Ashley Wright BSN, RN
Bronson Methodist Hospital (BMH)
Ms. Wright is a staff nurse on the Mother-Baby Unit of Bronson Methodist Hospital (BMH) in Kalamazoo, MI where she has worked since 2012. Ashley was instrumental in the development of the initial hourly rounding policy for the hospitalâ??s general medical units. Her work with the development of this policy was the impetus for the study for which she is being recognized. "Anticipatory Rounds: Perspectives of Postpartum Patients, Staff Nurses, and Nursing Leadership" is her first venture into research, which asks the questions "What are the most relevant nursing interactions when performing anticipatory rounds with patients on the Mother-Baby Unit?" And "what is the most appropriate frequency of anticipatory rounds at which relevant nursing interactions are performed?" Given her success, she plans to continue her studies, ultimately obtaining a PhD in Nursing Education and Research. Currently Ms. Wright chairs the OB Clinical Quality Council, and is a member of the OB policy and procedure committee. She also serves as a representative for OB at the Shared Governance Council and participates in the house-wide Clinical Quality Council. She holds the highest level (IV) on the Nursing Professional Advancement Ladder.
Purpose: The purpose of this study is to obtain the perspectives of postpartum patients, postpartum staff nurses and maternal-child nursing leaders regarding the relevance and timing of nursing interactions undertaken during anticipatory rounds on the Mother-Baby Unit.
Background/Significance: Patient safety and quality have always been a concern but gained national spotlight in 1999, when the IOM published To Err is Human: Building a Safer Health System. Nurses play a key role in addressing patient safety and quality. One strategy to address safety that has received considerable attention is anticipatory rounds on patients. Meade et al. (2006) were the first to evaluate the benefit of nursing rounds. They defined nursing rounds as rounds every hour on the patient by a nurse focusing on the "three ps" [pain, potty and positioning]. Following initiation of the hourly rounds practice, call light usage decreased, patient satisfaction scores increased. Since Meade et al.'s work in 2006, the practice of rounds on patients has received increasing attention. Although inspection of research findings demonstrates anticipatory rounds, also known as intentional, hourly, or comfort rounds, have been successful in medical-surgical units, there is minimal research regarding anticipatory rounds in the postpartum population. It is possible patients on the postpartum unit may require interventions different from patients on other units in the hospital. Since there is limited evidence regarding the needs of the postpartum population, exploring what patients, staff and leaders perceive to be the most relevant and timely interactions will contribute to a better understanding of patient needs, and help guide nursing practice.
Methods: A qualitative descriptive design using focus groups is proposed. The setting is a 405 bed hospital with 3400 births per year. Purposeful sampling will be employed. Three different perspectives will be obtained: staff nurses, leadership and patients. For staff nurses and patients, at least three focus groups will be conducted. Given the limited number of people in leadership, there will only be one focus group. Patients will be approached while still in the hospital and invited to participate. Staff nurses will be recruited by means of flyers announcing the study, a letter in their mailbox and an email sent to them. Leadership will be invited by means of a personal letter from the investigator.
Nursing Relevance/Implications: Nurses play a pivotal role in addressing patient safety and quality. This study addresses a gap in knowledge regarding key interactions during the postpartum period. The information obtained will guide the type and timing of interactions designed to avert significant safety issues and to increase the quality of care provided.