NURS 6001 Week 5 Research Article Pair Analysis Example

Two Designs, One Practice: A Paired Analysis of Research on Hourly Rounding

Student Name

College of Nursing, Walden University

NURS 6001: Foundations of Graduate Study

Instructor Name

Month Day, Year

Two Designs, One Practice: A Paired Analysis of Research on Hourly Rounding

Purposeful hourly rounding, in which nurses visit each patient on a schedule to address pain, position, toileting and possessions, is widely used on medical-surgical units to reduce falls and call-light use. This analysis pairs two peer-reviewed studies of the practice. The first asks whether rounding changes measurable outcomes; the second asks how patients experienced it. Reading them side by side shows what each kind of evidence can tell a practicing nurse.

The two were chosen deliberately. The quantitative study is one of the most frequently cited early trials of the practice and gave many hospitals their reason to adopt it. The qualitative study was chosen because patients are the people rounding is meant to serve, and their view is rarely measured directly. A nurse deciding whether to champion rounding on a unit needs both kinds of knowledge: whether it tends to work, and how it lands with the people receiving it.

Quantitative Study: Meade et al. (2006)

Purpose. To describe how often and why patients use call lights, and to test the effects of one-hour and two-hour nursing rounds on call-light use, patient satisfaction and falls.

Design. Quasi-experimental, with nonequivalent groups; units were not randomly assigned.

Sample and setting. Twenty-seven nursing units in 14 hospitals across the United States.

Data collection. Over six weeks, with the first two weeks as a baseline, staff rounded either hourly or every two hours following a protocol of specific actions, and call-light use, satisfaction and falls were recorded.

Key findings. Rounds with specific actions at set intervals were associated with statistically significant reductions in call-light use and falls and with higher patient satisfaction, at both intervals.

Limitations. Because units chose or were placed in their groups without randomization, differences between units may explain part of the effect, and a six-week study cannot show whether the change lasts.

Qualitative Study: Allen et al. (2016)

Purpose. To learn how patients perceived two communication practices, AIDET and hourly rounding, during their hospital stay.

Design. Descriptive qualitative study using interviews analyzed with open coding and constant comparison.

Sample and setting. A convenience sample of 14 adult medical-surgical inpatients from one mid-sized community hospital, interviewed after discharge.

Data collection. Semi-structured interviews, transcribed and coded for themes.

Key findings. Patients valued having their emotional needs met. Purposeful hourly rounding was not something patients noticed as a distinct practice; they described visits as medication passes and vital sign checks. Some did mention fewer call-light needs and fewer sleep interruptions.

Limitations. The small convenience sample from one hospital limits transferability, and recall after discharge may blur details of the stay.

Table 1

The Two Studies in Parallel

Discussion

In a standard evidence hierarchy for intervention questions, a quasi-experimental study ranks above a qualitative one, because it measures outcomes and compares groups (Dang et al., 2022). On the question of whether rounding reduces falls, Meade et al. (2006) is clearly the stronger source, though its lack of randomization means it still cannot prove cause.

The hierarchy, however, is built for questions about effect. Allen et al. (2016) answers a different question, one the quantitative study could never reach: what the practice looks like from the bed. Its finding that patients did not recognize rounding as a distinct practice is important for nurses. If patients cannot tell purposeful rounding from routine checks, then satisfaction gains may depend less on the schedule than on what nurses say and do during each visit, and nurses may need to name the purpose of the visit aloud. The qualitative study does not weaken the quantitative evidence; it suggests how the practice might work, and why it might fail when done as a box to tick.

Conclusion

Together the pair supports continuing structured rounding with a defined set of actions, and it suggests that nurses should make the purpose of each visit clear to patients. What the pair cannot supply is randomized evidence of effect on falls, or evidence that benefits last beyond a few weeks. Those would need stronger designs than either study used.

For my own medical-surgical unit, the practical step the pair suggests is small. Rather than adding more documentation to prove rounds happened, nurses could state the purpose of each visit to the patient, for instance by asking about pain, position and toileting by name. That would make the practice visible to the people it is designed for, and it could be tested by asking patients before discharge whether they noticed it.

References

Allen, T., Rieck, T., & Salsbury, S. (2016). Patient perceptions of an AIDET and hourly rounding program in a community hospital: Results of a qualitative study. Patient Experience Journal, 3(1), 42-49. https://doi.org/10.35680/2372-0247.1115

Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines (4th ed.). Sigma Theta Tau International.

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), 58-70. https://doi.org/10.1097/00000446-200609000-00029