Evaluation of a Standardized Hourly Rounding Process (SHaRP)

Abstract

Current research suggests that hourly rounds on hospitalized patients may be associated with improvements in care delivery and in the patients' perception of care, as well as a reduction in patient safety events. Implementing an hourly rounding protocol involves a major change in nursing staff workflow and a substantial training and education program to ensure the success of the program. This quasi-experimental study aimed to determine if a standardized hourly rounding process (SHaRP), implemented through a formal education program, would result in improved efficiency, quality, safety, and patient satisfaction metrics when compared to a less standardized process introduced through the traditional train-the-trainer method. Data were collected over a 6-month period and results were trended for an additional 6 months later to determine if significant gains were sustained over time. Significant reductions in call light use during the study period (p = .001) and the number of steps taken by the day-shift staff (p = .02) were seen on the intervention unit. Differences in the number of patient falls, 30-day readmission rates, and patients' perception of care were not statistically significant.

A systematic review: barriers to hourly rounding

“…, Braide , Shepard , Fabry , Krepper et al . ). Competing initiatives along with tasks and priorities are some of the attributes of workload that impedes hourly rounding on medical‐surgical units (Deitrick et al .…”

“…, Shepard , Krepper et al . ). Time constraints and perceptions of being too busy are brought on by several factors: the sheer number of patients to manage in the typical medical‐surgical unit, census fluctuations, acuity fluctuations and staffing levels (Hutchings , Kessler et al .…”

“…, Fabry , Krepper et al . ). Although staff thought rounding was a good idea, they could not figure out how to implement it with the existing workload, tasks and competing priorities (Shepard ).…”

“…, Forde‐Johnston , Krepper et al . ). One staff member stated that nurses do not have time to document every interaction on the rounding log in medical‐surgical units due to being too busy (Hutchings ).…”

“…Thirteen out of 20 articles identify that the amount of workload in medical-surgical units interferes with consistent hourly rounding (Blakley et al 2011, Dean 2012, Deitrick et al 2012, Hutchings 2012, Kessler et al 2012, Neville et al 2012, Rondinelli et al 2012, Sherrod et al 2012, Tucker et al 2012, Braide 2013, Shepard 2013, Fabry 2014, Krepper et al 2014. Competing initiatives along with tasks and priorities are some of the attributes of workload that impedes hourly rounding on medical-surgical units (Deitrick et al 2012, Kessler et al 2012, Sherrod et al 2012, Braide 2013, Shepard 2013).…”