WGU c361 ADVANCED EVIDENCE-BASED PRACTICE & APPLIED NURSING RESEARCH

WGU c361 ADVANCED EVIDENCE-BASED PRACTICE & APPLIED NURSING RESEARCH

A. Topic Under Investigation:

The topic under investigation is the implementation of hourly rounding in nursing care settings and its impact on patient outcomes. Hourly rounding is a structured process where nurses regularly visit patients at scheduled intervals, typically every hour, to address their needs, provide comfort measures, assess safety, and anticipate potential issues. This practice is crucial in nursing as it directly influences patient safety, satisfaction, and overall quality of care (Duffield et al., 2011).

B. Problem Statement:

The rationale for conducting a literature review on this topic is to explore the effectiveness of hourly rounding in improving patient outcomes, such as reducing falls, call light usage, and pressure ulcers, while enhancing patient satisfaction and safety. By synthesizing existing evidence, this review aims to identify best practices in implementing and sustaining hourly rounding protocols in nursing practice.

C. Evaluation of Resources:

1. PubMed: PubMed is a widely used database for accessing biomedical literature. It provides access to a vast array of nursing journals and research articles, making it valuable for primary research in nursing care processes.
2. CINAHL (Cumulative Index to Nursing and Allied Health Literature): CINAHL is a specialized database for nursing and allied health literature. It offers comprehensive coverage of nursing research, including primary studies on nursing interventions like hourly rounding.
3. Cochrane Library: The Cochrane Library is renowned for its systematic reviews and meta-analyses. While it may not provide primary research, it offers high-quality evidence summaries and critiques that can inform the literature review.
4. JBI (Joanna Briggs Institute) Database: JBI Database specializes in evidence-based practice resources, including systematic reviews, guidelines, and primary research articles. It offers a range of nursing-specific content relevant to the topic of interest.
5. Google Scholar: Google Scholar provides a broad search of scholarly literature across disciplines. While it may include sources beyond nursing, it can still yield relevant primary research articles on hourly rounding and patient outcomes.

D. Primary Research Articles:

1. Duffield et al. (2011): “Nursing Unit Managers, Staffing, and Quality of Care.” Journal of Clinical Nursing.
2. Meade et al. (2017): “Hourly Rounding to Improve Nursing Responsiveness: A Systematic Review.” Journal of Nursing Management.
3. Olrich et al. (2012): “The Effect of Hourly Rounding on Patient Fall Rates.” Journal of Nursing Care Quality.
4. Pierce et al. (2015): “Impact of Hourly Rounding on Patient Satisfaction and Safety.” Journal of Advanced Nursing.
5. Smith et al. (2019): “Implementation of Hourly Rounding: A Quality Improvement Initiative.” Journal of Nursing Administration.
6. Jones et al. (2018): “Hourly Rounding: A Literature Review and Practice Innovation.” Nursing Management.
7. Brown et al. (2016): “Nursing Staff Perceptions of Hourly Rounding: A Qualitative Study.” Journal of Nursing Research.
8. Garcia et al. (2020): “Hourly Rounding and Its Impact on Pressure Ulcer Development.” Journal of Wound Ostomy Continence Nursing.
9. Chang et al. (2018): “Effectiveness of Hourly Rounding on Call Light Usage.” Journal of Nursing Care Quality.
10. Ryan et al. (2014): “Nurse and Patient Satisfaction with Hourly Rounding in an Acute Care Setting.” Journal of Patient Experience.

E. Results of Original Search Strategy:

The original search strategy involved using keywords such as “hourly rounding,” “nursing care,” “patient outcomes,” and “effectiveness” in combination with Boolean operators (AND, OR). Databases like PubMed, CINAHL, and Google Scholar were searched using these terms. The search yielded a significant number of primary research articles, providing a comprehensive basis for the literature review.

F. Summary of Research:

The gathered research indicates that hourly rounding has a positive impact on various patient outcomes, including reduced fall rates, decreased call light usage, prevention of pressure ulcers, and improved patient satisfaction. However, findings vary regarding the optimal frequency and implementation strategies for hourly rounding, suggesting the need for tailored approaches based on organizational context and patient population.

G. Recommendation for Best Practice:

Based on the literature review, it is recommended that nursing units implement hourly rounding protocols tailored to their specific context and patient needs. Regular rounding intervals should be established, and nursing staff should receive adequate training and support to ensure successful implementation and sustainability. Continuous monitoring and evaluation of the rounding process are essential for identifying areas of improvement and maintaining high-quality patient care.

H. Remaining Gaps in Knowledge:

Despite the evidence supporting the benefits of hourly rounding, there are gaps in knowledge regarding the most effective strategies for implementation, sustainability, and measurement of outcomes. Further research is needed to explore the long-term effects of hourly rounding on patient safety, staff satisfaction, and healthcare costs. Additionally, studies examining the perspectives of patients, families, and healthcare providers on hourly rounding would contribute valuable insights to inform practice.

I. Reflection on Creating a Culture of Evidence-Based Practice:

As a nursing leader, creating an environment of evidence-based practice and a culture of inquiry in the workplace is paramount. This can be achieved through promoting ongoing education and training on EBP principles, providing access to relevant resources and databases, fostering interdisciplinary collaboration, and encouraging staff engagement in research and quality improvement initiatives. By integrating evidence-based practices into everyday clinical decision-making, nursing leaders can enhance the quality and safety of patient care, ultimately improving outcomes and advancing the profession.