Journal of Nursing and Health Studies

Nursing Quality Project: Making a Difference by Rounding Implementation of Purposeful Hourly Rounds (PHR) at Security Forces Hospital - Makkah

EuroSciCon Event on Nursing Diagnosis & Midwifery
September 10-11,2018 Prague,Czech Republic

Raiza Jaafar Jumah

Security Forces Hospital, Saudi Arabia

Keynote: J Nurs Health Stud

DOI: 10.21767/2574-2825-C4-010

Abstract

Security Forces Hospital Program Makkah (SFHM) – Male Surgical Unit (MSU) is a unit with 31 bed capacity and situated on the 4th floor of the SFHM building on the Eastern side. The client of the unit are adult male patients with Medical-Surgical cases specifically needed for Vascular, Orthopedic, Urology, ENT, Ophthalmology, General Surgery, and all types of surgical management and treatment. During the early months after the commencement of the hospital in 2013, the SFHM administration received complaints from the patients regarding the health care services provided to them. In order to improve patients’ satisfaction, the quality of services and patient experience; the project team proposed to implement the Purposeful Hourly Rounding Project at MSU as Pilot Phase, and then the project was generalized to all inpatients. The implementation of Purposely Hourly Rounding (PHR) System was commenced by our SFHM Director General Advisor and Executive Director of Nursing Affairs. It was adopted from the Hourly Rounding Supplement – Best Practice at Sacred Heart Hospital, Pensacola, Florida, United States and Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia. PHR by definition is the process of caring for patients round the clock of the assigned nursing staff in in-patient units through checking on an hourly basis for day shift and once every 2 hours for night shift. Day shift visits start from 6am until 10pm, while the night shift covers 10pm up to 6am. Aside from the usual routine of nurses, the Patient Rounding System emphasizes the importance of Therapeutic Nurse-Patient Relationship, support patient centered care, promote safety and surveillance mechanism, anticipate needs proactively, and structuring the nursing process. Every nurse must always introduce him/herself to the patient, explaining the scope and limitation of care and the importance of the patient’s participation in the Rounding System. Thus, these uphold overall patient satisfaction and pain-free hospital experience. Significantly, with the immediate attention given by the nurses, prominent impacts on patient safety and satisfaction after the application of the Rounding System were observed. Furthermore, there were no reports of patient fall and pressure ulcer, less patient call or call bell observed unless urgent attention, and most of the time patient did not interrupt nurses unnecessarily and wait for the next nurses’ visit. Additionally, patients can recognize their primary nurse, and finally, good patient-nurse interpersonal relation was seen. This table was taken from the Quality Program and Safety Patient Satisfaction Survey conducted at MSU 2015 The figure above illustrates the Patient Satisfaction before and after the implementation of the Patient Rounding System in Male Surgical Unit (MSU). It clearly shows that the program had an impact toward achieving patient safety and satisfaction. The Patient Relation representatives did the survey process and the Quality and Patient Safety Department (QPSD) tabulated the outcome. Furthermore, the evident improvement in the Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) scoring since the beginning of the pilot study in 2015. The results supported that, the result of the HCAHPS responsiveness improves response from 78% to 90% in the first quarter 2015. The nurse communication improved from 84% to 90% in the same period of time. There is a clear decrease in using medication pain from 52% to 29% moreover, the control of pain is still better after implementing PHR. Meanwhile, further recommendations for the following can be initiated: (1) Doctor’s participation in the Rounding System, (2) Sufficient number of Nursing and Medical staffing to facilitate the system effectively and efficiently and teamwork, (3) and Support from all the staff and management. Finally, this was one of the many great initiations of the Nursing Affairs to improve the care delivery system and uplift the Hospital purpose in fostering continuum quality care and satisfying the needs of our clients, family, and their significant others. There will be a lot of challenges and adjustments, but imposing a culture pro for good change and continuous improvement will inspire hospital staffs and others to pursue and support the project.

Biography

Raiza Jaafar Jumah is registered nurse in the Philippines and finished her Master in Nursing at Ateneo de Zamboanga University, Philippines. She has an extensive experience dealing with clinical teaching and supervision as a clinical nurse instructor. Furthermore, she is interested in surgical nursing, health care research, leadership and management. Currently, she is working as a surgical head nurse at Security Forces Hospital – Makkah, Saudi Arabia and pursuing her Master in Health Care Administration at Bellevue University, U.S.

E-mail: jumahraiza@gmail.com rjumah@sfhm.med.sa