Research Critique: Nurses’ Perception of Patient Rounding by K. Neville, K. Lake, D. LeMunyon, D. Paul, K. Whitmore
Introduction to Nursing Research
February 19, 2012

Research Critique: Nurses’ Perception of Patient Rounding by K. Neville, K. Lake, D. LeMunyon, D. Paul, K. Whitmore Hourly rounding may be described as the purposeful checking of assigned patients at regular intervals. When rounding on patients, nursing staff do so with the intent of checking the “4P’s”- pain, position, potty (the need to toilet), and proximity of personal items and safety measures (call light, phone, side rails etc.) (Halm, 2009 pg 581). Evidence reveals that when doing purposeful patient rounding, falls decreased, use of call lights decreased, and patient satisfaction scores increased. However, the majority of studies did not include evaluate nurses’ the perception of whether hourly rounding would benefit their own practice. So while hourly rounding may increase patient safety and satisfaction outcomes; this study evaluates whether hourly rounding will increase or decrease nursing job satisfaction and what factors may influence their views. Somerset Medical Center (SMC), a 350-bed medical center located in New Jersey implemented hourly rounding over a six-month trial period, which proved to increase patient satisfaction and perception of pain management while decreasing the fall rate and use of call light. However, the postproject did not include an evaluation of the nurses’ perception regarding the practice change (Neville, Lake, LeMunyon, Paul & Whitmore, 2012, pg 83). A study including 5 different units was conducted to evaluate the practice of hourly rounding and implement any modifications needed for further improvement in practice and nurse satisfaction if so indicated (Neville, Lake, LeMunyon, Paul & Whitmore, 2012, pg 83). A descriptive exploratory questionnaire titled “the Nurses Perception of Patient Rounding Scale (NPPRS) (K. Neville, unpublished manuscript, 2010), was developed to measure staff nurses perception of rounding practices. Nurses were recruited to evaluate the content of the NPPRS to ensure the validity of the questions. This resulted in 18 questions elimination because of redundancy (Neville, Lake, LeMunyon, Paul & Whitmore, 2012, pg 83). The NPPRS consisted of three subscales under the headings of communication, patient benefit, and nursing benefit. Questions were scored under a 1-5 rating system with 1 equaling strongly disagree and 5 equaling strongly agree. Examples of questions asked were: • Rounding is a practice that facilitates improved verbal ad non-verbal communication between patients and nurses • During rounding, I tailor my terminology to facilitate effective communication with patients and families Results regarding the subheading of total perception of patient rounding possible scores ranged from 42-210 with a mean score [SD] of 159.62[18.02]. This revealed no statistically significant differences among all units participating in the study. Results were positive on the overall perception of hourly rounding. Under the subheading of communication, the possible scores ranged from 16-80 with a mean score [SD] of 58.42 [6.81](Neville, Lake, LeMunyon, Paul & Whitmore, 2012, pg 85). The only statistically significant differences that were identified by using a t test, were noted to be between nurses perceived benefit and patient perceived benefit with nurses noting for patients to have the real benefit but not necessarily themselves. The scores both for nurse perceived benefit and patient perceived benefit ranged from 9-45. Mean scores were 27.83[5.03] and 36.54 [5.06] respectively (Neville, Lake, LeMunyon, Paul & Whitmore, 2012, pg 86). This qualitative study consisted of engaging registered nurses (RN) on five different units at SMC. The RN has anonymously answered and submitted questionnaires over a four week period. One hundred-fifty questionnaires were passed out with 49 (33%) completed questionnaires submitted. Anonymity was ensured throughout this study by placing unmarked envelopes in boxes placed on each unit. To further, decrease extraneous variables boxes could have been placed in neutral locations throughout SMC so as staff was not concerned non-participating nurses could not observe participants placing questions in the boxes. The literature review utilizes both qualitative and quantitative research relevant to patient rounding. Research data used range from 2005- 2010, with the majority of the studies taking place within the past five years. Evidence is clearly presented as to why hourly rounding was implemented in acute care settings nationally using the patient perception of their nursing care. This author discusses the 4 factors, formal scripting, patient acuity, skill mix of healthcare, that nurses perceive as “road blocks” to successful hourly rounding this creating the importance of this study. The conceptual and theoretical framework used in this study involves a grounded theory method of qualitative research. A care delivery framework model proposes a specific approach to nursing care through hourly rounding. Though the evidence reveals that purposefully rounding on patients by nursing staff has a positive results on patient outcomes involving patient safety matters and patient satisfaction scores nurses continue to perceive hourly rounding to be less beneficial to their own practice with the challenges including documentation issues, patient ratios and skill mix. Therefore, further research is needed to address the challenges of patient rounding for nursing (Neville, Lake, LeMunyon, Paul & Whitmore, 2012, pg 83).

References
Burns, N., & Grove, S. (2011). Understanding Nursing Research (5th Ed.). New York: Elsevier.
Halm, M. (2009). Hourly rounds: What does the evidence indicate? American Journal of Critical Care, 18(6), 581-584. doi: 10.4037/ajcc2009350
Neville, K., Lake, K., LeMunyon, D., Paul, D., & Whitmore, K. (2012). Nurses' perceptions of patient rounding. Journal of Nursing Administration, 42(2), 83-88. doi: 10.1097/NNA.0b013e318243365e