Background Intentional Rounding (the structured process whereby nurses carry out regular checks of patients using a standardised protocol to address issues of positioning, pain and personal needs) was introduced to NHS Hospitals in 2012 in response to the Francis Report (Francis, 2013). There are limited published examples of the benefits of implementing this in hospices. Pendleside Hospice wanted to explore the value of IR on its Inpatient Unit (IPU). It was clear that patients at high risk of falls and skin damage were being observed attentively but with limited evidence of how frequently this occurred. A quick and clear observation record was required.
Aims To ensure high quality, accurate records. To explore the use of Intentional Rounding (IR) in improving patient care.
Method The project followed the PDSA model with staff involvement throughout. The IR chart from the local NHS Trust was adapted for the hospice setting. The chart was trialled with feedback from nursing staff and regular amendments until they felt it was clear and easy to complete. The rationale for implementation was communicated with regular support to the team. Champions were identified early. The renamed ‘Falls Prevention and Skin Check Chart’ was incorporated into usual practice and aligned with hospice policies.
Results There is now clearer documentation to support incident investigations which in turn supports more individualised care plans for patients. Staff can easily see when patient cares are due. Reported falls are being examined to understand if the chart has contributed to a reduction in rates.
Conclusion Implementation of an adapted IR chart has improved evidence of care and enhanced management support. The use of the PDSA model has ensured a team approach and staff have embraced the change.
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