title: A quality improvement initiative to achieve high nursing presence during patient- and family-centered rounds.
abstract: OBJECTIVE
  The objectives of this study were to: (1) identify local barriers to nursing presence on patient- and family-centered rounds (PFCR); and (2) increase nursing attendance during PFCR.
  
  
  METHODS
  An electronic survey needs assessment was administered to nursing staff on a single acute medical care unit to identify local barriers to nursing presence on PFCR. Daily tracking of nursing presence on rounds was then performed over a 7-month period. During this time period, 2 Plan-Do-Study Act cycles were conducted. The first intervention was a workshop for nurses about PFCR. The second intervention was the development of a strategy to contact nurses by using a hands-free communication device so that nurses were notified when rounds were starting on their patients. To evaluate the impact of our interventions, a p-chart was generated for the outcome of average daily nursing attendance (%) on PFCR per week over the 7-month period.
  
  
  RESULTS
  Two barriers identified on the survey were: (1) nurses were uncertain if physicians valued their input during PFCR; and (2) nurses were unsure when the physician team would be conducting rounds on their patients. On the p-chart, the average percentage of nursing attendance before interventions was 47%. After the nursing workshop, no change in the mean nursing attendance on PFCR was noted. After initiation of the hands-free contact strategy, nursing attendance on PFCR rose to 80%.
  
  
  CONCLUSIONS
  A nursing contact strategy using a hands-free device led to a sustained increase in nursing attendance during PFCR.
authors.affiliation: Medical College of Wisconsin, Milwaukee, Wisconsin;
authors.forename: Anjali
authors.initials: A
authors.lastname: Sharma
authors.forename: Laura
authors.initials: L
authors.lastname: Norton
authors.forename: Sandra
authors.initials: S
authors.lastname: Gage
authors.forename: Bixiang
authors.initials: B
authors.lastname: Ren
authors.forename: Amanda
authors.initials: A
authors.lastname: Quesnell
authors.forename: Kim
authors.initials: K
authors.lastname: Zimmanck
authors.forename: Heather
authors.initials: H
authors.lastname: Toth
authors.forename: Michael
authors.initials: M
authors.lastname: Weisgerber
mesh_terms: D022143:Family Nursing / Q000458:organization & administration*; D006776:Hospitals, Pediatric; D006801:Humans; D024802:Nurse's Role; D009741:Nursing Staff, Hospital; D058996:Quality Improvement; D056164:Teaching Rounds / Q000458:organization & administration*
keywords: nursing involvement; patient- and family-centered rounds; quality improvement