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Patient Service-Nursing / Patient Rounds / Structured Method of Sharing Information / BESt 060

mean score of 4.75 for intervention group versus 4.18 for comparison group. Although these studies do not directly include rounds, one method of communication is the practice of rounds. If satisfaction is linked with improved communication, and rounds is a practice used at a particular institution, there is indirect evidence in these studies linking communication (of information from rounds) with satisfaction.

Landry et al., 2007(2A), conducted a randomized controlled study to answer the question: “Which format of rounds is preferred by residents and parents, bedside rounds or conference room rounds?” Patients who were planned to have 2 consecutive mornings in the PICU were randomized on Day One into either conference room rounds or bedside rounds. On Day Two rounds were conducted in the other method. Parents clearly preferred bedside rounds, so they could be included in discussion (81% wished all rounds were at the bedside), and residents were satisfied with either site, with comfort in asking questions slightly higher in the conference room setting (84% vs. 69%).

A NACHRI electronic mailing list set of questions was sent out in August 2008. There were four responses which answered the questions in some part, but did not directly address the clinical question regarding a structured method for sharing information. The questions sent out were “Does your unit/hospital have bedside rounds? If parents are present at the time of rounds, are they given the option to participate? If parents aren’t there, is there a structured way for the parents to receive the information from rounds? Does your unit/hospital participate in a survey for parents regarding satisfaction with their stay in the hospital?” The responses indicated that the hospitals did indeed have rounds in some format, but they did not have any structured methods for sharing information to families if they were not present on rounds.

In conclusion, the literature review did not find any research study directly addressing the use of a structured method to share information from rounds (the plan for the day) with families who are not present for rounds. There is evidence that family members want to be present on rounds, want to be able to understand the plan, and participate in decision making. (Rotman-Pikkielny et al., 2007 [4b], Latta et al., 2008 [4b].) Parents want information and assurance from the health team and are much more satisfied when they are included in rounds. Parents value partnering, being listened to, and want to feel safe with the care of their child. (Landry et al., 2007 [2a], Scott, 1998 [4a], Teare and Smith, 2004 [2b].) Despite evidence addressing rounds, communication and satisfaction, there was no research directly stating there should or should not be a structured method for sharing information from rounds.

The grade for the body of evidence cannot be assigned. Studies have not been done directly addressing the PICO question, and published studies found have inconsistent results in answering the PICO question.

Using the search word “rounds”, in the Nursing Policies, Procedures and Standards manual, the Medical Center Policy manual, and the Clinical Practice policies, there is no policy present which addresses rounds.

Health Benefits, Side Effects and Risks

Health Benefits-Having a structured method for sharing information could reduce the stress of the hospitalization and help the parent focus on their child achieving a level of wellness in order to be discharged to home. (Teare and Smith, 2004 [2b])

Side Effects-The introduction of a new method for sharing information from rounds to parents or guardians may cause concern or confusion as the learning process unfolds.

Risks-There is no significant risk identified.

Copyright © 2009 Cincinnati Children's Hospital Medical Center; all rights reserved.

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