KEY WORDS POTENTIAL CONFLICT OF INTEREST:The authors have indicated they have no potential confl icts of interest to disclose.A Quality Improvement Initiative to Achieve High Nursing Presence During Patient-and Family-Centered Rounds abstract OBJECTIVES: The objectives of this study were to: (1) identify local barriers to nursing presence on patient-and family-centered rounds (PFCR); and (2) increase nursing attendance during PFCR. METHODS:An electronic survey needs assessment was administered to nursing staff on a single acute medical care unit to identify local barriers to nursing presence on PFCR. Daily tracking of nursing presence on rounds was then performed over a 7-month period. During this time period, 2 Plan-DoStudy Act cycles were conducted. The fi rst intervention was a workshop for nurses about PFCR. The second intervention was the development of a strategy to contact nurses by using a hands-free communication device so that nurses were notifi ed when rounds were starting on their patients. To evaluate the impact of our interventions, a p-chart was generated for the outcome of average daily nursing attendance (%) on PFCR per week over the 7-month period. RESULTS:Two barriers identifi ed on the survey were: (1) nurses were uncertain if physicians valued their input during PFCR; and (2) nurses were unsure when the physician team would be conducting rounds on their patients. On the p-chart, the average percentage of nursing attendance before interventions was 47%. After the nursing workshop, no change in the mean nursing attendance on PFCR was noted. After initiation of the hands-free contact strategy, nursing attendance on PFCR rose to 80%. CONCLUSIONS:A nursing contact strategy using a hands-free device led to a sustained increase in nursing attendance during PFCR.Patient-and family-centered rounds (PFCR) have been identifi ed as an effective model for high-quality patient care. Research has shown that families are more satisfi ed when they are included on rounds and that patient care is optimal when both the patient and family are included in medical decision-making.

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The boxes in the boxplots above represent the interquartile range (or IQR, which is the range between the 25th and 75th percentiles) and the line in the box is the median. The x-shaped symbol in the box represents the mean.