Table 1

Hypothesised mechanisms of intentional rounding (stage 1)

Mechanism titleMechanism (resources)Mechanism (reasoning/responses)
M1: Consistency and comprehensiveness*Intentional rounding helps keep patient care consistent through the use of a structured, systematic approach, ensuring all patient needs are met and potentially less obvious aspects of care are considered and managed at every round.
Intentional rounding also helps ensure that family members are provided with consistent care and information in line with their needs (eg, the need for information, to be respected and to be comforted).
It can also prompt agency staff to deliver care to a required standard.
This provides reassurance and confidence in the quality of care to patients, their family members and staff.
M2: Allocated time*Intentional rounding gives nurses allocated ‘time to care’ (ie, time to check that patients are comfortable and their needs are being met, thereby treating patients with dignity and replaces ‘presumed care’).This helps nurses to organise their work and feel able to prioritise this aspect of nursing care.
M3: Accountability*Staff are required to complete and sign the intentional rounding record to say they have carried out hourly checks.This makes staff feel personally accountable for the standard of care.
This enables ward managers to monitor and audit the standard of care provided by nursing staff.
M4: Nurse–patient relationships and communication*Intentional rounding provides increased and improved communication between staff, patients and family members, and ensures that patients’ perceived basic fundamental needs are met.
It also provides more opportunities for positive nurse–patient relationships to develop based on trust, respect and caring.
This enables staff to get to know patients better and become more aware of their needs, notice unusual behaviours/appearances and detect subtle/significant changes that can impact on comfort and safety.
M5: Visibility*Intentional rounding increases the visibility/presence of nurses within a unit by increasing the time that nurses spend in the direct vicinity of their patients (ie, it gets nurses to the patient’s bedside).This relieves the uncertainty and anxiety often associated with vulnerable patients’ hospital experience (ie, the inability to predict when care will be delivered and when someone will be available to assist them with care).
This is comforting to family members because it denotes frequent and continuous assessment of the patient and their needs.
M6: Anticipation*Intentional rounding enables nurses to anticipate/pre-empt and proactively address patient needs instead of being reactive and waiting for patient call bells and alarms.This ensures that all patients receive regular care instead of unequally distributed care among patients, focused towards those who have frequent call bell use.
M7: Staff communication and/or teamworkingIntentional rounding provides healthcare professionals with documented evidence.This is used to enhance staff communication and teamwork, and prioritise care in future rounds.
M8: Patient empowermentIntentional rounding provides an opportunity for nursing staff, patients and family members to get to know each other better.This empowers patients to ask for what they need in order to maintain their comfort and well-being.
  • NB: All of the mechanisms were identified in empirical research papers, and six (marked with *) were also identified in the grey and policy literature.