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Posted 21 Oct 2013 in Open for better care

Intentional rounding is simple, fundamental, patient-centred and decreases workload.

That’s the view of Debbie Brown, Quality and Patient Safety Manager for Bay of Plenty DHB, and Nurse Leader Maurice Chamberlain.

According to Dix, Phillips and Braide (2012), intentional rounding was developed in the United States and then implemented in Britain’s National Health Service. It involves staff carrying out regular checks on individual patients at set intervals to assess and manage their fundamental care needs relating to five core elements:

  1. tidy environment
  2. bell in reach
  3. hydration
  4. mobility aids available and in reach
  5. continence.

Debbie Brown says the intentional rounding concept was analysed and trialled within the DHB’s working group. It has been adapted to create a concept known as ‘the four Ps’:

  1. positioning: making sure the patient is comfortable and assessing the risk of pressure ulcers
  2. personal needs: scheduling patient trips to the bathroom to avoid risk of falls
  3. pain: asking patients to describe their pain level on a scale of 0-10
  4. placement: making sure the items a patient needs are within easy reach.

Maurice Chamberlain says the Kaupapa Ward leads the way in intentional rounding, followed by Health in Ageing specialist services for older people. Both are based at Tauranga Hospital. Intentional rounding has now been introduced organisationally across both Tauranga and Whakatane Hospitals.

He says local anecdotal results align with the proven international research.

“Kaupapa has gone from a ward which continually received complaints to now one that regularly receives compliments. To make this change it is as simple as checking for these things ‘intentionally’ every time a staff member ‘rounds’ hourly,” he says.

The truths and myths about intentional rounding, from Bay of Plenty DHB

“But I already do this” TRUE – But do we do it intentionally and regularly? Or do we wait for the bell to ring?
“This is basic care” TRUE – and we should continue to promote that. It’s a culture shift, a different way of doing what we already do – it’s prevention of an incident.
“This will increase my workload” MYTH – all the evidence and data show intentional rounding reduces workload, use of call bells, and patient anxiety, while patient satisfaction increases.
“It’s another piece of paper to fill out” MYTH – This is not about a piece of paper; it’s a practical mindset about managing care intentionally and reducing potential harm.
“Is this is just another management tool?” MYTH – This concept came from nurses for health workers to see how they can improve care.
MYTH – This concept came from nurses for health workers to see how they can improve care.