HCA 699 Why should patient values and clinical judgment be included in applying the evidence in clinical decision making for an individual patient? Re: Topic 4 DQ 2

Evidence-based practice is important in improving the overall quality of patient care. Hourly nursing rounds is an EBP used to reduce patient falls at a medical-surgical unit (Flowers et al., 2016). However, implementing the evidence-based practice (EBP) is associated with many challenges acting as barriers (Patel, 2019). Lack of support from the stakeholders such as leaders and nurses, which could enhance the implementation of the project is a major barrier. Nurses have not taken hourly rounds with the seriousness it deserves. Sometimes staff perceives hourly rounds as an option or extra work imposed on them rather than as a daily care activity (Flowers et al., 2016). Staff should change their perception and beliefs regarding hourly rounds to ensure its effectiveness in preventing falls.

In addition, hospital leadership lack support for the hourly rounds. For instance, some leaders view hourly rounds as luxury and encourage it only when the staff has time and not short-staffed (Toole, Meluskey, & Hall, 2016). Furthermore, leaders do not recognize staff members who excel with hourly rounding. Also, leaders in most cases are not involved in the rounding. They should change their perception and hold the mirror for themselves. It is unfair for leaders to expect staff to round every hour when they themselves do not. Nurse participation in organizational activities and quality improvement measures is very important. According to Toole, Meluskey and Hall (2016), nurses are the most significant agents of change in a healthcare setting. However, they cannot succeed without leadership support. These two groups of stakeholders need to work in collaboration to support hourly rounds to reduce falls in the surgical unit.

References

Flowers, K., Wright, K., Langdon, R., McIlwrath, M., Wainwright, C., & Johnson, M. (2016). Intentional rounding: Facilitators, benefits and barriers. Journal of clinical nursing, 25(9-10), 1346-1355. doi: 10.1111/jocn.13217

Patel, N. (2019). Breaking barriers: Implementing evidence‐based practice. Oral Surgery, 12(4), 286-292. https://doi.org/10.1111/ors.12435

Toole, N., Meluskey, T., & Hall, N. (2016). A systematic review: Barriers to hourly rounding. Journal of nursing management, 24(3), 283-290. doi: 10.1111/jonm.12332.