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Hourly Rounding Implementation: A Multisite Description of Structures, Processes, and Outcomes

Rondinelli, June MSN, RN, CNS; Ecker, Margaret MS, RN; Crawford, Cecelia DNP(c), RN; Seelinger, Connie MSN, RN; Omery, Anna DNSc, RN, NEA-BC

JONA: The Journal of Nursing Administration: June 2012 - Volume 42 - Issue 6 - p 326–332
doi: 10.1097/NNA.0b013e31824ccd43

Objective: This study identifies structures, processes, and outcomes associated with hourly nurse rounding.

Background: Literature supports that nurse rounding every 1 to 2 hours affects quality outcomes. Evidence is lacking regarding the process of successful implementation.

Methods: Using an action research design, project leads implementing hourly rounding at 11 Southern California hospitals agreed to recorded telephone interviews. Transcribed interviews underwent content analysis.

Results: Analysis revealed 15 major themes. Structure themes include use of rounding behaviors described through an acronym and collaborative phone call. Processes include a library of tools to use incorporating both patient and staff feedback. Patient satisfaction and patient perception of being well cared for are 2 common outcome themes.

Conclusions: This study provides evidence that frequent reevaluation of structures and processes promote achievement of desired outcomes in relation to hourly rounding. The authors recommend abandonment of routinization and adoption of flexibility to sustain successful implementation of hourly rounding.

Author Affiliations: Project Manager (Ms Rondinelli) and Project Manager (Ms Crawford), Southern California Kaiser Permanente Regional Nursing Research Program, Pasadena; Nursing Quality Director (retired) (Ms Ecker), Los Angeles Medical Center, Kaiser Permanente Southern California, Los Angeles; Perinatal Director (Ms Seelinger), South Bay Medical Center, Kaiser Permanente Southern California, Harbor City; Nurse Scientist and Director of the Regional Nursing Research Program (Dr Omery), Kaiser Permanente, Southern California, Pasadena, California.

The authors declare no conflicts of interest.

Correspondence: Ms Rondinelli, Kaiser Foundation Hospitals, Southern California Regional Offices-Walnut Center, 393 E Walnut St, Pasadena, CA 91188 (

© 2012 Lippincott Williams & Wilkins, Inc.