NURSE LEADER ROUNDING ON PATIENTS CHECK LIST



UNIT: Staff: Date:

Manager: Coach:

|STEPS |Room/Bed |Room/Bed |Room/Bed |Room/Bed |

|Check with staff (Priority patients to be seen, process | | | | |

|success, issues, patient concerns/complaints) | | | | |

|Relationship Building: Personal connection from the nurse | | | | |

|Begin Rounding | | | | |

|Acknowledge & Personal Connection | | | | |

|Introduce Family inclusion (with permission) | | | | |

|Duration of Rounding | | | | |

|Explain Process & Why (key words – Our goal is to provide you | | | | |

|with very good care…) | | | | |

|White Board review (include Very Good Care items) DESIRED PAIN| | | | |

|LEVEL ON WHITE BOARD | | | | |

|Manage Up (staff, organization, MD,etc) | | | | |

|Safety – (hand washing, fall precaution follow up, wrist band | | | | |

|checks) | | | | |

|Key drivers from survey addressed | | | | |

|(Dig deeper – Survey issues) | | | | |

|Key Words used relating to survey | | | | |

| Validate staff behaviors (eg. need call light in last 24 | | | | |

|hrs,pain managed, intro themselves, etc) | | | | |

|Identified Staff/physicians to be recognized | | | | |

| If Discharge – (introduce survey) | | | | |

| Hourly Round: complete tasks (environmental assessment, | | | | |

|validate tasks done, log signed) | | | | |

|Request permission to check bathroom (KW- Consistent & VG) | | | | |

| Give Business Card | | | | |

|Closing Statement: “Is there anything else…” | | | | |

| Sign Hourly Rounding log (use red & circle anything | | | | |

|questionable) | | | | |

|Thank the patient | | | | |

|Ask self: What did I learn about the quality of care delivered? How hardwired are behaviors? |

|Log Rounding information | | | | |

|Coach every staff member post rounding (R&R, S-C-S, DESK) | | | | |

|Complete follow up on any issues identified & report back to | | | | |

|patient | | | | |

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May 2004:Observation Form

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