Page 12 - Report to Our Community 2018/19

Drive the convergence
of care, research
and education.

Checking in

on the hour

Intentional rounding helps
Toronto Western team enhance
patient safety and team-based care.

It’s 8 a.m. on the General Internal Medicine (GIM)
in-patient unit on 3B Fell at Toronto Western
Hospital, when nurse Deb Desveaux collects the
rounding sheet from the nursing station.

At the start of that day’s shift, Deb signed up for
the 8 a.m. and 1 p.m. time slots on the intentional
rounding schedule – where nurses on the unit assign
themselves to proactively check on each patient Nursing team on Toronto Western’s 3B Fell
every hour outside of their scheduled times for care.

“How are you doing today?” Deb says to the All nurses would respond to call bells, but patients
patient in the first room on her round. and their families would sometimes not understand
why they hadn’t seen their assigned nurse in a while
“Is there anything I can do for you?” during the shift.

Started by a 2016 Krembil Nursing Award idea Hourly rounding has helped to change that. Each
proposed by then 4B Fell nurses Marcella Chung 12-hour shift, nurses sign up for one or two slots
and Pearl Lau, intentional – or hourly – rounding of rounding. They visit every patient and check
has made a positive difference to patient care on 3B in with what’s called The 5 Ps: pain, promotion of
Fell, a mixed GIM/Cardiology unit. continence, position, physical environment, and
promise – where the nurse promises the patient to
“Hourly rounding has enhanced patient safety, come back with what they requested whether it be
fostered a team-based approach to care, and provided information, help or something else.
reassurance to both patients and staff that everyone’s
needs are being taken care of,” says Deb, who has On the rounding sheet, the nurse will check off
been with the team for more than four years. having seen each patient and note any changes in
their condition or if any care was provided.
On any given day, each nurse on the unit is assigned
four to five patients on average. Before hourly “Hourly rounding has helped to promote a change
rounding was adopted, nurses mostly focused on the in mindset for nurses because it is providing care
patients they were responsible for. As such, checks on based on what the patient identifies as a need and
patients outside of medication or other point of care not the care schedule,” says Sandra Li-James,
times could occasionally be inconsistent if a nurse Director, Professional Practice at TW.
became busy with an unstable patient or other duties.
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