Daily Charge Nurse Leader Rounds on a Cardiac Surgery Progressive Care Unit

Abstract

Problem: Patient satisfaction is the measure of the success of a healthcare system in today’s competitive markets. However, achieving patient satisfaction relies on multiple internal and external factors. The Cardiac Surgery Progressive Care Unit (CSPCU) at an urban medical center in the mid-Atlantic United States was seeking to improve their patient satisfaction scores on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCHAPS) data. Purpose: The purpose of this quality improvement project (QI) was to implement and evaluate the effectiveness of daily charge nurse leader rounds on patients admitted to a CSPCU. It is anticipated that there will be an increase in the total number of times a nurse leader rounds on a patient that subsequently will result in in an increase in patient satisfaction as measured by HCAHPS nurse communication scores. Methods: The QI project was implemented over a 14- week period in a CSPCU at an urban Maryland academic Medical Center. Charge nurses were educated on the process change and then completed ‘charge nurse leader’ rounds. The project leader checked the rounding rates bi-weekly. Nurse communication scores were collected preand- post implementation using the scores from the HCAHPS surveys. Results: The number of patients rounded on daily over the course of the project was 64.7% and during the implementation period a total of 1140 rounds were completed. The HCAHPS scores increased in the category of ‘RN explanation’ and slightly decreased in the categories of ‘RN listening’ and “RN courtesy”. Patients’ perception of the nurse leader rounding increased from 79.64% to 87.23%. Conclusions: Charge nurses can be utilized as informal leaders to complete nurse leader rounds. Leader rounds are able to be incorporated into the daily routine of the charge nurse. Patient satisfaction scores are impacted by many different factors. The increase seen in one domain of HCAHPS indicates that further studies should be completed to better understand how nurse leader rounds impact patient satisfaction.