137 - Impact of a Formal Nursing Role On Nursing Satisfaction and Presence on Family Centered Rounds

Poster Number: 137
Publication Number: 137.1453

Background: AAP policy recommends family-centered rounds (FCR) performed at bedside with the medical team and family as standard practice. As FCR has become more widespread, the role for the bedside RN has not been as well defined (3). The benefits of interdisciplinary bedside rounds on patient satisfaction and team communication have been demonstrated in various settings, but the effect of a formal role for bedside RNs is unknown (4-5). At our institution, FCR was reimplemented in 2019. The first phase involved physician education, the creation of physician rounding roles, and a checklist system. After implementation, resident satisfaction and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores both improved. However, RN participation in FCR remained low, with a RN present 12% of the time. In an effort to increase RN presence, a second phase was implemented during which RNs were notified prior to rounding on their patients. With this intervention, RN presence on rounds increased, but was still below the goal of 80%.

Objective: Over a 6-month period we aimed to reach RN presence of 80% on FCR. We also aimed to increase the percentage of RNs reporting satisfaction and feeling of engagement on rounds to 80%.

Design/Methods: A standardized RN role was created to increase active participation on rounds. RNs and physicians were surveyed to identify which information was most important to be reported, and it was decided the RN was to provide this update after the subjective portion of the intern’s oral presentation. Education was provided to residents in a lecture, and RN managers distributed information on this role via email and huddles to RNs.

Results: RN presence improved to 85% following introduction of the RN role, with a mean presence of 71% during the study period. Post intervention, 66% of RNs were satisfied with FCR, and 56% of RNs felt actively engaged in rounds. 82% of RNs reported a formal RN role enhanced communication amongst the team. After intervention RNs reported their questions were answered 95% of the time, and 96% felt the families’ questions were better answered.

Conclusion(s): A formal role for bedside RNs successfully increased bedside RN presence. Unfortunately, while education and re-education successfully led to goal increases in RN presence, these were not sustained over time. Additionally, despite this increased presence, we did not see a change in satisfaction with FCR or feelings of engagement among RNs, but we did find improved RN perceptions of communication between doctors with RNs and families.