Improving Patient Safety and Satisfaction through ASTER Rounds: A Prospective Interventional Study in a Saudi Hospital

Background: Patient safety remains a fundamental priority in healthcare systems globally. Delays in nursing response times have been identified as a significant contributor to adverse events such as hospital-acquired pressure injuries (HAPI), IV infiltrations, and patient dissatisfaction. Hourly rounding, particularly when adapted to local needs, is a promising intervention to address these concerns.Objective: This study aimed to evaluate the effectiveness of the ASTER Rounds protocol a structured, culturally tailored hourly rounding model in improving patient safety outcomes and satisfaction at ASTER Sanad Hospital in Riyadh, Saudi Arabia.Methods: A prospective, audit-based interventional study was conducted over seven months (November 2024 to May 2025), including 350 patients across inpatient departments. The intervention comprised structured hourly rounding guided by the ASTER framework (Anticipate Needs, Sensitivity & Safety, Tact, Elimination, Repositioning). Data were collected using three validated tools: the ASTER Audit Checklist, an Hourly Rounding Compliance Form, and the Nursing PREM Survey. Clinical outcomes such as HAPI, IV infiltrations, patient complaints, and expressions of appreciation were tracked monthly.Results: The implementation of ASTER Rounds led to a marked increase in rounding compliance from 72% to 91.5%. HAPI cases declined from 6 in November 2024 to zero by March 2025, while IV infiltrations reduced from 15 to 2 cases. Patient complaints fell from 25 to 2, whereas appreciation notes rose from 120 to 276. Nursing PREM survey scores indicated significant improvements in patient-perceived nurse responsiveness, communication, and clinical competence.Conclusion: ASTER Rounds significantly enhanced patient safety and satisfaction outcomes, demonstrating the efficacy of structured hourly rounding in a Middle Eastern context. The intervention proved adaptable, culturally sensitive, and effective in promoting standardized nursing care.