nursing department, noted that good ward rounds were happening in some places already and the guidance was an attempt to spread best practice everywhere.
RCP clinical vice-president Dr Linda Patterson added: “We want the ward round to become the cornerstone of care for inpatients.”
Dr Mark Temple, acute care fellow at the RCP’s medical workforce unit, highlighted the importance of freeing up nurses’ time so they could be fully involved.
“From a physician’s perspective, nurses are in a unique and privileged position because they are present on the ward round the clock, 24 hours a day, caring for patients.
“It’s really importance that a patient is not seen in isolation by consultant, that we’ve got a system which allows nurses to join the ward round.”
Dr Temple acknowledged that the NHS was currently facing “huge pressures” in terms of staffing, financial constraints and a “rising tide” of inpatients and emergency admissions.
“We are all under pressure to save money – we’re saying that a ward round is key to patient care and getting it right will save resources in the long term,” he said.
Dr Temple told Nursing Times that clinicians should spend around 15 minutes at the bedside of each new patient and 5-10 minutes for those already known to them. He estimated the round pre-briefing should take around 25 minutes in total.