e2 ASPAN NATIONAL CONFERENCE ABSTRACTS

Objective: The goal of the Day Surgery teamwas to improve pa-

tient satisfaction by consistently performing and documenting

hourly rounds in the medical record.

Process of Implementation: Two communication boards

were developed to improve the consistency of hourly round-

ing and subsequent documentation; an assignment board in

the nurses’ station and a white board in each patient’s room.

The assignment board indicated hourly rounds, as well as

other key pre-operative elements. The white board indicated

the assigned staff members’ names and estimated time of sur-

gery. Not only did we develop and install the two boards, but

we conducted monthly team meetings to engage staff in the

initiative by reporting on monitoring of documented hourly

rounding.

Statement of the successful practice and implications:

Monthly compliance rates soared to 78%, 90%, and 99% in the

first three months of monitoring. Team work and collaboration

can produce significant, achievable outcomes when they

become a priority for the team.

DISCHARGE INSTRUCTIONS: COLLABORATIVESTANDARDIZATIONSamantha West, RN, BSN, OCN, Carol Labby, RN

Roswell Park Cancer Institute, Buffalo, NY

Judith Pollina, RN, Denise Simmons, RN, Michelle

Tronolone, RN, Michelle Leonard, RN, Cristie Marschke, RN,

Amanda Englert, RN, Dawn Degrasse, RN, Lisa Hammond, RN,

Lisa Garvey, RN

Ambulatory Surgical Centers are fast paced areas. With so much

attention placed on time efficiency and throughput, the need

for ease and consistency in providing discharge instructions is

essential. It was noted by the RNs in the ASC, that patients

who had the same procedure, sometimes received inconsistent

discharge instructions, which depended on which RN was per-

forming the teach. Some discharge instructions were more de-

tailed and comprehensive than others. Also, in the event that

there was a float RN working in the ASC, he/she did not have

easy access to the proper instructions needed to provide to

the patients.

After identifying this breakdown in consistency and communi-

cation, and realizing that the current system was a potential pa-

tient safety hazard, the RNs in the ASC developed standardized

teaching sheets that were specific to each outpatient procedure

being performed. These forms were then distributed to each of

the attending surgeonswho performed each procedure for eval-

uation and approval. Then the forms were reviewed by the pa-

tient education department at RPCI, for final approval and

printed for use in the ASC.

These forms are given to each patient upon discharge and are

specific to their procedure. It is printed in large, bold-faced

font and the language chosen is in laymen’s terms to assure

ease in reading and understanding. Through collaboration be-

tween the ASC RNs and the Attending MDs, clear, concise in-

structions are easily communicated to patients in a uniform,

consistent fashion.

HOURLY COMFORT ROUNDING IN THEOUTPATIENT SETTINGTeam Leader: Magdalena Smith, MA, RN, OCN

NewYork-Presbyterian Hospital Weill Cornell Medical Center,

New York, NY

Team Member: Tak Tam, BSN, RN

Hourly Comfort Rounding (HCR) in the outpatient department

was implemented due to the increase of patients and family

members approaching the nurse’s station requesting informa-

tion about their surgery. Many patients and family members

were dissatisfied with the manner the information was given

to them resulting in patients’ dissatisfaction. Last minute notifi-

cation regarding OR delays and attending to patients’ needs cre-

ated an unpleasant atmosphere and did not promote a healthy,

healing and positive environment.

Our objectives:

1. to change our practice of how andwhen patients receive

their information,

2. to standardize our rounding practice thereby increasing

patient satisfaction and safety, and

3. improve documentation.

Literature reviewrevealedhourly rounding increased patients’ sat-

isfaction, decreased falls, and reducedcall lights on inpatientspop-

ulation (Meade, Bursell, & Ketelsen, 2006). However, there are

limited studiesdoneonhourly rounding in theoutpatient settings.

Barriers on the Hourly Comfort Rounding implementation will

be addressed. Strategies on how, when, and who do the HCR

will be discussed. It will demonstrate how the four “P’s” were

incorporated in HCR.

Since implementation of the practice a year ago, the number of

patients and family members’ inquiries decreased, patients and

staff’s satisfaction increased, and we received positive com-

ments from patients and family members.

Hourly Comfort Rounding transformed the unit practice,

changed patient’s perception of their care, provided patients

a pleasant hospital experience, decreased anxiety, and created

a positive and healing environment.

The staff has agreed to continue to improve and incorporate

Hourly Comfort Rounding in their practicewith different theme

approach.

WALK WITH ME

Cristie Roush, APRN-BC, Katrina Push, RN

Ann Arbor Veterans Administration Healthcare System,

Ann Arbor, MI

Jill Garner, RN, BSN, Charles Washington, RN

Our Evidenced Based practice Committee did a “missed care”

survey on our surgical ward in June 2011. The missed care sur-

vey showed that 86% of patients randomly surveyed stated they

were not given an opportunity to ambulate. The same survey

showed that 80% of the nursing staff randomly surveyed felt

the patientswere not being offered an opportunity to ambulate.

Nursing staff concluded the missed care was partly due to high

acuity of patients and time constraints.