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Title: An ethnographic study to understand the patient and nurse experience of rounding
Author: Langley, S.
ISNI:       0000 0004 5921 1830
Awarding Body: University of Salford
Current Institution: University of Salford
Date of Award: 2016
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Background: Nurse rounding has been widely practiced in the UK since 2012, transferred from the US as a nursing intervention which positively impacts on patient outcomes. Current evidence highlighted a dominance of quantitative studies tentatively linking rounding to impact measures of reduced falls, pressure sore incidence and reduced use of call bells. Outcome measures fail to elicit an understanding of what rounding means from the perspective of the patient or the nurse, moreover applied research evidence in the UK was limited. This study was designed to understand how the practice of rounding impacts on patient experience and nursing care in the NHS. Method: Ethnographic methodology was used to see, listen and talk about rounding with nurses and patients. Data collection involved participant observations (38), nurse (34) and patient (34) interviews alongside the analysis of documentary data across two NHS in-patient wards. Findings: Findings exposed a culture of rounding practice different from the process described in the literature, encapsulated within four themes: Presence, Actioning Care, Playing the Routine, and Engagement. Reduced falls rates and pressure ulcer prevalence were flawed outcomes of rounding practice, rounding had both social and clinical outcomes depending on the person delivering the round, and patients valued the regular presence of the rounder particularly the nurse in charge. The rounding model generated defined the outcomes of nursing rounding. Conclusion: The new knowledge identified rounding practice in its current form was in danger of becoming a tick box exercise with limited impact on patient experience and patient safety. However, recommendations identify opportunities exist for nursing to develop rounding as a mode of care delivery or as a way of offering social presence and engagement to patients. The constituents and constructs of the rounding process need to be further understood to find the true value of the practice to nursing.
Supervisor: Not available Sponsor: Central Manchester Foundation Trust
Qualification Name: Thesis (D.Prof.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available