BackgroundActive nursing rounds, also known as intentional, care or comfort rounds were first developed in the USA (Struder Group, 2007) and later introduced into UK hospitals in 2012 alongside other measures to improve the quality of nursing care (www.harmfreecare.org). They have been associated with reductions in pressure ulcers, falls and increased patient and staff satisfaction (Cornwell, 2012). A pressure ulcer audit (Hospice UK, 2016) on a hospice inpatient unit (IPU) highlighted the need to improve nurses’ skills in the prevention, management and documentation of skin integrity.AimTo design a comfort round tool specifically for use within the hospice IPU, implement comfort rounds and evaluate the impact on patients and nurses.MethodNurses on the IPU were consulted regarding the overall concept, naming and design of the tool. Training was provided and following implementation, feedback sought from IPU nurses and patients regarding the impact of comfort rounds on patient care and experience.ResultsNurses’ feedback: Healthcare assistants experienced job satisfaction with their involvement in continuity of patient care and evidencing care they provided. They felt areas for improvement included managing time pressures, patient choice, document design, training and team working. Patient feedback: 14 responses, all of whom were positive about the comfort rounds. They felt areas for improvement included communication about the rounds, patient choice and ensuring these discussions are communicated across the team.ConclusionComfort rounds have enabled our patients to feel less isolated and provided reassurances to family members. They support the consistent nursing care of our patients, including improving the involvement of the healthcare assistant workforce, optimising hydration and the prevention of pressure ulcers and falls. Initial assessment of patients admitted to the IPU needs to include discussion about the comfort rounds and creating individualised plans of care including the patient’s needs and preferences relating to comfort rounds.

documentation was developed, staff engagement activities were carried out and data was collected.Patient feedback was obtained and Goal Attainment Scores (GAS) used to measure achievement of personal goals. Results Our mid-point review demonstrated positive changes, including adaptions in the delivery of care to focus more on patient-centred rehabilitative goals across the multidisciplinary team. Data collection is continuing and the final evaluation will take place in July 2018. Conclusion Throughout the implementation of the project, challenges were identified in terms of the difficulty of initiating and maintaining the momentum of a cultural shift which has been previously evidenced. The final evaluation will therefore take account of both the objective outcomes and our reflections on how these challenges were addressed.

Home team; one has been recruited to a paid role.Quotes from Care Volunteers: 'I am so proud of myself ….taking on this learning at my age''I always dreamed I would be a nurse, now I feel my dream has pretty much come true'Quote from Staff 'Invaluable'…. 'The support these learners are providing staff and families has already made a massive impact to our services' Conclusion Comprehensive training can empower volunteers to provide a key role in supporting hands on patient care. Growing our own staff has now become a reality.