NURSING PATIENT CARE POLICY & PROCEDURE
April 29, 2016
Nursing Manual (Red)
Policy #: 14.35 AP
Title: Intentional Rounding (Adults and
To enhance the patient experience by supporting patient safety and proactively
anticipating patient needs.
Intentional Rounding will be conducted by Registered Nurses (RNs), Nursing
Assistants (NAs) or Patient Care Technicians (PCTs) on inpatient nursing units every
hour from 6:00 am until 10:00 pm and every two hours from 10:00 pm until 6:00 am.
Nursing units will maintain the UWH Intentional Rounding process to ensure an
established practice of rounding.
A. On admission, the admitting RN explains the process of Intentional Rounding to
the patient/family using the Intentional Rounding Health and Nutrition Facts For
B. Following the Knock/Acknowledge, Name, Occupation, Duty (KNOD) process, the
RN/NA/PCT knocks on the patient’s door, awaits acknowledgement, provides his
or her name and occupation, enters the patient room and tells the patient that s/he
is there to round on them.
C. The RN/NA/PCT addresses the following five items, tailoring the language used
to the patient and situation:
2. Personal needs (such as need to use bedpan/restroom, urinary catheter
3. Position (such as need to be turned from side-to-side)
4. Possessions (such as call light, glasses, cell phone, tissues easily
reachable by patient)
5. Prevention (safe environment, clutter-free, IV fluids, bed alarms on, etc.)
D. Upon completion of rounds, check with the patient to see if there is anything else
s/he needs, (e.g. “Is there something else I can do for you before I go? I have the
E. RNs and NA/PCTs will work together to ensure that intentional rounds are
accomplished. If a staff member is unable to complete intentional rounding,
assistance from another team member should be requested. This may include
other RNs, NA/PCTs, Care Team Leaders/Senior Team Members, Nurse Manager
or Clinical Nurse Specialist as they are available.
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F. The RN should discuss with the patient that if the patient is sleeping, the patient
will not be wakened, but that staff will be coming into the room to check on their
well-being. The RN/NA/PCT is still responsible to enter the room, complete an
environmental safety check, check the IV pump/fluids, make sure the call light
and other essentials are within reach, and that bed alarms/other alarms are on as
G. In order to indicate that rounds have been completed, the RN/NA/PCT should
update the notification tool to the current hour.
H. If a patient is off the unit, rounds will be deferred until the hour the patient
I. If a patient expresses reluctance to allow rounding, the RN should explain the
safety goals and concerns underlying rounding. If a patient is refusing to allow
rounding, the RN should consult the Care Team Leader, Nurse Manager, Clinical
Nurse Specialist, and/or Nursing Coordinator for assistance with problem-solving.
IV. UWHC CROSS REFERENCES
A. Health Facts For You 7181, Intentional Rounding
A. Aboumatar, H. J., Chang, B. H., Danaf, J., Shaear, M., Namuyinga, R., Elumalai,
S., Marsteller, J.A., & Pronovost, P. J. (2015, September). Promising Practices for
Achieving Patient-centered Hospital Care. Medical Care, 53(9), 758-767.
B. Forde-Johnston, C. (2014, April). Intentional rounding: a review of the literature.
Nursing Standard, 28(32), 37-42.
C. Halm, M. A. (2009, November). Hourly Rounds: What Does The Evidence
Indicate? American Journal of Critical Care, 18(6), 581-584.
D. Harrington, A., Bradley, S., Jeffers, L., Linedale, E., Kelman, S., & Killington, G.
(2013). The implementation of intentional rounding using participatory action
research. International Journal of Nursing Practice, 19, 523-529.
E. Lowe, L., & Hodgson, G. (2012, October). Hourly rounding in a high dependency
unit. Nursing Standard, 27(8), 35-40.
F. Olrich, T., Kalman, M., & Nigolian, C. (2012, January/ February). Hourly
Rounding: A Replication Study. MedSurg Nursing, 21(1), 23-36.
G. Tea, C., Ellison, M., & Feghali, F. (2008, July/August). Proactive Patient
Rounding to Increase Customer Service and Satisfaction on an Orthopaedic Unit.
Orthopaedic Nursing, 27(4), 233-240.
VI. REVIEWED BY
Director, Education & Development, Nursing/Patient Care
Director, Professional Services UW Health at The American Center
Nursing Patient Care Policy and Procedure Committee, April 2016
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Beth Houlahan, DNP, RN, CENP
Senior Vice President Patient Care Services, Chief Nursing Officer