1. Lockhart, Lisa MHA, MSN, RN, NE-BC

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Q: Why are nurse leader rounds important to patients and staff?

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A: Leadership rounding is a concept that's gained momentum in nursing. The time that a nurse leader spends with staff has a direct effect on retention, recruitment, engagement, staff satisfaction, and, ultimately, patient satisfaction and care quality. Rounding is "the process of visiting patients, nurses, and healthcare team members in patient care areas on a consistent basis for the purpose of engaging in meaningful conversations about their care or the nature of their work and suggestions for improvements."


First, let's ask ourselves, what constitutes a meaningful conversation? For the patient, we can focus on safety, perception of experience, cleanliness, wait times, pain control, and communication with healthcare providers. For staff members, leadership rounding is an opportunity for the nurse leader to witness adherence to safety initiatives and the use of communication tools, such as white boards and call lights. The nurse leader is present for handoff, bedside reporting, and the hardwiring of new processes and policies, and can work through the issues encountered by staff members during provision of care. The nurse leader can give feedback in real time and engage staff members in problem resolution. As a team, the nurse leader and staff members can examine why a process is or isn't working and determine what barriers exist to successful implementation.


Useful questions for the nurse leader to ask staff members during purposeful leadership rounds include:


* Do you have the equipment you need to do your job?


* Do you have any safety concerns?


* Are you having issues with other departments or services?


* Is there anyone you wish to recognize?


* What can I do to assist you?



Leadership rounds should be consistent and engrained in the nurse leader's routine. Rounding on patients should occur daily, with all patients on the unit if possible. If the unit is a procedural area, the nurse leader may round at different times of day. Typically, rounds shouldn't exceed 15 minutes per patient. Staff members may round with the nurse leader, but it isn't essential. Rounding on staff should be done in a quiet space for one-on-one time and limited to approximately 30 minutes. Group rounding on the unit can be occur any time of day or night. Rounding should be somewhat structured in that it's a hardwired process with a set of questions but spontaneous enough to be natural and comfortable for all involved.


When done consistently and with intention, engaging in leadership rounding is a solid evidence-based approach to driving safety and improving patient and staff satisfaction.




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