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/clinical/nursing-hub/tools/bedside/promote-action/resources/Leader-Rounding-Tool-for-Adult-Inpatients-2-2015.pdf

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Clinical Hub,Nursing Hub,Nursing Practice Tools and Resources,Bedside Shift Report,Promoting Action and Adoption,Resources

Leader Rounding Tool for Adult Inpatients

Leader Rounding Tool for Adult Inpatients - Clinical Hub, Nursing Hub, Nursing Practice Tools and Resources, Bedside Shift Report, Promoting Action and Adoption, Resources


1/29/2015

Leader Rounding Tool for Adult Inpatients
Good Morning or Afternoon, my name is _________ and I am the nurse manager on this unit. I am visiting with you today because I am interested in finding
how about your hospital stay. Would you mind answering a few questions?
I see your nurse is _______ she/he is excellent and they will take good care of you.


Date of Round
Patient 1


Patient 2 Patient 3 Patient 4 Patient 5 Patient 6 Patient 7 Patient 8
Are the staff doing a good job of keeping you
informed?
Yes No

Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Has anyone from the nursing staff explained
hourly rounding to you?
Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Has anyone talked to you about keeping you safe
from falling while in the hospital? Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Do the nurses conduct change of shift report in
your room? Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Do you have any concerns that you would like to
discuss with me about your hospital stay? Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Is there anybody you would like to acknowledge
that has been especially helpful?
Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Is there anything I can do for you right now to
make you more comfortable? I have the time. Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Observation: Was discharge date recorded on
white board? Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Observation: Was discharge time recorded on
white board? Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Unit Specific Question 1:

Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Unit Specific Question 2:

Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Unit Specific Question 3: Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
Comments


Enter results into survey monkey before the 4th of the following month: http://www.surveymonkey.com/s/V3979VX