Structured CNS rounds: Promoting Visibility and Enhancing Patient Outcomes
Topic of Interest
Capture Value of the CNS
Interprofessional Collaboration
Abstract
The onset of the Covid-19 pandemic resulted in reallocation of the CNS team as bedside nurses. Practicing side-by-side with clinicians highlighted needs for expert resources at the microsystem level. After resuming the CNS role, the team restructured its rounding process from a siloed method to a collaborative effort of enhancing visibility while maintaining focus on quality care and outcomes. Using the hospital’s predictive analytics tool as a catalyst, the CNS rounds on identified patients, making recommendations for care. Simultaneously, the CNS ensures best practices are in place to prevent hospital-acquired conditions. The team leveraged technology for efficient, focused data collection.
Utilizing dashboards created within the electronic application, the team quantifies time spent on nursing units and the interventions initiated for enhanced patient care and safety. Additionally, the team conducts ongoing monitoring of nurse-sensitive indicators influenced by the rounding process. Finally, data retrieved from the predictive analytics system allows the team to determine if the interventions put into place affect patient deterioration and prevent failure to rescue.
The revised rounding process brings clinical expertise to the bedside, guiding development of critical thinking and supporting interdisciplinary collaboration. Utilizing bidirectional communication between the CNS and bedside clinician enhances relationships and promotes positive patient outcomes. While the revised process is relatively new, the team continues to monitor improvement in nurse-sensitive indicators addressed during rounds such as central line and urinary catheter associated infections, hospital-acquired pressure injuries, aspiration pneumonia and falls.
Using structured processes while rounding at the patient bedside promotes critical thinking, enhances patient outcomes, and highlights the value of the clinical nurse specialist as a change agent. Staff appreciate the visibility of the CNS as an expert resource and the organization sees the worth through ongoing impact in quality outcomes.