Hi Germaine!
Our hospital has also just adopted the hourly rounding concept. Hourly rounds are done by the RN or CNA who are mom and baby's primary nursing care providers. I've heard the history behind hourly rounding and how it has been perceived as positive by patients, but I do wonder if it's effectiveness and enhancement of patient satisfaction was assessed with mother/baby couplets!
In our hospital, it is only the RN/CNA who do the rounds, so in my role as LC, though I have always asked moms if they have any needs before I leave the room, I am not part of the hourly rounding team. Basically I think this just results in more frequent interruptions, which, so far, hasn't seemed to be well appreciated by the moms (strangely, moms would prefer not to be interrupted MORE often, imagine that!)
As far as catching babies before they feed vs after - I tell moms to call and ask for me when baby is next ready to feed. I have found that those moms who are having any kind of difficulties or concerns will definitely call me. So far, in my experience, the moms who do not call me before the baby next feeds are the ones who are happy with how the feeds are going and don't feel a need for LC support. Granted this does not mean that there are no issues, just that the mother doesn't see any issues.
However, all I do is ensure that moms know I'm available, I tell them when I'm leaving for the day so that they have an idea of how long I'll be available, I also tell them that there is a chance I'll be busy with another mom, but I will do my best to see them.
The biggest problem I've had with hourly rounding is that, since the implementation of hourly rounding, I am seeing far more signs on doors that insist on no interruptions (we've always had these, but I used to see them far less frequently). Now with all the interruptions, the only way a mom can get any rest is to place these signs on the door, and, in conjunction with her nurse, they can declare a certain period where they do not receive hourly rounds. When I see this sign, I do NOT go in the room (I certainly don't want to be the one to wake her when she is expecting no disturbance), but that also means that I can't touch base with mom to let her know to call me when she is ready! This has created quite a challenge.
The only solution I've found is to emphasize to mom's nurse, very early in my shift, that mom should call me when baby is ready to feed.
Ok, so perhaps I haven't any useful solutions to share, only frustrations!!!
Casey Clubb, RN, IBCLC
West Linn, OR, USA
Original post:
Hello, and happy spring. Our hospital has now initiated that the staff rn
do purposeful rounding ( hourly rounding) every shift. The reason is to
enhance patient satisfaction, reduce falls,reduce the numbers of calls to
the desk, reduce noise level, reduce pain and prevent bed sores. IN the ob
unit some of these issues are less of a concern, but we do have falls, pain,
dissatisfied customers, noise, and calls to the desk. . Well, my question
is to the lc's who do purposeful rounding , what do you do to reduce patient
dissatisfaction.. when you want to assess a infant feeding and infant has
just been fed, and you tell the mother to call nurse to page you and they
forget,so that the next time you see them if at all the infant has just
been fed. Do you make appointments? do you put up a sign that says "call lc
for feeding, please" Any suggestions are appreciated. thank you Germaine
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