Intentional rounding: a critique of change in the 21st century

Abstract
The practice of intentional rounding has become established in the US, and has been actively promoted, not least by the Prime Minister, at visits to English hospitals and associated press releases which have presented quantified claims for its effectiveness. These claims have been repeated at conferences and in papers in professional journals. However, when subjected to a critical review the claims are found to be based on very poor evidence which has itself been subjected to serial misreporting. There is no body of research supporting universal introduction of the practice and yet it is presented as a research based initiative by the UK Government and nurse managers. As an example of translation of research to practice, the case of intentional rounding illustrates a number of tensions with the very idea of professional nursing practice. Systems of health care delivery are heavily influenced by political and commercial pressures, and these are in opposition to the function of professional nursing which includes the requirement to provide individualised care supported by a soundly appraised evidence base and autonomous practice. The experience of intentional rounding thus far suggests that where these pressures are in tension, nursing practice occupies a submissive position.