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 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.

 

Patient and family centered care

Bottom Line: PFCC is an original approach to p health care that is mutually beneficial among patients, families, and providers.

Digioia Care Experience-based Methodologies: Performance Improvement Roadmap to Value-driven Health Care. Clinical orthopaedics and related yr:2011

Vermoch Benchmarking patient- and family-centered care: highlights from a study of practices in 26 academic medical centers. Journal of healthcare risk management yr:2010 vol:30 iss:2 pg:4 -10

Guion Development of a concept map to convey understanding of patient and family-centered care. Journal for healthcare quality yr:2010 vol:32 iss:6 pg:27 -32

Brown Patient and family-centred care for pediatric patients in the emergency department. CJEM. Canadian journal of emergency medical care yr:2008 vol:10 iss:1 pg:38 -43

O’Malley Patient- and family-centered care and the role of the emergency physician providing care to a child in the emergency department. Annals of emergency medicine yr:2006 vol:48 iss:5 pg:643 -645

Boise The family’s role in person-centered care: practice considerations. Journal of psychosocial nursing and mental health services yr:2004 vol:42 iss:5 pg:12 -20

Hooper Patient-family centered care: are we there yet? Journal of perianesthesia nursing yr:2008 vol:23 iss:6 pg:440 -442

What effect does standard clinical attire to help patients recognize different caregivers have on patient satisfaction?

Search Methods
Searched PubMed and CINAHL for combinations of the following concepts:
dress OR attire OR uniforms
patient satisfaction
patient attitudes or perception
allied health personnel
patient care team
identification
nurse’s role

Search Results
Below are selected studies applying mostly to a general patient population. There are also studies about specific patient populations, such as behavioral health units.

PubMed
Relevant studies are in this PubMed collection.
These are observational studies of patient’s perception of nursing attire.

CINAHL
Title: An evidence-based approach to creating a new nursing dress code: a survey of patients reveal what nurses should — and shouldn’t — wear.
Authors: Windle L ; Halbert K ; Dumont C ; Tagnesi K ; Johnson K
Source: American Nurse Today (AM NURSE TODAY), 2008 Jan; 3(1): 17-9

Title: Dress code debate.
Authors: Kaser M ; Bugle LW ; Jackson E
Source: Nursing Management (NURS MANAGE), 2009 Jan; 40(1): 33-8
COMMENT: This small study included 20 patients and their family members and 12 nurses who represented children’s units. The preference of being able to distinguish nurses from other healthcare staff did come up in this study.

Title: Use of non-conventional nurses’ attire in a paediatric hospital: a quasi-experimental study.
Authors: Festini F ; Occhipinti V ; Cocco M ; Biermann K ; Neri S ; Giannini C ; Galici V ; de Martino M ; Caprilli S
Source: Journal of Clinical Nursing (J CLIN NURS), 2009 Apr; 18(7): 1018-26
COMMENT: Investigates parents and children’s (N=112) attitudes toward multi-colored v. white uniforms for nurses. Parents expressed preference for being able to distinguish nurses from other staff.

Title: True colors: more hospitals turn to standardized attire for nurses to better identify them to patients and to polish their professional image.
Authors: Gaskill M
Source: NurseWeek (15475131) (NURSEWEEK (S CENTRAL)), 2004 Oct 4; 11(21): 20-1

Reviewed and updated 4/16/2014

Are there studies on management of pain not related to surgery in postoperative patients?

There are no studies addressing management of pain not related to surgery in postoperative patients.

Search Method

Searched PubMed, CINAHL, and EMBASE for different combinations of these concepts:

  • Pain – etiology, drug therapy, prevention and control
  • Postoperative period or postoperative care
  • Rehabilitation OR physical therapy OR physiotherapy
  • Factors that interfere with rehabilitation (looked for these terms:  interfere* OR delay* OR prohibit*)
  • Arthroplasty/rehabilitation
  • Comparative study or clinical trial or cohort study or prospective study

Reviewed 4/29/2014 ldt