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Does intentional rounding improve patient outcomes?

  • Comments (9)

Braide M (2013) The effect of intentional rounding on essential care. Nursing Times; 109: 20, 16-18

Snelling P (2013) Intentional rounding: a critique of the evidence. Nursing Times; 109: 20, 19-21

‘Intentional rounding’, the practice of performing regular, set checks on patients regardless of clinical need, has been heavily promoted by David Cameron and NHS leaders and has been introduced in many hospitals.This week we’ve published articles arguing both for and against intentional rounding.

Braide M: “Intentional rounding is a structured approach to the delivery of fundamental care. It is widely recognised to benefit patients and endorsed by prime minister David Cameron as giving nurses “time to care”. Increased scrutiny of NHS care as a result of the Francis report, and the financial pressures caused by the requirement for the NHS to save £20bn by 2015 mean the need to evaluate how we coordinate and improve care has never been greater.”

Snelling P: “Intentional rounding has been heavily promoted by the prime minister David Cameron and others and is being widely implemented in UK hospitals. It is claimed that the practice has a number of benefits, including reduction in call bell use, falls and pressure ulcers and increased satisfaction. In this article, I will submit these claims to close scrutiny and argue that the evidence base is too flimsy to support the claims.

“Individual nurses and nurse managers should look more to evidence than to political expedience when implementing nursing policies.”

What do you think?

  • Does intentional rounding improve patient outcomes?
  • Is the evidence-base sound enough to support wide-spread use of intentional rounding?
  • Does this policy hinder nurses’ ability to make judgements of appropriate levels of observations?
  • What has been your experience of intentional rounding?
  • Comments (9)

Readers' comments (9)

  • Anonymous

    I started working as a nurse in the era of 'back rounds'; 'TPR (temp, pulse, resps) round' etc and what it did was ensure that the pressure areas and observations of the patients were done on time, and if any problems were noted they were picked up early and actioned. Also it gave the patients a sense that they were being cared for by staff who were interested in preventing any problems with the skin or their vital signs. It was also a chance to communicate with the patients, checking all was well but also getting to know them as individuals. The observations of the skin or vital signs were duly recorded on their charts and in the Kardex. Now you hear of patients not being washed or shaved not just for one day but a week and the incidence of pressure sores seems high in comparison to what I witnessed years ago. Pressure sores back then were looked at as a failure of basic nursing care although this is perhaps simplistic given the complexities and co-morbidities of patients' medical conditions.Too often you hear of nurses saying 'You are not my patient' when asked something by a patient. Doing the 'rounds' meant all nurses got to know the patients. The caring, respecting, interested aspect of the role of a nurse should not be underestimated in its importance to the patient.

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  • Anonymous

    Anonymous | 21-May-2013 5:39 pm

    good post. I had the similar experiences but isn't one of the problems now that the turnover of patients is far more rapid, creating another set of problems and adding to the already excessive amount of paperwork and affording less time to spend with each patient and getting to know them and identifying and attending to their needs as effectively as before? Nursing has also become far more technical and may involve an increasing number of tasks and of greater complexity than it used to which also includes those dumped on nurses by other hc professionals who spend less time on the wards. Over my 30 odd years in nursing I seem to have acquired an endless list of not only nursing related skills but also many which are not related and for which I received no training but nevertheless important for the smooth running of the ward and well being of staff and patients as nobody else every seems available fast enough to carry them out! These can also be time consuming and take nurses away from the bedside.

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  • Anonymous

    Anonymous | 21-May-2013 5:39 pm

    Further to your important point in your comment which one could expand upon:

    "'You are not my patient' when asked something by a patient."

    not very reassuring for the patient who happens to be on the receiving end! how about instead, 'I will find out for you' or I will find a nurse, etc. who can help you' or 'nobody is available at the moment but we will make sure somebody attends to you as soon as somebody is free' whilst making sure one does find somebody to get back to them as soon as possible rather than leaving the patient high and dry and waiting and wondering for ages when their needs will be addressed. A few words of assurance that their needs are important works wonders for their well being, feelings of security and trust in the service and can also avoid causes for complaints if they feel valued, respected and that somebody cares about their queries and needs. Although please not like these dreadful call centre recorded messages we have all experienced which repeatedly tell us whilst we hang on for ages thinking of our phone bill 'your call is important to us.......'!

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  • I would appear that everyone and the cat knows more about providing nursing care than nurses themselves !

    Weak and ineffective "nurse managers" grab onto the solutions provided by non nurses and attempt to implement some crazy ideas.

    We have a so called leader sat at the DH who really believes the problems of the profession can be solved by 6C's !

    Why are we not discussing appropriate nurse/patient ratios and skill mix? Get these two issues right and the reward would be improved patient care !

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  • Anonymous

    Jenny Jones

    "Why are we not discussing appropriate nurse/patient ratios and skill mix? Get these two issues right and the reward would be improved patient care !"

    definitely but seemingly there is a fear this would cost far more in the short term than all the wasted resources spent faffing around preaching about 'intentional rounding' and 'intentional six C's'!

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  • Anonymous

    "Does intentional rounding improve patient outcomes?"

    No.

    Next stupid question.

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  • Anonymous

    doing regular rounds might reassure patients on the ward but for that we need more nurses. why doesn't mr cameron understand that nurses are important for the smooth running of the wards and in the secondary care.
    coming up with new ideas does not resolve the problem of undersatffing.
    MR CAMERON GET IT RIGHT WE NEED MORE NURSES AN DDOCTORS TO CARE FOR PATIENTS.

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  • Anonymous

    Does intentional rounding improve pt outcomes? YES! Nothing to discuss.

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  • Anonymous

    isn't everything nurses do for their patients intentional?

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