740 - Family-Centered Rounds (FCR): Impact of Increased Bedside Nursing Presence on Nurse Satisfaction

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 740
Publication Number: 740.414

Audrey E. Wagner, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Katelyn Benson, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Donna Koscielniak, John R. Oishei Children's Hospital, Buffalo, NY, United States; Joann M.. Pilliod, John R. Oishei Children's Hospital, Kenmore, NY, United States; Audrey F. DeMaria, Oishei Childrens Hospital, Orchard Park, NY, United States; Kara Oliver, John R. Oishei Children's Hospital/ University at Buffalo, Amherst, NY, United States; Anna Hays, Oishei Childrens Hospital, University at Buffalo, Buffalo, NY, United States

Presenting Author(s)

Audrey E. Wagner, MD (she/her/hers)

Incoming Pediatrics PGY1
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States

Background: In 2003, an American Academy of Pediatrics policy statement defined family-centered care and its benefits. Conducting medical team rounds in patient’s rooms with family present, or family-centered rounds (FCR) was recommended as standard practice. Interdisciplinary family-centered care can increase patient, family, and professional satisfaction as well as improve communication and resource utilization (1-3). Bedside nurse (RN) presence is an integral part of the FCR model. At the John R. Oishei Children’s Hospital, FCR was reimplemented using quality improvement methodology in 2019. This initially involved education and training for physicians and RNs, the creation of physician rounding roles and a checklist system. After implementation, we found increased physician satisfaction with rounds, and increased Consumer Assessment of Healthcare Providers and Systems scores, yet RN participation remained low with only 12% present on FCR.

Objective: Over a 6-month period, we aimed to increase RN presence on FCR, RN satisfaction, and feelings of active engagement to 80%.

Design/Methods: RN managers provided the physician team with a daily list of RN ASCOM numbers and patient assignments. Pediatric clerkship students called bedside RNs prior to rounding on the patient. Daily RN presence on FCR was tracked by direct medical students at random intervals over from September 2021 to March 2022 both before (n=22) and after (n=47) the intervention. Average daily RN presence (%) was calculated. An electronic survey was collected from nursing staff before (n=28) and after (n=20) the intervention. Select questions assessed satisfaction with the rounding format, barriers to attendance, feelings of active engagement in rounds, and desire for a defined role in FCR.

Results: Nursing presence improved from 12% to 62% following the call intervention. The most common barrier to RN presence was engagement in patient care tasks. Pre-intervention, 29.6% of RNs were satisfied with the rounding format, and 30.8% of RNs felt actively engaged in rounds. Post-intervention, RN satisfaction with FCR format increased to 65%. Feelings of active engagement increased to 50%.

Conclusion(s): Having medical students call RNs prior to rounding on their patients successfully increased RN presence on rounds, RN satisfaction with FCR, and RN engagement. However, we were unable to achieve our goals of 80% presence, satisfaction, and feelings of active engagement. Next steps include further surveys to address barriers to RN presence on FCR as well as implementing a formal portion of FCR dedicated to nursing updates to create a standard active role.