Intentional rounding in acute adult healthcare settings : A systematic mixed-method review

Aims and objectives
To determine the impact of intentional rounding on patient and nursing outcomes and identify the barriers and facilitators surrounding implementation.

Background
Intentional rounding is an organised approach whereby health professionals’ regularly check on patients to ensure their fundamental care needs are met. Despite wide scale adoption of intentional rounding, there is limited evidence to inform practice.

Methods
This systematic mixed-method review was conducted using the Joanna Briggs Institute methodology. Databases CINAHL, MEDLINE, EMBASE, COCHRANE, SCOPUS and WEB of SCIENCE were searched to identify research studies published in English between January 2006–January 2017 that reported on intentional rounding and patient and nursing staff outcomes. Studies were assessed for methodological quality. The findings were synthesised into themes using a narrative approach.

Results
Twenty-one studies were included in the review. Six studies reported a reduction in the number of falls, and a further five studies reported a reduction in call bell use following the introduction of intentional rounding. Nurses’ satisfaction and attitudes towards intentional rounding were reported in seven studies with equivocal results. The quality of the studies was weak making comparisons difficult.

Conclusions
While results suggest positive outcomes for falls and call bell use, conclusions on the available data are overshadowed by the quality of the studies. Well-designed studies are required to advance evidence in this field.

Relevance to clinical practice
The evidence on intentional rounding is mixed and suggests that the introduction of intentional rounding should be accompanied by a protocol for robust evaluation to measure the impact of this process change. This should be accompanied by standardised reporting measures to enable comparisons and contribute to the quality of available evidence on intentional rounding.