5 P’s of Nursing: The Tried-and-True Rounding Care Plan

• The concept of hourly rounding likely isn’t new.  
• But as times change, it is evident that more efficient round methods are needed to ensure that all patients have their needs met.
• Along with clustering care, understanding and implementing the 5 P’s of nursing when completing rounds will not only promote positive patient outcomes and experiences but increase nursing staff satisfaction rates.

The concept of hourly rounding likely isn’t new — you have probably heard of and seen it since you were in nursing school. 

But as times change, and the healthcare industry continues to feel the wrath of the COVID-19 pandemic, it is evident that more efficient round methods are needed to ensure that all patients have their needs met

Along with clustering care, understanding and implementing the 5 P’s of nursing when completing rounds will not only promote positive patient outcomes and experiences but increase nursing staff satisfaction rates.  

Need a refresher on the 5 P’s of nursing rounds? Let’s get into it! 

What Are the 5 P’s of Nursing?

Pain

As we all know, pain is often something that we cannot see. 

In some cases, chronic pain is commonly identified as an ‘invisible illness.’  

When completing hourly rounds, it is vital that nurses are assessing and addressing any potential pain their patients might be experiencing.  

From a patient’s perspective, feeling heard is a major part of a healthcare facility experience, so it is important that the nurse and care team are playing an active role in ensuring that any expressed pain or discomfort is relayed to the physician.

Position

More than 2.5 million patients in acute-care facilities suffer from pressure ulcers, according to the Joint Commission.  

Hospital-Acquired Pressure Ulcer/Injuries (HAPU/I) can not only be detrimental to a patient and their health, but the reputation of the healthcare facility itself — especially when considering that prospective patients can view Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) results and HAPU/I data before determining where they will receive care.

The prevalence of HAPU/I and other health issues, such as blood clotting, muscle weakness, etc., can be significantly reduced during hourly nursing rounds.  

Once patient pain is addressed, try:

• Asking if they are comfortable;
• Repositioning them (follow your facility’s protocol);
• Adjusting any blankets or pillows if requested; or
• Reassessing their comfort.

Potty (or Personal Hygiene)

Urinary tract infections (UTIs) are one of the most common hospital-acquired infections (HAIs).  

Whether it is from a catheter, poor hygiene, or a blockage, various situations (some of which are preventable and can be performed during hourly rounds) can result in a UTI.

For some patients, a nurse simply asking, “Do you need to use the restroom?” is enough. However, there will be other instances where you might have to investigate further and ensure the patient does not need to relieve themselves.

In the event that the patient does need to use the restroom, the nurse and care team should be there to provide assistance.  

This also applies if the patient needs showering. 

Periphery

Depending on how long a patient’s hospital stay is, there will be many instances where they will need items moved around the room for their accessibility. 

From their own personal items, to perhaps even the trash can, it is inevitable that a nurse will maneuver items or refill water cups at least once or twice during their rounds. 

This is one of the most impactful 5 P’s of nursing rounds simply because it directly impacts a patient’s experience. If nurses are being responsive to peripheral requests that make their stay easier, it will improve the chances of positive reporting in a follow-up survey.

Pump

According to the Institute for Safe Medication Practices, IV sites and pumps should be checked every two hours or anytime a nurse comes in to reposition a patient.  

Of course, this can be modified or tailored to a specific facility’s protocol. However, it is essential that pumps and sites are checked frequently. 

The Bottom Line

All-in-all, the 5 P’s in nursing rounds are essential in promoting positive patient outcomes and experiences. Those on the healthcare team should all hold each other accountable to ensure that these steps are taken. 

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