Il giro visita: una prassi che garantisce la qualità? Una revisione integrativa della letteratura

Introduction The ward round is a long-standing practice rooting in bygone times. Despite being a key component of health care activities, it is often underestimated in care planning and management. Many studies report an enormous variance both in the purposes and in the management of the ward round, with nurses often invisible within the process and negative consequences on the patients’ clinical and emotional outcomes. The aim of the review is to summarize the main evidences regarding the WR practice as an evidence-based tool supporting the clinical governance in healthcare system. Methods An integrative review has been conducted using MedLine database, through PubMed, in order to identify primary indexed studies investigating the WR as a practice to ensure quality in the healthcare system. Results The 21 studies included in the review allowed to identify four main issues regarding WR: (I) “perceived quality by health professionals”; (II) perceived quality by patient”; (III) “quality management”; (IV) “professional quality”. Conclusions A structured WR, on a daily basis and with evidence-based tools, improves the managerial quality, the efficiency (cost containment and increased productivity - in terms of the ratio between volume of services provided and costs), the integration between business processes and professional quality. Moreover, in order to improve the perceived quality, the ward round practice needs to be reconsidered in a number of aspects: involvement of all the team members, patients and careers, awareness of the professional role, communication within the triad physician-nurse-patient.