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. 2022 Jul 8;11(14):3976.
doi: 10.3390/jcm11143976.

Intentional Rounding versus Standard of Care for Patients Hospitalised in Internal Medicine Wards: Results from a Cluster-Randomised Nation-Based Study

Dino Stefano Di Massimo  1 , Gianluca Catania  2   3 , Annachiara Crespi  4 , Andrea Fontanella  5 , Dario Manfellotto  6 , Micaela La Regina  7 , Stefano De Carli  8 , Laura Rasero  9   10 , Claudia Gatta  1 , Giovanna Pentella  11 , Gabriella Bordin  12 , Antonella Croso  1 , Annamaria Bagnasco  2 , Gualberto Gussoni  4 , Daiana Campani  13 , Erica Busca  14 , Danila Azzolina  13 , Alberto Dal Molin  13   14 , On Behalf Of The Intento Study Group
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Intentional Rounding versus Standard of Care for Patients Hospitalised in Internal Medicine Wards: Results from a Cluster-Randomised Nation-Based Study

Dino Stefano Di Massimo et al. J Clin Med. .

Abstract

The aim of the study was to explore the effects of Intentional Rounding, a regular-based proactive patient monitoring, on falls and pressure ulcers in internal medicine units. This is a cluster-randomised controlled study, where units were assigned (1:1) to Intentional Rounding (intervention group) or Standard of Care (control group). The primary outcome was the cumulative incidence of falls and new pressure ulcers. These events were considered separately as secondary endpoints, together with the number of bell calls and the evaluation of patient satisfaction. Primary analyses were carried out on the modified intention-to-treat population (hospitalisation of at least 10 days). Recruitment occurred between October 2019 and March 2020, at which time the study was prematurely closed due to the COVID-19 pandemic. Enrolment totalled 1822 patients at 26 sites; 779 patients were included in the modified intention-to-treat analysis. The intervention group had a lower risk of falls (adjusted incidence rate ratio 0.14; 95% confidence interval, 0.02-0.78; p = 0.03). There were no statistical differences in new pressure ulcers or the cumulative incidence of both adverse events. Mean bell calls for each patient were 15.4 ± 24.1 in the intervention group and 13.7 ± 20.5 in the control group (p = 0.38). Additionally, patient satisfaction in the intervention group was almost at the maximum level. Our study supports the usefulness of Intentional Rounding in a complex and vulnerable population such as that hospitalised in internal medicine units.

Keywords: accidental falls; internal medicine; nursing care; pressure ulcers; randomised controlled trial; safety.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Trial profile. The modified intention-to-treat population included the set of patients who had a duration of hospitalisation of at least 10 days.
Figure 2
Figure 2
Cumulative number of hospital stay events in the two patient populations. (a)—falls; (b)—new pressure ulcers; (c)—composite endpoint.
Figure 2
Figure 2
Cumulative number of hospital stay events in the two patient populations. (a)—falls; (b)—new pressure ulcers; (c)—composite endpoint.
See this image and copyright information in PMC

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