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Proactive Rounding – Actively Caring. Trudy Reid & Mary Burke Southern HSC Trust. Actively Caring. Southern Health and Social Care Trust Trudy Reid & Mary Burke . Organisation of Care .

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proactive rounding actively caring

Proactive Rounding – Actively Caring

Trudy Reid & Mary Burke

Southern HSC Trust

WSCNTL 2014, Kings Hall

Leading Care, Leading Teams - Innovating and Supporting Person-Centred Care

actively caring

Actively Caring

Southern Health and Social Care Trust

Trudy Reid & Mary Burke

organisation of care
Organisation of Care

The aim of this project is to review and address how nursing / midwifery care is organised and delivered in acute wards / departments, identify areas of best practice and to recognise opportunities to deliver patient safety and improve the patient experience.

phased approach
Phased approach

Two acute Hospital sites

  • Base Line 12 hour Observations of practice
  • Phase 1 – 11 pilot wards
  • Phase 2 - 19 wards across both sites
  • Evaluation included repeat Observations of practice
safe administration of medicines
Safe Administration of Medicines


  • To support individual nurses and midwives achieve safe administration of medicines and reduce inappropriate omitted and delayed medicines


  • Observation of medicines assessment tool
  • Self-assessment
  • Reflective learning
  • Work shop for band 6-7 (39 sisters attended)


  • Observation of practice
  • Audit
  • Reduction in all medication incidents (although incidents may increase initially as awareness heightened)
  • 53% completed self evaluation programme

This work was shared with Nurse Consultant, Clinical Education Centre, who will integrate the elements of this work stream

shift handover
Shift Handover


  • To review how shift handover currently takes place
  • To review the literature on shift handover
  • To provide a standardised approach to shift handover


  • Use SBAR guidance and template or adapt current templates


  • Observation of practice
  • Audit of handover process


  • The principles of the SBAR model of communication for handover are now implemented in all wards, most areas now generated electronically
  • Shift handover observed to be effective – reduction in time of handover - 45 mins – 25mins in MAU and 30mins-15 mins in Surgical admission ward, with only applicable and relevant information communicated
customer care
Customer Care


  • To ensure all staff are aware of their responsibility to inspire public confidence in all aspects of delivery of care

Methodology /Implementation

  • Delivery of PowerPoint presentation
  • Nursing supervision
  • Engaging with staff


  • Evaluation from participants
  • Observation of practice
  • Improve patient/client experience
  • Reduction in complaints


  • Overall total- 764 staff attended (58%)
  • Extended to other areas and disciplines – outpatients/community midwives/AHPs/medical staff (approx. 100)
proactive rounding
Proactive Rounding


  • To ensure that all patients have face to face contact with nursing staff minimum of two hourly


  • Use of proactive rounding tool


  • Observation of practice
  • Patient rounding audit too


Falls reduction by 25% *

‘At first I thought intentional rounding was nothing more than a paper exercise, now I feel it is really beneficial to patient care as now I hardly ever hear a buzzer and all patients are able to tell exactly who their nurse is..’

other elements of organisation of care
Other elements of organisation of care
  • Model of care
  • Prevention of Health Care Associated Infection
  • Roles and Responsibilities
rotational programme
Rotational Programme
  • Induction Programme
  • Competency based Programme
  • Named preceptors
  • Rotational programme
    • ED/MAU
      • 6 months ED 6 months in MAU
    • Trauma/orthopaedics
  • Clinical supervision
lunch learn
Lunch & Learn
  • MDT Learning together
  • Sharing the learning
  • New Initiatives
  • Examples of good practice and areas for development
  • NIPEC Educational Audit
patient safety briefings
Patient Safety Briefings
  • Weekly meeting at ward level
  • New guidance, policies, procedures and best practice
  • Audit feed back including NQI
  • Sharing the learning from complements, complaints, incidents, RCA and SAI
  • Feed back from weekly sisters meetings
  • Correspondence