Abstract

Introduction: The value of every day multidisciplinary ward round in Hospital Departments is well established, as it improves patients’ life quality and expectancy and promotes nurse-doctor relationship. However, an early in morning targeted ward round as a preparation for the main round, has not been studied.
Aim: The evaluation by the ICU and ward nurses of the novel action of the cardiology director to have early in the morning briefing, commencing at 6:20am. with the nurses and a subsequent targeted ICU and wards round.
Methodology: A questionnaire comprising 12 questions was distributed among 190 nurses working at Larnaca Hospital Departments. The questions concerned gender, age group and department of work. A Likert scale of 5 grades involved the following questions: Nurses were asked whether this novel, targeted, early in the morning round pleased them or not, pleased the patients or not, whether it was useful for nurses or not, whether it was useful for patients or not, whether it contributed to early clinical problems solution or not, whether it improved the psychological status of patients or not, whether it was complementary to the information given to patients or not and whether nurses would like to see this action be continued or not. Statistical analysis was carried out with Excel data basis and SPSS system. Chi squared techniques were applied and a statistical level of p<0.05 was considered significant.
Result: From 190 distributed questionnaires 161 (84.7%), 110 female (68.75%) and 51 male (31.25%) were completed. No trend among answers was observed, as far as gender, pleasure or usefulness for nurses or for patients are concerned, regarding age groups of nurses. Nurses of the cardiology and other wards were more pleased by the morning briefing/targeted round, compared to ICU nurses, p=0.002, considered the morning round more useful for themselves compared to ICU nurses, p=0.047, accepted that from this early round additional information was passed on to the patients compared to the nurses of the ICU, p=0.07 and considered this round more useful for patients compared to the consideration of ICU nurses, p=0.043. Nurses aged >31y stated that patients’ psychology improved with this early round, compared with nurses aged < 30y, p=0.004 and admitted that this early round added to patients’ information more, compared to those with age< 30y, p=0.018. A hundred and forty-six (90.63%) of the nurses would like to see this early round to be continued, one (0.62%) to see it stopped and 14 (8.75%) do not care with continuation or not of it.
Conclusion: ICU and wards nurses generally endorsed the early in the morning briefing/targeted round carried out by the cardiology director. However, the frequencies of the nurses’ answers concerning pleasure or usefulness derived for them or for the patients, between ICU and ward nurses were in the ICU less (p=0.002, p=0.047). The frequencies of nurses’ answers aged >31y and <30y, concerning improvement of patients’ psychology or complementary information provided to patients with the round, were more in those > 31y (p=0.004, p=0.018). Nurses may have cooperated well with the director of cardiology because this innovation reflects their values of providing the best and most timely care for patients. Nurses may have accepted him with leadership characteristics, independently of his ranking, given that nurses are not under his command.

Keywords:Cardiology director; Intensive care unit; Leadership; Nurse; Physician-Nurse Relationship; Ward round