What is Hourly Rounding?
Hourly rounding establishes a relationship between nursing staff and the patient. This
process involves setting a clear expectation between the nursing staff and patient. The patient is
educated that every hour from 0600-2100 the RN or CNA will be at the bedside to assess the
patient needs, specifically, the 4 P’s; pain, personal needs, positioning, placement (Ford, 2010,
p.189). During hours of sleep, 2100-0600, rounding will still take place, but every two hours.
Patients are still educated to use their call light if they need anything; however, when there is a
clear expectation that someone will be in the room within an hour, the goal is the patient will
wait for rounding time for less urgent requests. The patient and nurse will establish a trusting
relationship through consistent on-time rounding.
PICOT
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In adult patients in an acute care setting (P), does establishing a rounding schedule
between the patient and nurse (I) compared to purposeful rounding (C), affect patient safety and
communication (O) during the patient’s hospital stay (T)?
Literature Search Strategy
The author used multiple databases to locate evidence-based articles, such as; CINAHL,
Joanna Briggs Institute EBP, OVID Nursing Essential Collection, and ProQuest Nursing &
Allied Health Source (Grand Canyon University Library, 2017). Google scholar was also
utilized to find journals and locate a DOI. Then, the Grand Canyon University Library was used
to locate the DOI. Key words used included: rounding, hourly rounding, intentional rounding and
inpatient falls.
Evaluation of Literature: Comparison of Research Questions
Fall Prevention
Bouldin et al., (2013) and Fisher et al., (2014) are research studies focused on national
trends regarding hospital inpatient falls and the need for staff involvement to improve patient
safety through education. Bouldin et al., (2013) conducted their research in anticipation of the
Centers for Medicare and Medicaid Services (CMS) no longer reimbursing hospitals for care
related to injury due to falls. Fisher et al., (2014) implemented hourly rounding and increased
staff education to reduce falls and improve patient satisfaction. The paper will explore that fall
prevention statistics correlated to patient rounding.
Call Light Response Time and Falls
Tzeng & Yin, (2009) conducted an exploratory study to determine if call light use and the
average response time contributed to increased fall rates. The research design also encompasses a
rounding schedule and the impact of rounding. This study not only showed the relationship
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between call light uses and decreased patient falls. The study reflected the need to establish a
rounding schedule. The patients anticipated the nursing staff to be at their bedside which resulted
in a decreased use of the call light, which directly correlated to a reduction of inpatient falls.
