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Should we return to hourly rounds?

  • Comments (23)

The Kings Fund Point of Care programme is currently working with nurses to introduce hourly intentional rounding. An unnecessary ritual or a useful tool to help nurses plan care effectively?

What do you think?

  • Comments (23)

Readers' comments (23)

  • Anonymous

    Definitely - why did they ever take it away in the first place?

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  • Anonymous

    But aren't we busy enough?

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  • A far better idea would be to guarantee in law minimum RN to patient ratios. 2 RNs to look after 28+ patients is dangerous. So much research to back this up and yet the NHS chooses to stick its head in the sand. The dirty little secret that we hide from the general public. Plus all that would happen in reality would be yet anothet useless tickbox form for band 8s to audit in order to justify their jobs.

    If each RN had only 4-6 patients to care for, we would not need hourly rounds as the RN would be able to look after her patients properly, rather than the situation we have now on many medical wards. If you have 14 patients and 1 goes off, what happens to the other 13? We need to be shouting out that bedside nursing is a valuable job and that those who choose to stay as a bedside nurse should still be able to be paid as a band 6 or 7 so that skilled senior nurses are not lost to penpushing management jobs.

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  • Anonymous

    very sensible idea above - why has nobody else ever thought of that?!

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  • Anonymous

    in fact M/r/s Dino-Nurse it would work far better than hourly rounds as the patients would be observed and monitored consistently and their needs met far more rapidly by highly experienced nurses.

    hourly rounds could mean disturbing the patients in a fairly unproductive manner to the point of intrusion and nurses would be disturbed in their work in order to ensure somebody was available to do the round. on a thirty-bedded ward the hourly rounds would probably overlap and the staff might be tripping over one another's feet. alternatively one nurse could be employed just to run round and round for the whole shift but what sort of job would that be except for a headless chicken.

    quality of work would not necessarily be better as it could just be a question of rushing round for the sake of ticking the boxes without really observing the condition and seeing to the needs of each and every patient. if the boxes were more detailed it would require more time to fill them in.

    the problem is how do we get anyone to listen to the valid arguments about the ratios, agree to the funding of the extra staff needed and then actually take the initiative of implementing them.

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  • Well said Dino Nurse.

    The problem is short sighted moronic management who have absolutely piss all clinical experience are setting the standards by which we must work, based on profit and cost alone.

    Anonymous | 21-Jun-2011 1:28 pm, "how do we get anyone to listen to the valid arguments about the ratios, agree to the funding of the extra staff needed and then actually take the initiative of implementing them"


    Easy.

    Strike.

    It worked in Australia.

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  • Anonymous

    true Mike, hourly rounds have little to do with professional skilled clinical nursing.

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  • Anonymous | 21-Jun-2011 11:21 pm they have their place, but not as a comprehensive cure all when there is no clinical justification for hourly rounds that leads to more paperwork and does not get to the true heart of the problems we face in Nursing.

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  • Anonymous

    When in charge I am accountable for ALL care on my unit => I go round regularly. Bloomin' difficult when I also have patient caseload and am doing IVs for others as well as doing ward round, troubleshooting, trying to cover next shift, checking ordering, doing all sorts of bureaucratic crud etc....

    Let us ensure nurse in charge has no direct patient allocation if we are going to accept this idea.

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  • We have hourly rounds for falls risk patients developed from practice in the USA. It is a form filling, which is audited and ommison can be a reason for a capability proceding, so falls back on the trained nurse if not completed. Can be ok on a good day, hard to imposible on a bad one with patient detrioting and relatives and patient requesting to speak to a trained nursed. Works if you have teamwork and the hca not only ensure the pt are settled but fill in the paperwork, Othewise it an retrospective estimate of what was occuring. with less pt say 8 instead of 12 it is more accurate and pt get the care thye need

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