NURSING AT McLEAN

Rounding by any other name...
- by Sheila Evans, RN/PC

Recently, while attending a Partners-wide meeting, I heard nurses from other hospitals talking about 'rounding,' an apparently new intervention. I was puzzled, I didn't know what they meant. As they talked more about this 'novel' intervention, looking in on every patient at scheduled times, I thought, Oh! 'checks,' as we at McLean call it.

Rounding, or performing checks, every five, 15, or 30 minutes, is a key element of patient safety at McLean. Each staff member assigned to do checks receives report from the person being relieved. An important part of this 'hand-off' is the dual-check component where both staff members perform checks together, so all patients are seen by both the incoming and outgoing staff.

Since the checks person is out on the unit accessible to patients and other staff, he or she is in a unique position to monitor for potential risks, incidents, or significant changes in patients' conditions. It is a big responsibility. At the same time, it's a great opportunity for the checks person to establish trusting relationships with patients. The checks person also has the ability to intervene 'in situ,' diffusing issues before they escalate and promoting a calm, therapeutic milieu.

Rounding, or performing checks, also means checking the environment every 15 minutes. Showers, bathrooms, and common areas are checked for potential hazards to patients, staff, and visitors. Once again, a continuous sweep of the environment helps mitigate dangerous situations and keep the unit safe.

According to the nurses at this Partners-wide meeting, patient satisfaction has increased with the introduction of their new rounding intervention. I strongly believe checks has always been a significant factor in patient satisfaction at McLean. Many valuable interactions and interventions take place while doing checks. They also promote safety as patients trust that staff will return at structured intervals to perform these checks.