Barriers Encountered by Care Providers that Inhibit Purposeful Hourly Rounding

Answer

1. Literature Evaluation Table

   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. This is a review of literature and cannot be used.	Quantitative study as it used a pre-post test design. This is a dissertation and cannot be used
   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. A review of literature and cannot be used	Qualitative research study as it used the descriptive method for data collection and analysis.	Quantitative research study using retrospective data reviews This a dissertation and cannot be used.
   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.
   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.

   Saireen, you have a good topic but need to revise your question.  See my comments.  Your articles must discuss hourly rounding and preventing falls. You have 2 qualitative articles, but I do not know if they discuss falls.  You will need to read them  You have no quantitative articles for week 3.  Linn