APNs implemented individualized approaches and provided care that exceeds the type of care typically staffed and reimbursed in the American health care system by applying a Transitional Care Model, advanced clinical judgment, and doing whatever was necessary to prevent negative outcomes. Reimbursement reform as well as more formalized support systems and resources are necessary for APNs to consistently provide such care to patients and their caregivers during this vulnerable time of transition.

Objective Synthesize the evidence concerning the effect of hourly rounding programs on patient satisfaction with nursing care, and discuss implications for nurse administrators. Background Patient satisfaction is a key metric that influences both hospital ratings and reimbursement. Studies have suggested that purposeful nursing rounds can improve patient satisfaction but the evidence to date has not been systematically examined. Methods Systematic review of published literature and GRADE analysis of evidence regarding nursing rounds. Results There is little consistency in how results of hourly rounds were measured, precluding quantitative analysis. There is moderate-strength evidence that hourly rounding programs improve patients’ perception of nursing responsiveness. There is also moderate-strength evidence that these programs reduce patient falls and call light use. Conclusions Nurse administrators should consider implementing an hourly rounding program while controlled trials discern the most cost-effective approach.