Call for improved ward rounds

Published: 04 October 2012

A nurse should be at every bedside to help improve the quality of ward rounds, according to a joint report by the Royal College of Nursing and the Royal College of Physicians.

The recommendation came as the colleges called for a “concerted culture change” with clinical staff, managers and hospital executives engaging with, and focusing on, improving the quality of ward rounds.

Nurses provide the hub of patient care, and their involvement in a daily bedside clinical review is central to the effectiveness of the ward round. Doctors use ward rounds to form the basis of their decision-making for a patient’s care – but at present, in many places, other members of the multidisciplinary team are not present.

Steve Jamieson, Head of the RCN’s Nursing Department, said ward rounds are a key way of co-ordinating care for every hospital inpatient.

He said: “There is considerable variation between hospitals in both how and why ward rounds are conducted, and their clinical importance to patients. But the information gained and shared during a ward round is crucial to a patient’s ongoing care.”

Other recommendations in the report include:

• preparation for the ward round should include a pre-round briefing
• consultant-led ward rounds should be conducted in the morning to facilitate completion of tasks during the working day
• patients, carers and relatives should be provided with a summary sheet clearly presenting information discussed in the ward round
• patients with dementia and learning disabilities should be supported as far as possible to make decisions about their care
• patients’ records should be kept centrally to promote effective communication and team working
• ward-round teams should utilise locally adapted checklists to reduce omissions, improve patient safety and strengthen multidisciplinary communication.

With competing priorities for both time and staff, teams – right up to managers and executive boards – must ensure that ward rounds remain a priority, the report says. Reinstating ward rounds will facilitate the delivery of compassionate care, enabling doctors and nurses to plan for care jointly.

Read Ward rounds in medicine: Principles for best practice (PDF 2MB) [see how to access PDF files].