Nursing Rounds, Reports

& Case Method of

Teaching
Presented By:- Ms. Rosana
James
M.Sc. Nursing Previous Year
CCON
NURSING ROUND’S
 INTRODUCTION
A small group of the staff members ,not more
than five and a leader & teachers visit the bed
sides of the clients, nursing
superintendents, ward sisters taking rounds
of hospital wards. it helps the nursing
members to know about all the patients in
the wards there problems & ways of solving.
 Types
• Giving the transfer report at the change of
shifts.
• One used to acquaint the staff with all
patient.
 Purposes
• To demonstrate important clinical
manifestation in clients
• To clarify terminology used and studied
• To compare client’s reaction to disease.
• To demonstrate the effects of drugs.
• To illustrate successful improvisation.
• To illustrate skillful nursing care.
• To compare methods of meeting the
needs
Cont…
• Rounds are useful in situations, where
assignments are made to provide continuity
of care.
• Instructional purposes for student nurses.
• To learn about disease, pattern of care,
treatment.
• To acquaint nurses with all patients.
FACTORS TO BE KEPT IN MIND WHEN
PLANNING NURSING ROUNDS.
 To consult students previous clinical
experience to avoid repetition & to add to
earlier experience.
 Keep in mind the probable value & availability
of clinical material.
 Explain the plan to the patient.
 Introduce the patient to the group.
 Make the patient feel important.
 Have a post-conference for summary &
further explanation.
 Records the nursing rounds in the ward
teaching records.
 Preparation by the Head Nurse
• The head nurse selects the patients before round
, according to the time available.
• Rounds not last longer than an hour .
• Head nurse needs to read the patients histories,
know the plan for their treatment and its
results , the patients progress and prognosis,
their nursing care and its effectiveness.
Cont.....
• Rounds for staff nurses should be held
separately from those of students .
• Rounds for senior students should be
held separately from those of junior
students at a time.
 Procedure for Conducting
Nursing Rounds
 A brief discussion at the side of the patient’s
room/ward has to be held.
 Necessary data are given.
 The purpose of the visit to the patient is
outlined by the head nurse, special
observation to be made or pointed out at
this time.
Cont.....
 4-5 patients are selected for instruction.
 The head nurse herself may present the
uses or she may ask the students who
are assigned to these patients to answers
the questions of the group or her
questions.
 The students are asked to present the
cases regarding other particulars.
Cont.....
 The participants may also be involved such
as counting pulse,respiration, examining the
conjunctive, pitting edema etc.
 The patients case sheet can also be utilized
with presentation.
 Thank the patient before leaving & tidy up
the bed.
Examples of Nursing Rounds
• Demonstration of symptoms
• To clarify terminology
1.Herpes simplex
2.Anemic pallor
• Effects of drug
1.Allergic reaction
2.Sedative effect
 Advantages
• This method provides opportunity to learn about the
patients progress through the highly experienced
nursing experts.
• Nursing Rounds provide an opportunity for students
to learn about the effect of different drugs ,treatment
modality, any changes and progress of patient.
• Students can select patients with specific problems
and plan proper nursing care.
• Response of the patient is more natural.
 Disadvantages
• It is not suitable method of teaching for a
bigger group of students.
• Requires very carefully planning.
• The bedside discussion about patient during
nursing round may be uncomfortable for the
patient and it may be a cause of anxiety.
• It time consuming.
REPORTS
 Introduction
• Reports can be compiled daily, weekly,
monthly, quarterly and annually. Report
summarizes the services of the nurse
and/ or the agency.
 DEFINITION
• A report is a system of communication
aimed at transferring essential information
necessary for safe and holistic patient care.
 PURPOSES OF WRITING
REPORTS
• It is an important tool of communication between the
patient, nurse and members of the health team.
• It provides communication to the in-coming nurse on
duty by giving brief and accurate information on the
patient.
• It avoids harassment for the new nurse who comes
for duty for the first time.
• Reports when complete helps provide better patient
care.
 TYPES OF REPORT
• ORAL REPORT:- this report are given when
the information is for immediate use not for
permanency.
• WRITTEN REPORT:- reports are to be
written when the information is to be used by
several personnel.
 Oral report
 The information is for immediate use and not for
permanency.
 Based on material included in a written report.
 Reports between the head nurse(nurse-in –charge)
and her assistant ,e.g. patients’ conditions,
treatment
 Reports between nurses who are assigned to
bedside care.
 Reports of staff members to the charge nurses
 Nurse in –charge reports to bedside nurses.
 Report of the charge nurse to the
nurse supervisor:It includes
names,diagnosis’treatment of each
patient.
 Reports of the charge nurse to the
clinical instructor.
 Reports of the supervisor to the
director of nursing.
 Report of the charge nurse to the
physician .
 A report can be given orally in person
or by audiotape.
 Written reports
Census reports
• Daily census or the number of patients in
the nursing unit at midnight.
Reports on mistakes and accidents
• Accurate and comprehensive reports on
both the patients charts and in the accident
reports is essential to protect the hospital
(documentation for legal consequences).
 Change of shift report
• In this type of report on the duty nurse
summarize information about assigned
client. It is also known as end of shift
report. It is given orally or during rounds at
the client bed side.
Change of shift includes:-
• Background data gathered from client
interaction and assessment
• Nursing and medical diagnosis of problems
• Current changes in client health and change in
treatment
• Effective interventions including lab test and
diagnostic result.
• Progress of client health.
• Modifications in the plan of care
• Client or family fresh complaints.
 TRANSFER REPORT
• Patients will frequently transferred from
one unit to another to receive different
level of care. A transfer report includes
communication of information about client
from the nurse on sending unit to the
nurse on receiving unit.
Transfer report includes
• Clients name, age, gender, physician name,
medical diagnosis, surgery if performed
• Summary of progress
• Current health status
• Current plan of care
• Any special precaution, such as isolation
etc.
• Need for any special equipment.
 Incident report
• Incident report are used to document any unusual
occurrence or accident . Such as fall, medication
error, needle stick injury.
• It includes:
• Record the date, time and place where the incident
occurred.
• Describe incidence in concise way
• Describe client condition at the time of incidence,
measure taken by nurse, physician
• Submit report as soon as possible
• Keep a written account of incident report.
 Legal Reports
• Incident reports and reports on accidents,
mistakes and complaints are legal in
nature. In such reports, the content is
stated briefly and objectively giving all
pertinent information. Accuracy
,timeliness, completeness and relevancy
to the problems are maintained promptly
while making such reports.
 Nursing responsibility while
keeping records and reports
• The records and reports should be kept under
safe custody.
• No individual sheet is separated from the
complete report
• Records and reports must place confidentiality
• No stranger is permitted to read the reports
• All reports to be handled carefully
• Protection from loss
• Filling should be done alphabetically,
numerically with cards and geogra-phically
• Assess periodically to determine the use
of records and reports and reexamination
for means of simplification.
CASE METHOD
 Introduction
• Case Method also known as case study is a
blueprint of nursing care rendered by a
nursing student to a selected patient for a
particular time of period by following nursing
process approach,with an intention to
develop comprehensive nursing care
abilities.
 Purposes of Case Study
• It provides an opportunity to the student to
learn nursing skills using the problem
solving approach.
• Students learn to identify and define a
patient's problem.
• It helps the student solve the patients
problems by critical and reflective thinking.
• It accentutes the health and social
aspects of nursing.
 Convey
knowledge, facts,
information to
Improve Students students
Apply theory to a
self esteem
situation

Deal with opinion

differences Enhance students’
decision making
skills

Listen to others Improve students’

technical or
behavioural skills
in analysing data

Case
Method
Prepare to handle
limited Stimulate
information students’ interest
in a subject

Differentiate
assumptions from
inferences Augments critical
thinking

Present a realistic
Appreciate
picture of the
compulsions in
complexities in a
decision making
Judge between situation
different courses
of action
 Principles of Case Study
• The student should be able to make their
nursing care study on a patient for whose care
they are responsible.
• The selection of the patients can be done by
coordination between the clinical instructor and
students.
• The first part of the study should be concerned
with information and facts about patient .
Cont.....
• The second part of the nursing case study takes in
the responsibilities and the activities the nursing
student will be concerned with in giving
comprehensive nursing care to the patient.
• It should emphasis on the individual needs of a
patient and how they are met.
• It should serve as an excellent tool to demonstrate
nursing skills,scientific knowledge & sciological or
psychological insight into the problems of the
patient.
 Forms of Case Study

 Written
 Verbal /Oral
 Advantages
 Written Case Study
1. It provides for individual diffirences of the
patient.
2. Gives an opportunity for self expression in
writing.
3. Provides experience in organizing and writing
a paper in a scientific manner.
4. Is a source of material for future reference.
 Advantage
 Verbal/oral Case Study
1. It provides an opportunity for the instructor to
direct student thinking into new channels & correct
errors of information.
2. It is time saving and dose not require lengthy
recopying of notes.
3. It offers an opportunity for public- speaking
experience.
4. The student feels the thrillof achievement in
presenting the study to others.
 Disadvantage
• It gives no opportunity to brachout and
incorporate new ideas once the study is
completed.
• It require time to write a case study.
• It leaves no records that may be kept for
future reference in oral case study.
 Conclusion
• Nursing rounds/visits are part of nursing services. It is a tool
of supervision. It controls the quality given by nurses in
hospital and community settings. Nursing rounds are a part
of evaluation and performance appraisal. Nursing round is
one of the main responsibility of nurse managers.
• Reports are oral or written exchanges of information shared
between caregivers or workers in a number of ways. A
report summarises the services of the person or personnel
and of the agency.
• case study is a blueprint of nursing care rendered by a
nursing student with an intention to develop comprehensive
nursing care abilities.
 BIBLIOGRAPHY
• Basvanthappa, 2003 ‘Text book of nursing
education’,first edition ,Jaypee brothers
Medical publishers
• K.P Neeraja ‘Text book of nursing
education’(2003), first edition 2009,published
by Jaypee Brothers Medical Publishers.
 ASSIGNMENT
• Write the nursing responsibility of ward
incharge where you are posted while
conducting the rounds. And mention the
process of change in shift reports in your
clinical area.
THANK YOU