Research Article
Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran
Faculty of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran
a r t i c l e i n f o
s u m m a r y
Article history:
Received 18 July 2013
Received in revised form
24 April 2014
Accepted 23 June 2014
Purpose: The purpose of the study was to determine the impact of regular nursing rounds on patient
satisfaction with nursing care.
Methods: This was a controlled clinical trial in which 100 hospitalized patients in a medical surgical ward
were allocated to control and experimental groups through convenience sampling. The experimental
group received regular nursing rounds every 1e2 hours. Routine care was performed for the control
group. Patient satisfaction with the quality of nursing care was assessed on the second and fth days of
hospitalization in both groups using Patient Satisfaction with Nursing Care Quality Questionnaire.
Results: On the second day, patient satisfaction scores of the two groups had no signicant difference
(p .499). However, the intervention was associated with statistically signicant increased patient
satisfaction in the experimental group compared to the control group (p < .001).
Conclusion: Implementing regular nursing rounds had a positive impact on patient satisfaction. This
method may hence improve patient-nurse interactions and promote the quality of nursing care and
patient satisfaction.
Copyright 2014, Korean Society of Nursing Science. Published by Elsevier. All rights reserved.
Keywords:
communication
needs assessment
nurse's practice patterns
patient satisfaction
Introduction
While the focus has been on slowing the growth of health care
costs, new emphasis is being given to improve the quality and
outcomes of health care. On the other hand, to improve the quality
of health care, accessible and reliable indicators of quality are
needed. Various indicators such as hospital mortality, length of
stay, readmission, and rate of disease recurrence are used to evaluate the quality of hospital services. Besides all these indicators,
patient satisfaction scores have been used as an index for guiding
quality improvement projects (Lo, Stuenkel, & Rodriguez, 2009).
Thus, patient satisfaction has become an established outcome indicator of the quality and efciency of the health care systems
(Merkouris et al., 2013).
In view of the fact that nurses play a crucial role in patients'
experience of hospitalization, patient satisfaction with nursing care
comprises a signicant part of the overall satisfaction with the
http://dx.doi.org/10.1016/j.anr.2014.10.005
1976-1317/Copyright 2014, Korean Society of Nursing Science. Published by Elsevier. All rights reserved.
283
of participation in the study, being free to leave the study, the riskfree nature of the intervention, not forfeiting the standard care
procedure, and condentiality.
Instruments
A self-administered questionnaire on demographics was used to
assess age, sex, marital status, education level, and hospitalization
frequency of participants. Patient satisfaction was evaluated by the
Patient Satisfaction with Nursing Care Quality Questionnaire
(PSNCQQ). The PSNCQQ was developed and tested by Laschinger,
Hall, Pedersen, and Almost (2005). The questionnaire was modied after obtaining permission to use and modify it. The modied
version comprised 21 questions based on a 5-point Likert scale
(weak to excellent). The total score of each questionnaire (ranging
between 21 and 105) was calculated by summing up all scores. Each
item of the PSNCQQ consists of a phrase to designate the content of
the question or signpost, followed by a more detailed question or
descriptor (Reck, 2010). For example, in the rst item of the instrument, information you were given is used as a signpost for the
descriptor that follows, How clear and complete the nurses' explanations were about tests, treatments, and what to expect.
Below are a few of the other items of the questionnaire:
Attention of nurses to your condition: How often nurses
checked on you and how well they kept track of how you were
doing.
Nursing staff response to your calls: How quick they were to
help.
Daily routine of nurses: How well they adjusted their schedules
to your needs.
Coordination of care: The teamwork between nurses and other
hospital staff who took care of you.
This questionnaire was used and validated in previous Iranian
studies (Negarandeh, Mohammadi, Zabolypour, & Ghojegh, 2012).
In order to evaluate the reliability of the PSNCQQ through testretest, 15 patients completed it twice with a 3-day interval. The
intraclass correlation coefcient of the questionnaire was
conrmed with r at .91.
Data collection
PSNCQQ was completed on the second and fth days of hospitalization for two reasons: (a) in assessing patients' satisfaction, it is
necessary to let patients have enough experience with nursing services, and (b) the mean length of hospital stays of patients in this
ward was 5.5 days. In the experimental group, nurses undertook
regular clinical rounds as a communicative method. They individually visited patients every 1e2 hours (at least every 2 hours) from 8
a.m. until 10 p.m. They not only communicated with patients, but
also assessed their needs by focusing on their pain, comfort, assistance, and training needs. The nurses were taught to perform their
rounds during a 20-minute training session and were supervised by
the researcher to ensure their correct performance throughout the
rounds. Although the researcher presented in the ward, he remained
as an observer and provided help only if necessary.
The control group received the ward's usual care. In this ward
nurses provide care according to functional method. Functional
nursing, sometimes referred to as task nursing, places emphasis on
tasks which are distributed according to levels of expertise. This
method has an inert weakness as it places emphasis on tasks rather
than providing patient-centered care.
284
Data analysis
Table 2 Comparisons between Mean Patient Satisfaction Scores on Second and Fifth
Days in Experimental and Control Groups.
The collected data were analyzed using independent t test, chisquare test, and Fisher's exact test in SPSS for Windows 16.0 (SPSS
Inc., Chicago, IL, USA). A p less than .05 was considered signicant.
Results
Categories
Control
group
Age
18e30
31e50
51e70
71
Female
Male
Single
Married
Widowed/
divorced/
separated
Illiterate
Primary
Diploma
Collegiate
No
Once
Twice
3
12
25
8
5
29
21
11
34
5
(24)
(50)
(16)
(10)
(58)
(42)
(22)
(68)
(10)
14
18
15
3
28
22
8
37
5
(28)
(36)
(30)
(6)
(56)
(44)
(16)
(74)
(10)
7
17
12
14
22
16
6
6
(14)
(34)
(24)
(28)
(44)
(32)
(12)
(12)
6
20
13
11
23
17
6
4
(12)
(40)
(26)
(22)
(46)
(34)
(12)
(8)
n (%)
Marital
status
Educational
status
History of
hospitalization
(in the past
2 years)
Control group
Experimental group
59.8 16.3
55.3 12.7
<.022b
57.5 17.6
68.8 8.8
<.0001b
p
.499a
<.0001a
Participant characteristics
Gender
Experimental
group
c2/f
0.730a
.467
0.040b
.840
1.212a
.797
0.720a
.908
0.781a
.797
n (%)
285
Han, C.-H., Connolly, P. M., & Canham, D. (2003). Measuring patient satisfaction as
an outcome of nursing care at a teaching hospital of southern Taiwan. Journal of
Nursing Care Quality, 18(2), 143e150. http://dx.doi.org/10.1097/00001786200304000-00008
Joolaee, S., Givari, A., Taavoni, S., Bahrani, N., & Reza Pour, R. (2008).
Patients' satisfaction with provided nursing care. Iranian Journal of Nursing
Research, 2(7), 37e44. Retrieved fall/winter, 2008 from http://www.ijnr.ir/
browse.php?a_codeA-10-30-2&slc_langen&sid1
Kalman, M., Olrich, T., & Nigolian, C. (2008). Hourly nursing rounds: shaping nursing
culture to achieve nursing quality outcomes. Clinical Nurse Specialist, 22(2).
http://dx.doi.org/10.1097/01.NUR.0000311770.57800.27, 94e94.
Langen, I., Myhren, H., Ekeberg, O., & Stokland, O. (2006). Patient's satisfaction and
distress compared with expectations of the medical staff. Patient Education and
Counseling, 63(1e2), 118e125. http://dx.doi.org/10.1016/j.pec.2005.09.008.
Laschinger, H. S., Hall, L. M., Pedersen, C., & Almost, J. (2005). A psychometric
analysis of the patient satisfaction with nursing care quality questionnaire: an
actionable approach to measuring patient satisfaction. Journal of Nursing Care
Quality, 20(3), 220e230. Retrieved July/September, 2005 from http://www.ncbi.
nlm.nih.gov/pubmed/15965386?doptCitation
Lo, S., Stuenkel, D. L., & Rodriguez, L. (2009). The impact of diagnosis-specic
discharge instructions on patient satisfaction. Journal of Perianesthesia
Nursing, 24(3), 156e162. http://dx.doi.org/10.1016/j.jopan.2009.03.004.
McCabe, C. (2004). Nurse-patient communication: an exploration of patients' experiences. Journal of Clinical Nursing, 13(1), 41e49. http://dx.doi.org/10.1111/
j.1365-2702.2004.00817.x.
Meade, C. M., Bursell, A. L., & Ketelsen, L. (2006). Effects of nursing rounds: on
patients' call light use, satisfaction, and safety. American Journal of Nursing,
106(9), 58e70. Retrieved September, 2006 from http://www.ncbi.nlm.nih.gov/
pubmed/16954767
Meade, C. M., Kennedy, J., & Kaplan, J. (2010). The effects of emergency department
staff rounding on patient safety and satisfaction. Journal of Emergency Medicine,
38(5), 666e674. http://dx.doi.org/10.1016/j.jemermed.2008.03.042.
Merkouris, A., Andreadou, A., Athini, E., Hatzimbalasi, M., Rovithis, M., &
Papastavrou, E. (2013). Assessment of patient satisfaction in public hospitals in
Cyprus: a descriptive study. Health Science Journal, 7(1), 28e40. Retrieved
January, 2013 from http://connection.ebscohost.com/c/articles/88845677/
assessment-patient-satisfaction-public-hospitals-cyprus-descriptive-study
Mrayyan, M. T. (2006). Jordanian nurses' job satisfaction, patients' satisfaction and
quality of nursing care. International Nursing Review, 53(3), 224e230. http://
dx.doi.org/10.1111/j.1466-7657.2006.00439.x.
Negarandeh, R., Mohammadi, S., Zabolypour, S., & Ghojegh, T. A. (2012). Relationship between quality of senior nursing students' caring behaviors and patients'
satisfaction. Hayat, 18(3), 10e21. Retrieved August, 2012 from http://hayat.tums.
ac.ir/browse.php?a_id19&sid1&slc_langen
Neville, K., Lake, K., LeMunyon, D., Paul, D., & Whitmore, K. (2012). Nurses' perceptions of patient rounding. Journal of Nursing Administration, 42(2), 83e88.
http://dx.doi.org/10.1097/Nna.0b013e318243365e.
Reck, D. L. (2010). Patients' expectations and satisfaction with nursing care, and their
nurses' awareness of their expectations (Doctoral dissertation). Retrieved June 14,
2010 from https://etda.libraries.psu.edu/paper/11079/6767
Sobaski, T., Abraham, M., Fillmore, R., McFall, D. E., & Davidhizar, R. (2008). The
effect of routine rounding by nursing staff on patient satisfaction on a cardiac
telemetry unit. Health Care Management (Frederick), 27(4), 332e337. http://
www.ncbi.nlm.nih.gov/pubmed/19011416
Toma, G., Triner, W., & McNutt, L.-A. (2009). Patient satisfaction as a function of
emergency department previsit expectations. Annals of Emergency Medicine,
54(3), 360e367. http://dx.doi.org/10.1016/j.annemergmed.2009.01.024.
Von Essen, L., Larsson, G., Oberg, K., & Sjoden, P. O. (2002). 'Satisfaction with care':
associations with health-related quality of life and psychosocial function among
Swedish patients with endocrine gastrointestinal tumours. European Journal of
Cancer Care, 11(2), 91e99. Retrieved June, 2002 from http://www.ncbi.nlm.nih.
gov/pubmed/12099944
Woodard, J. L. (2009). Effects of rounding on patient satisfaction and patient safety
on a medical-surgical unit. Clinical Nurse Specialist, 23(4), 200e206. Retrieved
August, 2009 from http://dx.doi.org/10.1097/NUR.0b013e3181a8ca8a