It comprised targeted questions to gather information and establish rapport, and five open questions exploring participants’ experiences of ward rounds (Box 1). For example: ‘There were just too many people, I just wanted to talk to one person.’ Three participants generated ideas to change this aspect of the ward round, including not having as many people present. Ward rounds play a crucial part in reviewing and planning a patient’s care. Management skills are also essential as they are required to obtain a job as a mental health nurse. The journal Open Mind (Wolf, 1997) has, however, outlined a code of conduct for ward rounds, with the suggestion of standardising the code across NHS psychiatric services. Search the Greater Manchester Mental Health NHS FT website. All members of the clinical team are adequately prepared for the ward round/case conference and have a good understanding of the patient’s condition and current status. collaborative working and efficient use of resources. executives all fully engaged and focused on improving the quality of ward rounds. Some of these issues were identified in the Open Mind publication (Wolf, 1997), so this small study certainly provides evidence to support the recommended changes. Follow us on Twitter Qualitative methods are recommended for studies of this type (Goodwin et al, 1999; Greenwood et al, 1999), or a combination of qualitative and quantitative methods (Birtwistle et al, 2000; Lovell, 1995), because measuring the complex concept of patient satisfaction in any meaningful way is difficult and tends to be insensitive to potentially negative views about services (Greenwood et al, 1999; Lovell, 1995). A semi-structured interview was developed in conjunction with previous findings and informal discussion with ward staff. If you have any questions, contact IT.support@improvement.nhs.uk. They provide an opportunity for the multidisciplinary Inpatient Services - Adults already receiving mental health support folder; Can my family support me during ward round? Ward round internal professional standard (IPS) However, the results are designed to show inpatient perceptions of ward rounds as they occurred and are still useful in understanding patients’ reactions to them, regardless of the impact of mental illness. However, in the context of their presenting acute mental health problems and the perception that the ward round feels too intimidating to cope with, it is unsurprising that a patient’s memory of what happened may be skewed. An independent researcher was asked to assign data to one of the emergent categories in the same way. All results/investigations have been seen prior to the ward round and are filed within the patient’s notes. There are many resources from across the NHS that show some of the things to consider when running an effective ward round. Key = these sections must be checked in all patients Scheduling regular nurse bedside ward rounds (called ‘intentional rounding’) may not improve nurse-patient communication, as most interactions occur outside of these rounds. Levels of distress may have contributed to the discrepancy between participants’ recollections of whether they were introduced to unknown faces, and the first author’s own recollection that in fact all patients were introduced to new faces. timely, relevant manner. team to come together to review a patient’s condition and develop a co-ordinated This seems to be reflected by the poor awareness some had regarding the role of each professional present in the ward round. What Is Comorbidity? The ward rounds vary in nature from a phone call to discuss all the patients with a focus on those highlighted by the care home, to a video ward round. The task may be considered as analogous to a team assembling a very difficult jig- saw puzzle „against the clock‟. It may be a limitation in terms of obtaining reliable data, and has been used as a criticism of patient satisfaction surveys in the past (Crawford and Kessel, 1999). Each interview lasted approximately half an hour. If the independent researcher’s categories agreed with this research, the categories were likely to be reliable. 'Ward rounds in medicine: principles for best practice' from the Royal college of Nursing and the Royal College of Physicians, looks at how to include senior nurses and other members of the multidisciplinary team in ward rounds. My next placement was then on a male acute ward so that's a generic mental health ward for men 18 to 65 and you will literally see every kind of mental illness possible. Dr For example: ‘When I have progress I feel all right, when I don’t I feel disappointed.’, Three statements referred to the way in which the feelings expressed could have consequences for the patient in the ward round. Medical ward rounds are complex clinical activities, critical to providing high quality, safe care for patients in a timely, relevant manner. I toddled round the ward giving sweets to … plan of care, while facilitating full engagement of the patient and/or carers The limited time frame available and the ethnic mix on the ward at the time of this study meant it was not possible to recruit participants who were not white. A semi-structured interview was developed in conjunction with previous findings and informal discussion with ward staff. For example: ‘Everyone was sitting there in high chairs’ and ‘they had to get everyone in the same room, so they all sat around, perched.’, One participant referred to having appointment times: ‘You don’t have a set time … if you go and see a doctor or a nurse you always have a set time … I think it’s very unprofessional … they just assume you’ll be sitting round.’. Participants expressed a much greater understanding of the role of the psychiatrist, senior house officer and social worker in the ward round than any other professional group, including: nurses, community psychiatric nurse, clinical psychologist and the team as a whole. For the latest improvements arising from the SAFER patient flow bundle and Red2Green days see Facebook, Twitter, The Academy of Fabulous Stuff and The Edge. Productive mental health ward toolkit; The toolkit contains a range of tools to support each module as you go along. It is important for qualitative researchers to consider how participants view the interviewer - for example as someone involved in their care, as an advocate or as a researcher - as this may influence the outcome of the research (what participants are willing to say) and the process of data interpretation (what researchers are willing to report) (Salmon, 1996). You will still have access to all the products and services you had access to previously. For example: ‘You know I coped with it. Ward rounds are a crucial aspect of acute care, but nurses’ involvement varies. Six patients expressed dissatisfaction. Type: Guidance . This would be an important area to explore in future studies. It is the point at which professionals and patients can discuss future care in the community, according to the principles of the care programme approach, to provide a ‘sound framework for service delivery’ (Social Services Inspectorate, 1999). The interviews were transcribed and responses to open questions were analysed using content analysis (Day, 1993; Weber, 1990) with emergent themes being identified once the data was collected. Six were of a general nature, for example: ‘The whole thing was very good in general.’ Three were more specific, referring to feeling relaxed, challenged by or interested in the process. How to find us . Pond Ward, Pine Ward, Shore Ward: Park Royal Mental Health Centre. A group of consultant psychiatrists identified seven key domains for ward round (S ocial needs, C ommunity Mental Health Team liaison, A ssessments required, M ental Health Act, P rescriptions: medication electroconvulsive therapy (ECT), T2/T3, E ngagement with relatives and carers, R isk Assessment and Pass Plans). The best practice principles set out below by the RCP and RCN show how this can be achieved: Ward rounds may have become too institutionalised in terms of how they attempt to meet the needs of the patient. School of Nursing, Midwifery and Social Work, University of Manchester, This paper is dedicated to the lead author, Dr Magdalen Fiddler, who unexpectedly and tragically died before this paper could be submitted. The issues covered include a patient’s right not to attend, having set appointment times, asking questions in a respectful and sensitive manner, thinking about seating arrangements and keeping the number of professionals present to a minimum. Further, a recent Department of Health document emphasises the need for ‘clarity about the aims, timing and organisation of regular clinical activities such as ward reviews … agreed in consultation with service users’ (DoH, 2002). Western Sussex Hospitals Wards Round Considerative Checklist Make one member of the team the “Safety Checker” who uses this checklist before leaving each patient. 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