ETHIOPIAN

POLICE FORCE G
Nursing Round & Nursing HOSPITAL
QUALITY
Care Protocol OFFICE
April .2025
 1. Nursing round protocol

A Nursing Round Protocol is a structured guideline that outlines how nursing staff should conduct
routine patient checks to ensure quality care, improve patient satisfaction, and enhance
communication among healthcare teams. Below is a general example of a nursing round protocol
that can be customized to suit your facility's needs.

Nursing Round Protocol

1. Purpose

 To ensure regular assessment and monitoring of patient needs.

 To enhance patient safety, comfort, and satisfaction.
 To promote team collaboration and communication.

2. Frequency of Rounds

 Every hour for high-acuity patients (e.g., ICU).

 Every 2 hours for stable patients.
 Special rounds (e.g., medication, wound care) per doctor's orders or care plan.

3. Roles and Responsibilities

 Primary Nurse: Leads the round, performs assessments, updates care plans.
 Support Nurse or Assistant: Assists with repositioning, hygiene, supplies.
 Charge Nurse (Optional): Oversees protocol adherence, supports coordination.

4. Components of Each Round (The "4 P's" Approach)

 Pain: Ask about and assess pain levels using appropriate scales.
 Positioning: Reposition the patient to prevent pressure injuries.
 Personal Needs: Assist with toileting, hygiene, and comfort.
 Possessions: Ensure call bell, phone, water, and other items are within reach.

5. Communication

 Document findings and interventions in the patient’s record.

 Report changes in condition to the appropriate team member.
 Use SBAR (Situation-Background-Assessment-Recommendation) for handoff.

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6. Documentation

 Time of the round

 Observations made
 Interventions performed
 Patient response
 Signature or initials of attending nurse

7. Special Considerations

 Include family members when appropriate.

 Respect patient privacy and preferences.
 Modify the frequency and scope based on patient acuity.

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 2. Nursing Care Protocol
The Nursing Care Protocol is a set of guidelines and procedures that nurses follow to provide safe,
effective, and high-quality care to patients. These protocols are designed to standardize the care
process, ensure consistency, improve patient outcomes, and enhance the quality of nursing services. A
comprehensive nursing care protocol ensures that nursing practices align with clinical guidelines and
best practices, promoting patient safety and holistic care.

1. Purpose of the Nursing Care Protocol

 To standardize nursing practices to ensure that all patients receive evidence-based care.
 To improve the quality of care and patient outcomes by promoting consistency.
 To ensure the safe administration of nursing interventions and medications.
 To guide nurses in assessing, planning, implementing, and evaluating patient care.
 To enhance communication and collaboration among the healthcare team.

2. Scope

 This protocol applies to all nursing staff involved in direct patient care across all healthcare
settings (e.g., hospitals, outpatient clinics, long-term care facilities, and home health care).
 It includes care procedures for adult and paediatric patients, as well as specific protocols
for specialized nursing areas (e.g., critical care, emergency care, oncology).

3. Key Components of Nursing Care Protocol

a. Assessment

 Patient history: Collect relevant medical, surgical, and family history. This includes
allergies, lifestyle, and psychosocial factors.
 Physical assessment: Perform a thorough physical examination, including vital signs, skin
condition, neurological status, respiratory and cardiovascular assessments, and
musculoskeletal checks.
 Psychosocial assessment: Identify any emotional, mental, or social issues that could affect
the patient's health and care plan.
 Pain assessment: Determine pain levels using standardized pain scales and assess the type,
duration, and intensity of the pain.
 Risk assessment: Identify risks such as falls, infections, pressure ulcers, and medication side
effects. Utilize relevant assessment tools (e.g., Braden scale for pressure ulcers).

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b. Planning

 Care plan development: Collaboratively develop an individualized care plan with specific
goals and outcomes based on the assessment.
 Prioritization: Prioritize nursing interventions based on the patient’s immediate needs,
severity of symptoms, and clinical condition.
 Collaboration with the healthcare team: Work closely with physicians, dietitians, physical
therapists, and other healthcare providers to create a comprehensive care plan.

c. Implementation

 Administering treatments and interventions: Provide medications, perform procedures,

and carry out other interventions as prescribed or required by the care plan.
 Patient education: Educate the patient and their family on their condition, treatment plan,
and any lifestyle or behavioral changes required (e.g., medication adherence, infection control
measures).
 Emotional support: Offer emotional and psychological support to the patient and their
family to help them cope with the illness or medical procedure.
 Documentation: Document all nursing interventions, assessments, and patient responses in
the patient’s medical record in real-time.

d. Monitoring and Evaluation

 Monitor patient responses: Observe the patient’s response to interventions and adjust the
care plan as needed. This includes reassessing vital signs, wound conditions, and overall
physical and mental status.
 Evaluate effectiveness: Regularly evaluate whether the nursing care plan is achieving the
desired outcomes and modify it if necessary.
 Communicate with the healthcare team: Regularly communicate with the rest of the
healthcare team about the patient’s condition, progress, and any changes in care needs.

e. Documentation

 Accurate record-keeping: Maintain accurate, complete, and timely documentation in the

patient’s medical records to ensure continuity of care and legal compliance.
 Patient responses: Document the patient’s responses to treatments, medications, and
interventions, including any adverse reactions or complications.

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  Care plan updates: Update the care plan and documentation based on any changes in the
patient's condition or treatment plan.

4. Standardized Nursing Interventions

Some common nursing interventions, along with associated protocols, include:

a. Medication Administration

 Verify orders: Ensure that the physician's orders are clear and accurate.
 Patient identification: Confirm the patient’s identity using two identifiers before
administering medications.
 Route and timing: Administer medications as prescribed (e.g., oral, IV, subcutaneous) and at
the correct time.
 Monitor side effects: Observe for potential side effects or adverse reactions, especially with
high-risk medications (e.g., opioids, anticoagulants).
 Document: Record the medication administration, dose, route, time, and any observed
reactions.

b. Infection Control

 Hand hygiene: Adhere to proper handwashing techniques before and after patient care.
 Personal protective equipment (PPE): Wear appropriate PPE (e.g., gloves, masks, gowns)
according to the type of care or patient condition (e.g., isolation precautions).
 Wound care: Follow proper aseptic techniques when dressing wounds or inserting devices
(e.g., catheters, IV lines).
 Environmental cleaning: Ensure proper cleaning and disinfecting of patient care areas.

c. Pain Management

 Assess pain levels: Use appropriate pain scales to assess pain levels regularly.
 Administer pain relief: Provide analgesics or other pain relief methods as per the physician's
orders.
 Monitor effectiveness: Evaluate the effectiveness of the pain relief measures and adjust as
necessary.

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d. Mobility and Positioning

 Falls prevention: Implement fall risk assessments and take preventative measures (e.g., bed
rails, proper footwear, assisting with mobility).
 Positioning: Reposition patients regularly, especially those who are immobile, to prevent
pressure ulcers and improve circulation.
 Assist with movement: Help patients with ambulation and transferring to different positions
to prevent strain or injury.

5. Special Considerations

a. Pediatric Nursing

 Growth and development: Assess the child’s development according to age-appropriate

milestones.
 Family-centered care: Involve the family in the care process and provide education tailored
to the family’s understanding and needs.
 Pain management: Use appropriate pain scales for children and administer pain relief based
on their needs and developmental stage.

b. Geriatric Nursing

 Chronic conditions: Consider the impact of chronic conditions (e.g., diabetes, hypertension,
arthritis) on the patient’s overall health.
 Polypharmacy: Be vigilant about managing multiple medications to avoid drug interactions
and side effects.
 Cognitive impairment: Assess for cognitive decline or dementia and implement appropriate
interventions to support cognitive function.

c. Critical Care Nursing

 Life support: Provide care to patients requiring life-sustaining treatments such as ventilators
or dialysis.
 Continuous monitoring: Closely monitor vital signs and other critical parameters.
 Patient and family support: Offer emotional support to both the patient and their family,
providing updates on the patient’s condition.

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6. Nursing Care Protocol for Specific Conditions

 Wound Care: Follow established protocols for managing different types of wounds (e.g.,
surgical wounds, pressure ulcers), including dressing changes, monitoring for infection, and
promoting wound healing.
 Cardiopulmonary Resuscitation (CPR): Adhere to the latest Advanced Cardiovascular
Life Support (ACLS) or Basic Life Support (BLS) guidelines for emergency resuscitation.
 Diabetic Care: Manage blood glucose levels, educate the patient on dietary modifications,
and ensure proper insulin administration.
 Post-Operative Care: Monitor vital signs, manage pain, prevent infection, and encourage
early mobilization following surgery.

7. Review and Continuous Improvement

 Ongoing training: Regularly train nursing staff on updated protocols, new medical evidence,
and best practices.
 Feedback mechanisms: Implement a system for receiving feedback on care protocols and
identify areas for improvement.
 Audit and evaluation: Conduct regular audits to evaluate adherence to protocols and make
adjustments as necessary.

8. Documentation and Legal Considerations

 Nurses should document all care provided in a timely and accurate manner, as it can serve as
both a legal record and a communication tool within the healthcare team.
 Failure to document or poor documentation practices can lead to clinical errors,
misunderstandings, and potential legal issues.

Conclusion

The Nursing Care Protocol is vital for ensuring safe, high-quality patient care. By following
established guidelines for assessment, planning, implementation, and evaluation, nurses can provide
consistent and evidence-based care while improving patient outcomes. Standardized protocols also
help in maintaining a high level of professionalism and ensuring that patient safety is always
prioritized. Regular updates, training, and feedback ensure that the protocols remain relevant and
effective.