title: The impact of Nursing Rounds on the practice environment and nurse satisfaction in intensive care: pre-test post-test comparative study.
abstract: BACKGROUND
  Factors previously shown to influence patient care include effective decision making, team work, evidence based practice, staffing and job satisfaction. Clinical rounds have the potential to optimise these factors and impact on patient outcomes, but use of this strategy by intensive care nurses has not been reported.
  
  
  OBJECTIVE
  To determine the effect of implementing Nursing Rounds in the intensive care environment on patient care planning and nurses' perceptions of the practice environment and work satisfaction.
  
  
  METHODS
  Pre-test post-test 2 group comparative design.
  
  
  METHODS
  Two intensive care units in tertiary teaching hospitals in Australia.
  
  
  METHODS
  A convenience sample of registered nurses (n=244) working full time or part time in the participating intensive care units.
  
  
  METHODS
  Nurses in participating intensive care units were asked to complete the Practice Environment Scale-Nursing Work Index (PES-NWI) and the Nursing Worklife Satisfaction Scale (NWSS) prior to and after a 12 month period during which regular Nursing Rounds were conducted in the intervention unit. Issues raised during Nursing Rounds were described and categorised. The characteristics of the sample and scale scores were summarised with differences between pre and post scores analysed using t-tests for continuous variables and chi-square tests for categorical variables. Independent predictors of the PES-NWI were determined using multivariate linear regression.
  
  
  RESULTS
  Nursing Rounds resulted in 577 changes being initiated for 171 patients reviewed; these changes related to the physical, psychological--individual, psychological--family, or professional practice aspects of care. Total PES-NWI and NWSS scores were similar before and after the study period in both participating units. The NWSS sub-scale of interaction between nurses improved in the intervention unit during the study period (pre--4.85±0.93; post--5.36±0.89, p=0.002) with no significant increase in the control group. Factors independently related to higher PES-NWI included intervention site and less years in critical care (p<0.05).
  
  
  CONCLUSIONS
  Implementation of Nursing Rounds within the intensive care environment is feasible and is an effective strategy for initiating change to patient care. Application and testing of this strategy, including identification of the most appropriate methods of measuring impact, in other settings is needed to determine generalisability.
authors.affiliation: Research Centre for Clinical and Community Practice Innovation, Griffith University and Princess Alexandra Hospital, Australia. l.aitken@griffith.edu.au
authors.forename: Leanne M
authors.initials: LM
authors.lastname: Aitken
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Burmeister
authors.forename: Samantha
authors.initials: S
authors.lastname: Clayton
authors.forename: Christine
authors.initials: C
authors.lastname: Dalais
authors.forename: Glenn
authors.initials: G
authors.lastname: Gardner
mesh_terms: D001315:Australia; D003422:Critical Care; D006801:Humans; D007588:Job Satisfaction; D009741:Nursing Staff, Hospital / Q000523:psychology*