IMPORTANCE OF THE STUDY. Ward rounding has been a historical clinical method of inter-professional collaboration to support inpatient care through the sharing of mental models by exchanging information and discussing plans of care, treatment goals, and discharge plans for the patient. The extant literature reports that rounds are frequently led by doctors with infrequent nurse-physician collaboration and patients’ interactions with doctors during ward rounds tend to be brief.
OBJECTIVE. To explore the effects of nurse-led morning ward rounds on patient contact time.
DESIGN. An ethnographic prospective observational study comparing nurse-led and physician-led rounds. SETTING. A General Medicine ward at the National University Hospital in Singapore.
INTERVENTION. A pilot intervention of nurse-led ward rounds for one week in June 2014. In the pilot intervention, nurses used the SPICES mnemonic to present their patients’ conditions to the clinical teams during morning rounds.
MEASURES AND ANALYSES. Two observers shadowed the clinical teams for 57 patients. The amount of time that the clinical teams spent at the bedside of each patient was recorded.
RESULTS. The results showed that the average time spent with patients at the bedside was significantly longer for nurse-led rounds compared to physician-led rounds. Also, the average time spent with patients at the bedside trended down toward the end of the 2-hour morning round time for resident-led ward rounds but it remained relatively consistent with an upward trend near the end of the 2-hour morning round for nurse-led rounds.
CONCLUSION. The preliminary data suggests that quality time spent with patients at the bedside during morning rounds may be improved by nurse-led rounds