Book reviewed in this article: Measuring Patient Satisfaction for Improved Patient ServicesBy Steven Stusser, Rose Marie Davis A Compendium of Forms, Tables, and Charts for Use in Monitoring and Evaluation The Hospital Administrator's Guide to Severity Measurement Systems Guide to Nursing Management (4th ed.)By Ann Marriner‐Tomey Malpractice Prevention and Liability Control for Hospitals (2nd ed.) By James E. Orlikoff, Audrone M. Vanagunas The Many Faces of Managed Care (2nd ed.)By Lee Cohen Adelizzi, Editor Implementing Total Quality Management: An Overview By Joseph R. Jablonski Delineation of Clinical Privileges: Sample Criteria and Forms Hospital Quality‐Related Data: Recommendations for Appropriate Data Requests, Analysis, and Utilization Building New Nursing Organizations: Visions and Realities

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.

IntroductionThe ‘Hospice in your Home’ service plans to extend its reach to support more patients in their own homes. This was also an important move forward for the Hospice to achieve its objective to ‘touch’ more people with a palliative diagnosis but not necessarily Specialist needs but those who would benefit from companionship, carer breaks and practical support.The Hospice in your Home service commenced November 2013 to support patients at home who are considered to be in the last weeks of life. The initial plans included a volunteer element to the team.AimsThe aim of the project is to establish a team of volunteers to be ‘companions’ to patients at home.MethodsPlanning and discussion with all Hospice departments to agree to a service that extended Hospice services to patients with ‘non-Specialist’ needs.The development of a role profile by the Service Development Lead in conjunction with the NAHH NW Managers.Collaboration with the Voluntary Services Manager to deliver information events and select volunteers for the role. Identification of learning needs with the Education Department and development of an education programme. The volunteers would be integrated with the Hospice in your Home team with a joint policy, protocols, supervision and a code of conduct.Development of a risk assessment tool and documentation for volunteers to enter visit details in the Electronic Patient Record.Roll out of the project in June 2015.Evaluation of the project – measuring patient experience, the numbers and length of visits and identify referral sources.ConclusionThe project will commence in June 2015. The desired outcome is that volunteers can enable the Hospice to reach out to the wider population of palliative patients delivering a supportive service that is seamless between volunteers and the Hospice in your Home team.