ABSTRACT Aim To synthesise published literature to understand how, when and under what circumstances Intentional Rounding in acute hospital settings improves patient safety and make recommendations for implementation in real‐world settings. Background Inpatient falls often result in injury due to complex interactions between the hospital environment and patient risk factors. Intentional Rounding (IR) is a structured process whereby nurses and care staff carry out regular checks with individual patients to address their needs in hospital. Design Realist Synthesis. Methods Searches were conducted in six bibliographic databases until February 2026. A total of 34 studies were included, and 18 references from grey literature were appraised and included. Results Fourteen initial programme theories were identified and refined throughout the synthesis to identify five mechanisms which support implementation of IR in an acute hospital setting, with six programme theories developed. The mechanisms included motivation, accountability, engagement, consistency, comprehensiveness, and critical thinking. Contextual factors that may constrain the implementation of IR include the organisational support and availability of resources. Based on our findings, we have seven recommendations for consideration when designing and implementing an IR programme in the acute hospital setting. Conclusion This synthesis has provided programme theories and recommendations that can guide research design when implementing an intervention at ward level. Implications for the Profession and Patient Care IR has been used in hospitals as an intervention to improve patient safety and reduce adverse events, such as falls. Reporting Method Realist And Meta‐narrative Evidence Syntheses: Evolving Standards (RAMESES—1). Patient or Public Consultation An in‐person stakeholder engagement workshop was facilitated in March 2025, with patient representatives, hospital staff and members of the public. This engagement assisted the process of theory refinement to ensure research findings were clear and useful for those involved in providing and receiving IR in a hospital setting.
Hetherton et al. (Tue,) studied this question.