Nurses working in a hospital setting are often required to complete hourly rounding, which is the practice of checking in on all patients under your care at least once every hour. The cyclical nature of rounding may seem repetitious, but it is a critical part of providing patients with exceptional care and boosting satisfaction ratings. The 5 Ps in nursing can help you improve your rounding practices and make the task more enjoyable as a result.
What Are the 5 Ps of Nursing?
The 5 Ps of nursing are defined by Readiness Rounds as a set of best practices for hourly rounding that can help increase efficiency, bolster patient outcomes, and improve job satisfaction ratings among nursing staff.
The 5 Ps nursing practices should be executed when visiting each individual patient. The 5 Ps include:
- Pain
- Position
- Potty or personal hygiene
- Periphery
- Pump
Importance of the 5 Ps in Nursing Practice
In hospitals, nurses receive a list of patients for whom they are required to care during a given shift. While rounding, they need to make sure they visit each patient once every hour—or once every two hours if working an overnight shift. Purposeful rounding ensures that nurses take a proactive approach to patient care, allowing them to address ongoing patient needs before any complications or issues arise.
Role of the 5 Ps in Patient Satisfaction
According to Readiness Rounds, nurses who practice the 5 Ps during rounds are frequently able to improve patient satisfaction ratings, sometimes by more than 10 percent. Intentional and purposeful rounding provides patients with clear information about the care they are receiving and helps increase trust in their providers. As rounding is cyclical and occurs once per hour, they can begin to better trust and understand that their nurse will continue to manage their pain and comfort levels while offering them the care they need.
An In-Depth Look Into the 5 Ps
By taking a deep dive into the 5 Ps of nursing, you can improve your rounding practice and provide patients with the best possible care throughout your entire shift.
Pain: The First ‘P’ of Nursing
In many cases, the patients under your care are actively experiencing discomfort, and as a nurse, it is part of your responsibility to manage their pain levels. The first question you should ask your patients when rounding is, “Are you in any pain or discomfort?” With the understanding that pain is incredibly subjective, some nurses ask patients to use a number scale to identify their level of pain.
Asking about a patient’s pain level offers several benefits. Not only does it allow you to address your patient’s needs and cater to their comfort, but it also helps your patient feel heard and valued.
Position: The Second ‘P’ of Nursing
Hospital patients often have limited mobility. Depending on the equipment they are hooked up to, they may be unable to adjust their position or make themselves comfortable. After you have evaluated your patient’s pain levels, you want to move onto the second ‘P’ — position.
You should ask your patient if they are comfortable or would like you to adjust their pillows or bed. Adjusting position helps your patients feel more comfortable and relaxed during their stay as well as prevents complications, such as bed sores, pneumonia, and muscle weakness.
Potty or Personal Hygiene: The Third ‘P’ of Nursing
Once you address their pain and position, you should also talk to your patient about their personal hygiene needs. You can do this by simply asking patients if they need to use the restroom. Be mindful, however, that some patients may feel uncomfortable asking for help or even might not be able to tell you that they have to go to the bathroom. While rounding, be sure to take note of your patient’s condition and verify on their chart that they have been using the bathroom regularly.
Periphery: The Fourth ‘P’ of Nursing
It may be the fourth component of purposeful rounding, but in many ways, periphery can be the most impactful part of your rounding experience. Periphery refers to a patient’s ability to reach what they want and need. By recognizing that patients are limited in their mobility and confined to a hospital room, you have the opportunity to immediately improve their experience.
For instance, some ways to address periphery would be asking if your patient can reach everything they need (such as a TV remote or a book they are reading) or if you can bring them anything from another part of the room.
Asking about periphery shows that you care about patients’ comfort and mental well-being, plus helps them develop a deeper sense of trust in you.
Pump: The Fifth ‘P’ of Nursing
As the fifth and final ‘P’ of nursing, pump is a crucial part of purposeful rounding. According to the Institute for Safe Medication Practices, patient pumps and IV sites should be evaluated at least once every two hours or any time a nurse checks on a patient’s position.
While checking the patient’s pump, you should verify:
- Medication and dosage requirements
- Proper placement
- Pump settings
The 5 Ps and Fall Prevention
Structured, actionable rounding not only helps improve patient satisfaction ratings but also significantly reduces the risk of patient falls. Some studies have found that practicing the 5 Ps in nursing can reduce patient fall rates by up to 50 percent.
How the 5 Ps Aid in Preventing Patient Falls
Purposeful rounding helps prevent patient falls because, when nurses regularly address the unique needs of individual patients, this can lower the risk of patients attempting to move about the room without proper supervision. When patients know their nurse will be checking in on a regular basis, they are less likely to try to use the bathroom on their own or reposition themselves.
Overcoming Obstacles in Implementing the 5 Ps
Hourly rounding is considered the ideal practice for nurses who work in hospital settings, but the reality of the matter is that it is not always easy to execute this regimented schedule in real time.
Common Challenges and Solutions in Practicing the 5 Ps
When it comes to implementing hourly rounding, these are some of the most common challenges facing nurses and hospital administrators:
- Staff shortages – Many hospitals simply do not have enough nurses on staff to provide hourly rounding. According to the American Nurses Association, the nurse staffing crisis must be addressed in order to improve patient outcomes.
- Training – In order to leverage the 5 Ps in nursing, nurses must be properly trained and provided a script to work with. Hospitals should offer this type of professional development if they want to enact the culture shift required to implement effective hourly rounding.
How Can the 5 Ps Improve Nursing Best Practices?
The 5 Ps improve nursing best practices in numerous ways. Mainly, this structured approach to rounding simplifies the process, allows nurses to proactively address the needs of patients, and highlights the importance of the patient experience.
Are There Any Limitations to the 5 Ps Approach?
While this has been shown to be an effective approach to rounding, there are some limitations. For example, it can be difficult for nurses or hospital administrators to measure the results of the 5 Ps approach. In addition, it could keep nurses too strictly focused on the script, leaving less room for personalized care and attention.
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