Transforming Change of Shift Handoff: Implementing Walking Rounds in Adult Bone Marrow Transplant

The adult bone marrow transplant unit of this NCI designated comprehensive cancer center performed change of shift report with an electronic nursing hand off and face to face reporting. In an effort to improve communication, positively impact patient satisfaction, decrease intershift call bell interruptions, provide an opportunity for peer review, and reinforce patient safety guidelines we have implemented bedside walking rounds.

Walking rounds were implemented as an enhancement to the existing nursing handoff process.  We believe it provides an opportunity for the patient to participate in their plan of care increasing feelings of personal empowerment, improves communication between nurses, provides a clinically relevant opportunity for 2 nurses to perform patient identification, and permits the daily re-enforcement of patient safety guidelines enhancing patient’s feelings of safety and security.

Staff was educated regarding the benefits of walking rounds, staff suggestions were solicited for clinically relevant assessments to be performed during walking rounds and to create buy in for project implementation.  Walking rounds now occur in the patient’s room at shift change with an opportunity for patient input and the potential for early assessment of acute changes in patient’s condition.

 Data was collected prior to and after the implementation of walking rounds categorizing the frequency of shift change interruption and the reasons for patient calls.  The data supports a decrease in the frequency of patient calls during shift change since the program’s implementation.  Anecdotal evidence, from patients reporting, suggests increased patient satisfaction related to decreases in call bell response time.  

Walking rounds has been a beneficial enhancement to patient handoff, improving communication, empowering patients, decreasing shift change interruptions, decreasing call bell response time, and improving patient’s and nurse’s satisfaction by enabling a safe professional transfer of care.