A qualitative exploration of intentional nursing round models in the emergency department setting: investigating the barriers to their use and success

Abstract

The research offers an insight into the staff's perceptions of using intentional rounding and also explains the practical difficulties faced by the nursing staff with potential suggestions that may help to address these problems. Benefits include more open communication between staff and patients and potentially more timely response to patient need, which positively impacts levels of safety and satisfaction. Barriers include lack of staff engagement, and the environmental factors and pressures, within the ED setting.

Intentional rounding in hospital wards to improve regular interaction and engagement between nurses and patients: a realist evaluation

“…A total of 44 papers were included in the realist synthesis, drawn from a variety of sources [i.e. the professional press (n = 21), 3,7-9,22-38 peer-reviewed journals (n = 18), [39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] study reports (n = 4) 4,57-59 and one doctoral thesis]. 60 The research was primarily undertaken in the USA (n = 25) 3,7-9,22, [25][26][27]32,33,[35][36][37][38][39][40][41][42]44,47,48,[52][53][54]60 but also included research from the UK (n = 12), 4,23,24,28,30,31,34,46,51,[57]…”

“…Context-mechanism-outcome 1: intentional rounding ensures that consistent and comprehensive care is delivered to all patients by all nurses A total of 21 papers 4,9,11,24,[26][27][28][29][30][31][32][41][42][43][44][45][46][47]57,58,60 highlighted the link between IR and consistent and comprehensive care. The structured, systematic approach to IR prompted and guided the delivery of care to a required standard, helped staff to remember to conduct all aspects of care on each round 4,58 and identified tasks that might otherwise be missed.…”

“…43 Context-mechanism-outcome 4: intentional rounding enhances nurse-patient communication and/or relationships A total of 17 papers highlighted the positive impact that IR could have on nurse-patient communication. 4,22,24,28,30,34,35,40,41,43,[45][46][47][57][58][59][60] It was widely reported that IR increased the frequency of nurse-patient communications; 4,28,34,40,47,57,58 staff believed that this was welcomed by patients and their carers, 24,28,40,46 making them feel more involved in their care, 28 more likely to voice concerns 40 and less likely to feel ignored/neglected. 57 There was less evidence that IR improved the quality of nurse-patient communication, although some staff felt that it was the final question ('Is there anything else I can do for you?')…”

Intentional rounding – An integrative literature review

“…IR is a systematic approach to checking individual patients at set intervals, anticipating patient needs, reducing adverse advents, offering greater comfort and reducing anxiety for patients. IR started as “patient comfort rounds,” in an effort to ensure that each patient was comfortable and that fundamental care needs such as pain assessment and control, personal comfort and environmental needs were met (Flowers et al., ; Forde‐Johnston, ; Meade, Bursell, & Ketelsen, ; Morgan et al., ; Kirk & Kane, ) . This rationale for regular rounding is to give holistic care and to meet all medical, social and behavioural needs.…”

“…as pain assessment and control, personal comfort and environmental needs were met (Flowers et al, 2016;Forde-Johnston, 2014;Meade, Bursell, & Ketelsen, 2006;Morgan et al, 2016;Kirk & Kane, 2016) .…”