Changing nursing practice: Implementation challenges of intentional rounding on three rehabilitation units

The purpose of this article is to critically examine the process and results of a participatory action study designed to implement intentional rounding on a rehabilitation inpatient service. As a change initiative, this brief case study highlights the successes and challenges of implementing a practice intervention. Intentional rounding is a nursing intervention whereby hourly contact and support is provided to patients and families to strengthen the therapeutic relationship and proactively address their needs. Three units implemented rounding, and pre- and post-data were collected on four indicators: patient falls, call bell frequencies, satisfaction with care, and the nurses' practice environment. The results demonstrated small, positive changes in all indicators, but the level of rounding was lower than expected. Focus groups revealed the complexities of integrating rounding into established routines. Three factors were identified that contributed to the findings.