Nurses Play Integral Role in Tower 8AB Rounds
From left, Marie Campobello, PA-C, Vasant Jayasankar, MD, 8AB NIC Sharon Wong, RN, and Debbie Reynolds, RN, participate in rounds on 8A.
When looking at ways to improve patient care, the first thing Tower 8 leadership did was survey staff nurses to get their input. The survey results prompted a change in rounding procedure that serves as the foundation for improving communication of the daily plan by ensuring nurse participation in patient rounds.
Because 8AB is a surgical floor, rounds occur between 6 and 7 a.m., when patients are just waking up, being wheeled off to surgery or due for medications. “It’s a busy time for everyone,” said Suellen Breakey, PhD, RN, Cardiac Surgery nurse coordinator. “Nurses sort of fell out of the rounding process because of that.”
This change, led by Breakey, Nurse Manager Alison Gilmore, RN, and Prem Shekar, MD, also received support from sponsors Mary Lou Moore, MSN, RN, CCRN, director of Cardiovascular Nursing, and R. Morton Bolman, MD, chief of Cardiac Surgery. All were instrumental in supporting the effort to change the process for rounds. Instead of rounding room to room, the new rounds format is per nursing assignment.
“The nurse doesn’t have to be there the whole hour waiting for each patient to be called,” Gilmore said. “Now, nurse A goes, then nurse B, and so on.”
The rounds are proving key in facilitating dialogue between nurses, residents and fellows.
“Because the night shift nurses are involved, they provide relevant information to the physician team during the rounds and then pass on information from rounds to the nurse taking over at 7 a.m.,” Breakey said. “This transfer of information is crucial in making the plan of care work throughout the day.”
The new process began in March and has been well received by both nurses and physicians.
“We need to take back a unified plan of care to each patient,” said Shekar, a cardiac surgeon. “That plan needs to reflect the input of everyone: the physician, physician assistant, nurse practitioner and nurse. It is very important for patient confidence and satisfaction that they hear the same plan of care from all providers.”
He added, “It has helped streamline patient care. Now, by 10 a.m., we have a unified plan of care for the patient.”
Tower 8 is continuing to improve the plan of care. The next step is creating a Web-generated progress note.