What is the recent evidence for intentional rounds in the intensive care unit?

Searched CINAHL and PubMed for patient rounds AND (“intensive care” OR “critical care”)  with a limit of English.

Six quasi-experimental studies in CINAHL measuring nurse satisfaction, ventilator-associated pneumonia, cental-line associated bloodstream infection, nosocomial infections, healthcare outcomes, family presence, and facilitators and barriers to patient care rounds
Adding intensive care or critical care eliminates many studies that may also be relevant.

(MH “Patient Rounds”) AND (hourly OR intentional OR proactive OR comfort)
These results include several experimental and quasi-experimental studies. If you want to look at specific outcomes, see the following searches for particular topics:

Falls – (MH “Patient Rounds”) AND (hourly OR intentional OR proactive OR comfort) AND falls

Patient satisfaction – (MH “Patient Rounds”) AND (hourly OR intentional OR proactive OR comfort) AND patient satisfaction

Patient centered care – (MH “Patient Rounds”) AND (MH “Patient centered care”)

Papers in PubMed search: (rounds OR rounding) AND (intentional OR hourly OR time factors OR proactive) AND (nurses OR nursing) AND (safety OR quality improvement OR infection OR pneumonia OR pressure ulcers OR falls OR patient satisfaction OR patient outcome assessment OR outcomes assessments) AND (“intensive care” OR “critical care”)
This search retrieves papers examining common outcomes in the intensive care unit.  Other outcomes can be included in the search.

Reviewed and updated 5/1/2014 ldt

What is the evidence-based research on the type and effectiveness of intentional rounding on inpatient psychiatry units?

The Bottom Line: Intentional rounding can have a positive effect on call light use, patient falls, satisfaction and other criteria.

Searching PsychInfo, CINAHL and PubMed for the concepts of intentional (or hourly) rounding and patient satisfaction produced this sampling of results.

Gardner, Glenn, Measuring the effect of patient comfort rounds on practice environment and patient satisfaction: A pilot study. International Journal of Nursing Practice, Vol 15(4), Aug, 2009. pp. 287-293.

The latest evidence on hourly rounding and rapid response teams in decreasing adverse events in hospitals. Worldviews on evidence-based nursing 2007 vol:4 iss:4 pg:220

Halm, Margo Hourly rounds: what does the evidence indicate? American journal of critical care 2009 vol:18 iss:6 pg:581 -584

Baker, Stephanie. Rounding for outcomes: an evidence-based tool to improve nurse retention, patient safety, and quality of care. Journal of emergency nursing 2010 vol:36 iss:2 pg:162 -164

CHRISTINE M. MEADE, PHD, AMY L. BURSELL, PHD, LYN KETELSEN, MBA, RN Effects of Nursing Rounds on Patients’ Call Light Use, Satisfaction, and Safety

What is the evidence on actively engaging nurses at bedside shift report?

Joanna Briggs Institute’s JBI+COnNECT, an evidence summary source, has published this evidence summary on clinical handover.
Good overview of evidence, but nothing specifically on nurses’ attitudes or how to actively engage nurses in bedside shift report specifically.

PubMed
bedside shift AND (report OR round* OR handover) AND (attitudes OR (nurses AND psychology))
The articles below are from the PubMed search and describe implementation of or changes to shift reports and may be most helpful.

1: Chaboyer W, McMurray A, Wallis M. Bedside nursing handover: a case study. Int
J Nurs Pract. 2010 Feb;16(1):27-34. PubMed PMID: 20158545.

2: Staggers N, Jennings BM. The content and context of change of shift report on
medical and surgical units. J Nurs Adm. 2009 Sep;39(9):393-8. PubMed PMID:
19745636.

3: Athwal P, Fields W, Wagnell E. Standardization of change-of-shift report. J
Nurs Care Qual. 2009 Apr-Jun;24(2):143-7. PubMed PMID: 19287253.

4: Caruso EM. The evolution of nurse-to-nurse bedside report on a
medical-surgical cardiology unit. Medsurg Nurs. 2007 Feb;16(1):17-22. PubMed
PMID: 17441625.

5: Anderson CD, Mangino RR. Nurse shift report: who says you can’t talk in front
of the patient? Nurs Adm Q. 2006 Apr-Jun;30(2):112-22. PubMed PMID: 16648723.

6: Philpin S. ‘Handing over’: transmission of information between nurses in an
intensive therapy unit. Nurs Crit Care. 2006 Mar-Apr;11(2):86-93. PubMed PMID:
16555756.

7: Manias E, Street A. The handover: uncovering the hidden practices of nurses.
Intensive Crit Care Nurs. 2000 Dec;16(6):373-83. PubMed PMID: 11091469.

CINAHL search:  bedside AND shift AND (report OR round* OR handover) AND (attitudes OR (nurses AND psychology))
Limited to English and Peer-reviewed,   Excluded records that are also in Medline (PubMed)
Retrieved one additional record that includes a survey of nurses’ attitudes.
Communication at the bedside to enhance patient care: A survey of nurses’ experience and perspective of handover.Detail Only Available (includes abstract); Street, Maryann; Eustace, Paula; Livingston, Patricia M; Craike, Melinda J; Kent, Bridie; Patterson, Denise; International Journal of Nursing Practice, 2011 Apr; 17 (2): 133-40.

The fulltext for this article is available through the JBI+  journals page.

What are the best practices for reducing restraint use in medical and geriatric psychiatric units?

Systematic reviews

Mechanical restraint-which interventions prevent episodes of mechanical restraint?-a systematic review. Bak J, Brandt-Christensen M, Sestoft DM, Zoffmann V.  Perspect Psychiatr Care. 2011 Apr 19.

Interventions for preventing and managing aggressive patients admitted to an acute hospital setting: a systematic review.  Kynoch K, Wu CJ, Chang AM.  Worldviews Evid Based Nurs. 2011 Jun;8(2):76-86.

Special care units for dementia individuals with behavioural problems.  Lai CK, Yeung JH, Mok V, Chi I.   Cochrane Database Syst Rev. 2009 Oct 7;(4):CD006470.

Interventions to reduce the use of seclusion and restraint in inpatient psychiatric settings: what we know so far a review of the literature.  Scanlan JN.  Int J Soc Psychiatry. 2010 Jul;56(4):412-23.

Changing the practice of physical restraint use in acute care.  Park M, Tang JH.
J Gerontol Nurs. 2007 Feb;33(2):9-16

A systematic review of the safety and effectiveness of restraint and seclusion as interventions for the short-term management of violence in adult psychiatric inpatient settings and emergency departments.  Nelstrop L, et al.  Worldviews Evid Based Nurs. 2006;3(1):8-18.

Other recent studies on reducing restraint use:

The effect of staff training on agitation and use of restraint in nursing home residents with dementia: a single-blind, randomized controlled trial.  Testad I, Ballard C, Brønnick K, Aarsland D.  J Clin Psychiatry. 2010 Jan;71(1):80-6.

A cluster-randomized trial of an educational intervention to reduce the use of physical restraints with psychogeriatric nursing home residents.  Huizing AR, Hamers JP, Gulpers MJ, Berger MP.  J Am Geriatr Soc. 2009 Jul;57(7):1139-48.

 

Is use of color in the healthcare environment effective at reducing the rate of falls in inpatients?

Bottom line:  No published research has been identified on the use of color  in hospital settings to reduce falls other than to alert healthcare staff, but there is research on the ability to perceive color in adults with visual impairment, which affects many older patients.

Summary:  For a review of perception of color and discussion of implications for healthcare environments, see
J Clin Nurs. 2009 Feb;18(3):366-72.
Källstrand-Ericson J, Hildingh C. Visual impairment and falls: a register study.
Discussion on p. 369 includes review of literature on color perception in visual impairment.

Searched Joanna Briggs, PubMed, CINAHL, and Web of Science

Reviewed 4/9/2014 ldt

What is the prevalence of falls for hospitalized psychiatric and geriatric patients?

Observational studies:

Enloe M, et al.  Falls in Acute Care: An Academic Medical Center Six-Year Review.  J Patient Safety.  2005; 1(4): 208-214.
Retrospective study of falls at an academic medical center over 6 years.  RESULTS:  Table 2 shows the unadjusted annual fall rates were 5.86/1,000 patient days on the psychiatry units and Table 3 shows that broken down by age (regardless of service the patient was on), the fall rate for patients age 55-74 was 2.90/1,000 patient days and the rate for patients ages 75 and older was 4.08/1,000 patient days.

Schwendimann R, et al.  Characteristics of hospital inpatient falls across clinical departments.  Gerontology. 2008;54(6):342-8
Prospective study at 1,300 bed academic hospital over 13 weeks.  RESULTS:  Rate of falls on geriatrics units was 10.7/1,000 patient days.

Kerzman H, et al.  Characteristics of falls in hospitalized patients.  J Adv Nursing 2004; 47(2), 223–229.
Retrospective study of falls at a 2000-bed medical center in 1998.  RESULTS:  The rates of falls was 115/1,000 hospital admissions in the geriatric wards and 91 per 1,000 admissions in the psychiatric wards.  Rates per 1,000 inpatient days were not reported.