June 25, 2013 Ingrid Chezlek, RN, MSN Chief Nursing Office Metro Health Hospital 5900 Byron

Centre Ave. Wyoming, MI

RE: Hourly Nurse Rounding Dear Ms. Chezlek, I am a registered nurse at Metro in the Childbirth Center. As part of my studies to complete a BSN degree, I have researched a small change in nursing practice I believe could be of great benefit to patients and nursing staff at our institution. It is called hourly nurse rounding, or intentional rounding. Nurse rounding is a process that is heartily endorsed by the Studer Group, an organization dedicated to improve the quality of health care in the United States. My proposal is that intentional hourly rounding by nurses would occur on all inpatient units. The purpose of these rounds would be to address patient safety needs, positioning, pain control and personal needs such as toileting. Hourly rounding has been shown to decrease patient falls by 60%, which would enhance our culture of safety at Metro. Pain relief measures, including repositioning, are met in a timely manner and result in an increase patient care satisfaction. The satisfaction scores at one institution was increased from a 38.3 % rating of excellent to 80.1% after hourly rounding was implemented! Several studies have shown that call light use by the patients decreases significantly. This aides in the more efficient use of time for the RNs on the floor and provides blocks of time for uninterrupted patient care and documentation. Adopting this practice would involve education of the nursing staff on how to do hourly rounding and what it should encompass. A slight resistance to a change in practice would be anticipated but a small investment of time in nursing education would pay huge benefits in patient and nursing satisfaction. However, the advantages seen by nursing staff after implementation was overwhelmingly positive in several studies. Other hospitals that have instituted this operational and culture change have reported less disruption in performing patient-centered care and increased nurse satisfaction with patient care. Instituting hourly nurse rounding at Metro could increase patient safety, patient satisfaction and reduce the use of patient call lights. It is my hope that you will consider implementing this change at Metro, at least on a trial basis. If you desire more information about hourly nurse rounding, I am available to meet with you at your convenience and I will make the studies mentioned above available to you at your request. I am looking forward to your feedback on this proposal. Sincerely,

Denise VanderWeele, RN-BC

Denise: Excellent job on the advocacy letter. You have clearly demonstrated your understanding of the requirements and it was a great topic for discussion. Thank you for your insight. Writing to our legislator, director, Board of Directors, or any stakeholder does make an impact on healthcare. Sometimes it may not be in our timing but the subject matter plants the seeds. Consider removing the Re: ... and address the CNO as Dear (add her name as you have it). Keep up the great job...we are nearing the end of the course (half way mark). Eppie