The delivery of compassionate nursing care in a tick-box culture: Qualitative perspectives from a realist evaluation of intentional rounding.
Sarah Sims, Mary Leamy, Ros Levenson and 3 others
PMID 32380263WHAT IT FOUND
Nursing staff and patients described intentional rounding as mainly extra checks and paperwork.
They did not describe it as adding compassionate care. Many patients were unaware it was happening; some staff said forms could be ticked without the round being done.
Key findings
01Most frontline nursing staff and senior nurse managers interviewed did not believe intentional rounding improved their own standard of nursing care or the care delivered by their Trust.
02Only three nursing staff and no senior nurse managers felt intentional rounding improved the quality of nurse-patient communication.
03The majority of patients and family carers interviewed had not been aware that intentional rounding was occurring; only four patients and no carers said it had been explained to them.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The findings come from interviews in England only and from a small number of selected wards, so they may not apply to other settings. Trust nursing managers chose the wards, which may have introduced bias. Most patients and carers did not know intentional rounding was happening, so it was often unclear whether the care they described was part of a rounding episode. The study reports perceptions and experiences, not measured patient outcomes, so it cannot show whether intentional rounding improves care or safety.
Declared interests
Funded by the National Institute for Health Research, Health Services and Delivery Research programme; the supplied text does not report author competing-interest declarations.
The easy way to misread this
Do not read intentional rounding documentation as proof that a round happened or that compassionate care was delivered. Some participants said forms could be completed without the round being done, and many patients were unaware rounding was occurring.