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QUESTION
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.
Use the "Literature Evaluation Table" to complete this assignment.
Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
The PICOT question will provide a framework for your capstone project.
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.
Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
Literature Evaluation Table
Student Name:
Summary of Clinical Issue (200-250 words):
PICOT Question:
Criteria
Article 1
Article 2
Article 3
APA-Formatted Article Citation with Permalink
How Does the Article Relate to the PICOT Question?
Quantitative, Qualitative (How do you know?)
Purpose Statement
Research Question
Outcome
Setting
(Where did the study take place?)
Sample
Method
Key Findings of the Study
Recommendations of the Researcher
Criteria
Article 4
Article 5
Article 6
APA-Formatted Article Citation with Permalink
How Does the Article Relate to the PICOT Question?
Quantitative, Qualitative (How do you know?)
Purpose Statement
Research Question
Outcome
Setting
(Where did the study take place?)
Sample
Method
Key Findings of the Study
Recommendations of the Researcher
| Subject | Nursing | Pages | 7 | Style | APA |
|---|
Answer
Literature Evaluation Table
Summary of Clinical Issue (200-250 words):
Barriers Encountered by Care Providers that Inhibit Purposeful Hourly Rounding
Hourly rounding refers to a structured means of enhancing patient-centred communication in healthcare between patients, families, and staff to ensure the provision of quality care and resultant positive outcomes. Healthcare institutions that have consistently and effectively applied hourly rounding report a drop in patient falls, reduces pressure ulcers, and reduced call lights for enhanced nurse efficiency and overall satisfaction. Others suggest better patient perception of the quality of care, reduced skin breakdown for elderly patients, and better HCAHPS and patient experience scores. Purposeful rounding operates as a systematic nurse-driven intervention that allows either a nurse or unlicensed assistive personnel to access a patient’s ward unit at regular intervals to assess and manage their care needs and demands. The program meets the primary personal needs of patients, including but not limited to toileting needs, pain management, re-positioning, and access to personal items, especially among elderly patients. However, despite the significant positive impact of purposeful hourly rounding in care organizations and the confirmed benefits to patient safety, care quality, and overall scores in patient satisfaction, some barriers inhibit the implementation and safe utilization of this evidence-based practice. Inconsistent purposeful rounding by nurse care providers following unit-based walls limits safety and healthcare benefits conferred by the proactive and anticipatory traits.
PICOT Question:
Do barriers to purposeful hourly rounding encountered by nurses and nursing assistants inhibit quality care provision to older patients of 65 years and above?
|
Criteria |
Article 1 |
Article 2 |
Article 3 |
|
APA-Formatted Article Citation with Permalink |
Allen, T., Rieck, T., & Salsbury, S. (2016). Patient perceptions of an AIDET and hourly rounding program in a community hospital: Results of a qualitative study. Patient Experience Journal, 3(1), 42-49. |
Christiansen, A., Coventry, L., Graham, R., Jacob, E., Twigg, D., & Whitehead, L. (2018). Intentional rounding in acute adult healthcare settings: A systematic mixed‐method review. Journal of clinical nursing, 27(9-10), 1759-1792. |
Odias, M. J. B. (2015). Barriers encountered by nurses and nursing assistants that prevent purposeful rounding. |
|
How Does the Article Relate to the PICOT Question? |
Informing on patients’ perception of hourly rounding program and how it impacts on levels of care satisfaction. |
Reviewing the effect of intentional rounding on the safety of patients in acute care settings. |
It assesses core barriers that registered nurses and nursing assistants encounter during practice that inhibit hourly rounding programs. |
|
Quantitative, Qualitative (How do you know?) |
Qualitative study as the researchers used qualitative surveys in data collection. |
Utilized both qualitative and quantitative approaches as it was a mixed-method study. |
Quantitative study as it used a pre-post test design. |
|
Purpose Statement |
To assess the impact of hourly rounding on patient care. |
To synthesize existing evidence on the effects of intentional rounding on patient and staff outcomes. |
To assess and highlight all healthcare barriers affecting hourly rounding in care institutions while compromising the quality of care delivered to patients. |
|
Research Question |
What is the relationship between hourly rounding and patient satisfaction? |
How does hourly rounding affect staff and patients safety outcomes? |
What are the core barriers inhibiting hourly rounding and safe, quality care provision to patients? |
|
Outcome |
Hourly patient rounding enhances high satisfaction scores and improves quality of care. |
Hourly rounding increases patient safety, falls prevention, satisfaction, attitude and compliance, and nurse responsiveness in care institutions. |
Poor communication is the main barrier in purposeful hourly rounding programs. |
|
Setting (Where did the study take place?) |
A 400-bed community hospital in the Midwestern United States |
Acute care units. |
Urology medical surgical unit. |
|
Sample |
A convenience sample of inpatients from surgical units. |
Ranged from 4418 to 100 heath care staff |
38 registered nurses, 9 nursing assistants, and 4 unit secretaries. |
|
Method |
Descriptive study method |
Pre-test and post-test designs, |
Pre-post design using pre-implementation needs assessment survey and a post-intervention survey. |
|
Key Findings of the Study |
Purposeful hourly rounding was found to reduce the totality of call lights. Care providers were able to reach their needs such as using restrooms, managing pains, and adjusting positions in bed. |
The study provided mixed evidence concerning the effect of intentional rounding on patient safety. Participants agreed that IR enhances fall prevention in care, reduces call bell use, while increasing overall patient satisfaction levels. |
Poor communication is the main barrier to purposeful hourly rounding as it inhibits safe delivery of patient care, hence, poor patient satisfaction scores and overall quality. |
|
Recommendations of the Researcher |
Care institutions should introduce purposeful hourly rounding as a care regime to ensure they meet the growing care demands of patients in good time. |
Intentional rounding and its fit with the execution setting remains as essential as the care intervention. Care institutions should engage their frontline staff and remove any existing barriers that would impede the efficacy of the program. |
Unit champions for registered nurses and nursing assistants should be designed to role model communication between care providers during purposeful rounds to enhance team work and quality patient care. |
|
Criteria |
Article 4 |
Article 5 |
Article 6 |
|
APA-Formatted Article Citation with Permalink |
Toole, N., Meluskey, T., & Hall, N. (2016). A systematic review: barriers to hourly rounding. Journal of nursing management, 24(3), 283-290. |
Flowers, K., Wright, K., Langdon, R., McIlwrath, M., Wainwright, C., & Johnson, M. (2016). Intentional rounding: facilitators, benefits and barriers. Journal of clinical nursing, 25(9-10), 1346-1355. |
Brown, C. H. (2016). The Effect of Purposeful Hourly Rounding on the Incidence of Patient Falls. |
|
How Does the Article Relate to the PICOT Question? |
The article relates to the PICOT question by systematically reviewing barriers to hourly rounding in healthcare and how they affect the implementation of the practice. |
It assesses the facilitators, benefits, and barriers of intentional hourly rounding in healthcare. |
It analyzes the impact of rounding routines on quality of care and services, patient safety, and overall satisfaction levels. |
|
Quantitative, Qualitative (How do you know?) |
It is a qualitative study as it searched four databases basing on the inclusion/exclusion criteria. |
Qualitative research study as it used the descriptive method for data collection and analysis. |
Quantitative research study using retrospective data reviews |
|
Purpose Statement |
To analyze a comprehensive list of barriers impacting effective sustainment of hourly rounding in adult inpatient medical and surgical units. |
To evaluate the execution, practice, and sustainability of intentional rounding in aged care and maternity units. |
Assessing the importance of hourly rounding in care practice and how it reduces overall patient falls.
|
|
Research Question |
Which hospital barriers influence effective implementation of purposeful hourly rounding? |
What are the key facilitators, barriers, and benefits of incorporating hourly rounding practice in healthcare settings? |
What is the impact of purposeful hourly rounding on incidence of patient falls? |
|
Outcome |
Workload issues, levels of patient acuity, inadequate staff training, and burdensome rounding logs inhibit hourly rounding in care units for elderly patients. |
Roles and responsibilities and the context of work environment are the key barriers to hourly rounding. |
Hourly rounding reduces patient falls and increases safety in care units. |
|
Setting (Where did the study take place?) |
Adult inpatient medical and surgical units. |
Aged care and maternity units. |
241-bed acute care facility in the Southeastern United States. |
|
Sample |
Four data bases were searched and 20 articles reviewed. |
15 nurses in three focus groups |
All documented falls between October 2013 and December 2015. |
|
Method |
Literature review |
Descriptive method |
Retrospective data reviews |
|
Key Findings of the Study |
Workload issues, levels of patient acuity, inadequate staff training, burdensome rounding logs, missing staff buy-in, and lack of sustainability are key healthcare barriers inhibiting hourly rounding. |
The working culture, context of environment, and legal issues present key barriers in the implementation of hourly rounding programs in healthcare. |
Hourly rounding enhances patient safety and overall satisfaction scores by inhibiting life-threatening incidences such as patient falls among elderly patients. |
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Recommendations of the Researcher |
Healthcare leaders should utilize this information to assess and implement successful options to overcoming the listed barriers before, during, and after the execution process, and strategize on alleviating them completely. |
Care institutions should consider incorporating intentional rounding into daily practices as a management tool. Besides enhancing accountability, it offers support essential for sustainability. |
Care organizations should embrace hourly rounding as a strategy of enhancing quality and safe care. Administrators should enhance the implementation process by analyzing likely barriers that can inhibit the efficacy of the practice. |
References
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