Nursing Round 6e6w30

Bishwajit Mazumder Nursing Instructor Dhaka Nursing College, Dhaka E. mail: [email protected]

NURSING ROUNDS After the class, the participants will be able to: Describe brief teaching methods of the nursing rounds Know the characteristics of nursing rounds Describe how to construct the nursing rounds method Describe the advantages and disadvantage of nursing rounds method Introduction The practice of nursing grand rounds is a teaching strategy that uses the patients' bedside for direct, purposeful experiences. These experiences may involve demonstrations, interview or discussion of patients problems and nursing care. Rounds also afford an excellent opportunity for exchange of ideas about patient care situations, which may involve clinical faculty, students, and staff. The use of rounds as a teaching strategy requires planning. Planning includes obtaining permission from patients and providing information about the nature of the rounds and the role the patients will play. After the session, patient participation should be acknowledged and some form of debriefing should occur, including planning for subsequent rounds (Billings & Halstead, 2012). According to Phillip (2012) show that Nursing Grand Rounds are one effective method of providing teaching and learning experiences for professional nurses. Through Nursing Grand Rounds nurses collaborate and share ideas about today’s dynamic health care environment and topics relevant to clinical nursing practice (Phillips, 2012). In clinical, the instructor introduced the client to the student, and together they discuss the client's care. The instructor can also use this time to appraise the students' observations, communication, and decision-making skills (Daniels, 2004).

The characteristics of nursing grand round Nursing grand rounds are a means of proving between the nurse director and each individual in nursing service (Marquis & Huston, 1998). According to Gaberson and Oermann (2010) show that Nursing grand rounds involve the observation and often interview of a patient or several patients in the clinical setting, a Webcast of grand rounds conducted elsewhere, or a multimedia program of the grand rounds. (A webcast is a media presentation distributed over the Internet using streaming media technology to distribute a single content source to many simultaneous listeners/viewers. A webcast may either be distributed live or on demand. Essentially, webcasting is “broadcasting” over the Internet). NGR provides an opportunity to observe a patient with a specific condition, discuss assessment and interpretation of data, and propose interventions and changes in the plan of care. Nursing grand rounds may involve nursing students and staff member only or be interdisciplinary. Rounds are valuable for examining issues facing patients, families, and communities and for exposing students to situations they may not encounter in their clinical experiences (Gaberson & Oermann, 2010). Nursing grand rounds also can be used for staff education. The objective of nursing rounds is to bring up-to-date information in monthly educational sessions to nurses worldwide. Their grand rounds are available live in the classroom, via the intranet ((Intranet is the generic term for a collection of private computer networks within an organization. An intranet uses network technologies as a tool to facilitate communication between people or work groups to improve the data sharing capability and overall knowledge base of an organization's employee) and internet, by videotape, and on public access television. They also can be done by independent study via the intranet and Internet. Other settings use grand rounds for highlighting nurses' and clinical expertise and promoting best practices (Iacono, 2008). For grand rounds in the clinical setting, activities at the patient's bedside should begin with an introduction of the patient to students, emphasizing the patient's contribution to student learning. If possible, the person conducting the rounds should include the patient and the family in the discussion, seeking their perspective of the health problem and input in the care. The teacher's role is that of consultant, clarifying information and assisting the student in keeping the discussion on the goals set for the

rounds. Students should direct any questions to the teacher prior to and after the grand rounds, and sensitive issues should be discussed when the rounds are completed and out of the patient's presence (Gaberson & Oermann, 2010). Type of nursing rounds Nursing rounds are a visiting into patient’s area involving the students' learning experiences. Nursing rounds revealed that students responded to this method of teaching with enthusiasm. Their interest in learning increased and they showed ability to share ideas and knowledge with others for the benefit of patients. Nursing rounds are given separate names according to the purpose they serve . a) Information giving rounds : It is used to acquaint the staff with all patients on the ward or division . b) Instructional rounds : Here the nurse is expected to read the charts and come to rounds with basic information in mind . c) Problem solving rounds: This is to help the nursing staff learn to conduct initial interviews make an assessment of patient’s needs and identify nursing care problems . Purposes of nursing rounds: 1. To demonstrate symptoms important in nursing care . 2. To compare the patient’s reaction to disease and study the disease conditions. 3. To demonstrate the effects of drugs i.e. indication , actions and reactions of drugs . 4. To illustrate the skillful nursing care. 5. To compare methods of meeting nursing needs and to have a better understanding and to give more purposeful care to patients. 6. To illustrate successful improvisation and to give opportunity for the use of different applications. Planning nursing rounds in the mind: 1. To consult student’s previous clinical experience to avoid repetition and to add to earlier experience. 2. Keep in mind the probable value and availability of clinical material .

3. If some demonstration is done , it should not have a deleterious effect on the patient. 4. Explain the plan to the patient. 5. Introduce the patient to the group. 6. Make the patient feel important . 7. Have post conference for summary and further explanation . 8. Record the nursing rounds in the ward teaching records with a summary of nursing points stressed. Prepared by the head nurse: 1. Amount participants: a small group of staff or students preferably not more than 4 or 5 and a leader or a teacher visit the bedside of patients. 2. The head nurse selects the patients beforehand according to the time available. Rounds not lost longer than an hour (≤ 1:00). 3. The head nurse needs to read the patient histories, know the plan for their treatment and its results the patient’s progress and prognosis, their nursing care and its effectiveness. 4. The head nurse should post the time for rounds at least a week in advance and indicate the type of preparation the nurse is to make, that in whether she is to know thoroughly the history care and progress of her own patients or briefly that of all patients in the ward. 5. The central figure in nursing round is the patient. Method of Conducting Nursing Rounds: 1/ The hold a brief conference at the side of the patient’s room/ward The necessary data are given. The purpose of the visit to the patient is by the head nurse, special observation to be made or pointed out at this time. 2/ Selected for instruction include 4 to 5 patients. 3/ The head nurse may present some information by herself or she may ask the students who are assigned to these patients to answer the questions of the group or her questions. 4/ The students are asked to present the cases regarding other particulars. The participants may also be involved such as counting pulse, respiration, examining the conjunctive, pitting, edema etc.

5/ Thank patient before leaving and tidy up the bed. 6/ Post Conference The presentation summarizes and further explanation if any, may be given, questions are invited from the students. Advantage - Promote student learning about characteristics of common health problems, team work - Develop students' presentation skill - Increases ability about disease information of patients such as sign, symptom, and manifested in body of patient act. - Increases the learning ability about critical, thinking of the individual students. - Increases interest to share idea and knowledge with others - Increase the relationship between nurses with clients, help patient comfort and feel nature. - Enable students to: + identify patient problems and issues in a clinical situation + Evaluate the effectiveness of nursing in interventions + Share clinical knowledge with peers and identify gaps in their own understanding + Develop new perspectives about the patient' care + Critical thinking about nursing care of their self and given by their peers + Dialogue about patient care and changes in clinical practice with peers and experts participating in the rounds. Disadvantage: - Some time use long time, talk too much when assesses, intervention patient in clinic. It can make patients uncomfortable. - This method will not effectively if teacher, participant did not prepare knowledge before visit patient. Conclusion: Nursing grand round is the effective teaching method in clinical. It can develop learning ability student individual. Teachers can assess the students' competence  teachers provide knowledge and skill in learning process  high quality of care  promotes public health. Nursing grand round provides a great

mentoring opportunity for clinical faculty, allowing development of their teaching skills (Sherrill, 2012). References: Billings, M. N. & Halstead, A. J. (2012). Teaching in nursing: A guide for faculty. (4th Ed) United States of America. Barrette, J. (2004), “Ward Management and Education”, 14th edition, komark publishers Pp:357- 368. Daniels, R. (2004). Nursing Fundamentals: Caring and Clinical Decision-Making. United States of America. Gaberson, B. K., Oermann, H. M. (2010). Clinical Teaching Strategies in Nursing. (3rd Ed). United States of America. Iacono, M. (2008). Showcasing nursing talent: Nursing grand rounds. Journal of Peoria-anesthesia nursing, 23, 349-354. Marquis, B. L. & Huston, C. J. (1998). Management decision making for nurse. (3rd Ed). Philadelphia, Lippincott Williams & Wilkins, New York. Phillips, S. (2012). Nursing Grand Rounds-Nursing report . Retried from http://www.bannerhealth.com/Locations/Arizona/Banner+Good+Samaritan+ Medical+Center/Health+Professionals/For+Nurses/Nursing+Grand+Rounds. htm. Neeraja, K. P. ( 2003 ) “ Text book of Nsg education “ Ist edition , by Jaypee brothers, New Delhi , Pp No : 231-235 . Sherrill, K. J. (2012). Using nursing grand rounds to enforce quality and safety education for nurses competencies. Teaching and learning in nursing.