Impact of an hourly rounding program on call bell use, patient safety, and patient satisfaction in an adult medical ward

By Yung Hoi Mei, RN, BNurs (HKU), MSc (CUHK)

Purpose

This project evaluated the impact of structured hourly nurse rounds implementation on patient call bell usage, patient safety and fall incidents, and patient satisfaction.

Background

High frequency call bell use for non-urgent needs was identified in a 40-bed adult medical ward. Frequent alarm sounds resulted in a noisy working environment and stressful atmosphere. It was difficult for staff to readily discriminate urgent patient needs from non-urgent needs. Hourly nurse rounding can reduce frequency of call bell use for non-urgent needs. Hourly rounding also has a positive impact on patient safety and satisfaction.

Methods

A 3-month pilot of hourly rounding by nurses and student nurses was performed on one adult medical ward. Pre- and post-intervention data were collected and analyzed, including call bell use frequency, fall rates, and patient satisfaction scores. Follow up post-intervention data was collected at 4-months and 6-months post-intervention.

Results

Implementation of an hourly nurse rounding program has reduced patient call bell use (from baseline by 18% and further reduced by 7% in follow up) and overall increased patient satisfaction scores (from 79 to 88). The unit’s rate of falls has significantly reduced since the initiation of hourly rounding compared with 2015 (from 0.6/100 bed days to 0.1/100 bed days).

Discussion

Hourly nurse rounding in this single-unit project resulted in improved patient safety and satisfaction. The program should be implemented in other units to evaluate impact in other areas. In order to sustain the program, staff involvement should be increased and staff satisfaction metrics should also be evaluated.

Implications/Conclusion

Routine hourly nurse rounding can reduce call bell use frequency, promote patient safety as demonstrated by reduced fall rates, and increase patient satisfaction with nursing care. Based on these measures, operational changes of nursing care in the hospital were suggested.