Safe Care Stories from the Field: Cuyuna Regional Medical Center

Posted on July 14, 2022 by Julie Apold

Cuyuna Regional Medical Center: Shift-to-Shift Team Safety and Dignity Rounds

Today, we highlight a successful Safe Care practice from Cuyuna Regional Medical Center (CRMC) in Crosby – Change of Shift Nursing Team Rounds. Jenny Pederson, RN, Quality Care Coordinator for the Care Center, is leading this new practice. It takes approximately five minutes during shift change and prioritizes residents' safety and dignity.

"Prior to the start of COVID-19, CRMC had been conducting Compliance Rounds to check that the previous shift had completed their tasks," shared Pederson. "The focus was on the staff and holding staff accountable for their work. During COVID-19, the rounding process gradually decreased due to competing demands. This spring, we decided it was time for a fresh start to reinstate a shift change rounding practice. We wanted to  create a process and culture that was positive and resident-centered.”

How Do Change of Shift Nursing Team Rounds Work?

During shift change, team members from the oncoming and outgoing shifts complete room-to-room rounds focused on residents’ safety and dignity. Team members include nursing assistants and a team leader who can be an RN, LPN, or TMA.

Safety checks include items ranging from ensuring that bed brakes are on to checking to see if the resident has the appropriate footwear and that the pathway to the bathroom is free of clutter. Included in the dignity checks are practices such as having garbage cans free of soiled incontinence products and rooms free of soiled linens and dirty dishes. Other items included in the checks are checking that the soiled utility rooms are clean and that charting has been completed.

Following each resident room check, teams briefly gather outside the room to share any new essential information about the resident from the outgoing shift to the oncoming shift. CMRC has implemented a THINK communication system to enhance teamwork and create a positive culture as a component of the rounding process. The THINK acronym stands for communication that is true (T), helpful (H), inspiring (I), necessary (N), and kind (K). 

Shift Change Team Rounding with Mary Jo Beaudry, Resident; Jennie Hatcher, CNA;

Haley Worley, RN, Nurse Manager; and Meghan Pomeroy, RN

Results So Far

Data analyzed from 70 audits of the rounding process have already shown positive outcomes. To date, 87% of the time, safety check items were complete, e.g., call lights were within reach, walker was at the bedside, and commonly used items were within reach. Auditors found that the most significant improvement opportunity was ensuring that the call light was within reach. For the dignity check items, 74% of the time, all items were complete, e.g., rooms were free of soiled linens and in order. The key opportunities for improvement included garbage free of soiled incontinence products and being emptied. 

Impact for Staff

While the primary goal of Change of Shift Nursing Rounds is to improve resident safety, quality and dignity, the rounding process promotes teamwork and a caring, professional, and welcoming environment. Although staff members were initially hesitant to implement a new process, Pederson reports they are seeing the benefits for their residents and a positive shift in team culture. "We used to hear more of a negative, staff-focused response when tasks weren't completed and now have a more positive, resident-focused response to incomplete tasks .”

Thank you to the team at CRMC for sharing their Safe Care practice. 

If you have a Safe Care Story to share, contact Julie Apold, Vice President of Quality & Performance Excellence.