How Much Time are Physicians and Nurses Spending Together at the Patient Bedside?

J Hosp Med. 2019 Aug 1;14(8):468-473. doi: 10.12788/jhm.3204. Epub 2019 May 12.

Abstract

Background: Bedside rounding involving both nurses and physicians has numerous benefits for patients and staff. However, precise quantitative data on the current extent of physician-nurse (MD-RN) overlap at the patient bedside are lacking.

Objective: This study aimed to examine the frequency of nurse and physician overlap at the patient beside and what factors affect this frequency.

Design: This is a prospective, observational study of time-motion data generated from wearable radio frequency identification (RFID)-based locator technology.

Setting: Single-institution academic hospital.

Measurements: The length of physician rounds, frequency of rounds that include nurses simultaneously at the bedside, and length of MD-RN overlap were measured and analyzed by ward, day of week, and distance between patient room and nursing station.

Results: A total of 739 MD rounding events were captured over 90 consecutive days. Of these events, 267 took place in single-bed patient rooms. The frequency of MD-RN overlap was 30.0%, and there was no statistical difference between the three wards studied. Overall, the average length of all MD rounds was 7.31 ± 0.58 minutes, but rounding involving a bedside nurse lasted longer than rounds with MDs alone (9.56 vs 5.68 minutes, P < .05). There was no difference in either the length of rounds or the frequency of MD-RN overlap between weekdays and weekends. Finally, patient rooms located farther away from the nursing station had a lower likelihood of MD-RN overlap (Pearson's r = -0.67, P < .05).

Conclusion: RFID-based technology provides precise, automated, and high-throughput time-motion data to capture nurse and physician activity. At our institution, 30.0% of rounds involve a bedside nurse, highlighting a potential barrier to bedside interdisciplinary rounding.

Publication types

  • Observational Study

MeSH terms

  • Academic Medical Centers
  • Female
  • Humans
  • Male
  • Nurses / statistics & numerical data*
  • Patient Care Team / statistics & numerical data*
  • Patients' Rooms / statistics & numerical data
  • Physicians / statistics & numerical data*
  • Prospective Studies
  • Radio Frequency Identification Device / statistics & numerical data*
  • Teaching Rounds*