5 ways to transform purposeful nurse rounding

Author: Ashley Nelson, MS, BSN, RN

Over the past few decades, managing time and resources has been a persistent challenge in healthcare.  

And after disruptions in the healthcare industry, the question remains for leaders and staff alike—how can we reclaim hours while improving patient care and enhancing work environments for nurses?  

Together, let’s explore actionable ways teams can personalize nursing care, save time, and foster better outcomes by being intentional in their rounding practices. 

Explore NRC Health’s patient experience solutions to improve your nurse rounding processes and reclaim more hours in your day. Contact us to learn more.

Before we discuss strategies, it’s essential to lay the foundation with the “4 P’s” of nurse rounding.  

The 4 P’s of nurse rounding is a standardized framework widely used in healthcare to ensure comprehensive care during each patient encounter.  

The 4 P’s include: 

1. Pain: Assess the patient’s pain level and provide necessary interventions. 
2. Positioning: Ensure proper positioning for comfort and functional health outcomes. 
3. Personal needs: Address individual needs like hydration, bathroom needs, warmth, and hygiene. 
4. Proximity of items: Make sure the patient can access personal items and call buttons easily. 

This model helps nurses personalize care, save time, and eliminate duplication of work through structured, purposeful interactions.  Most importantly, these tactics, when done consistently, reduce the number of falls within an organization and enhance the experience for all involved. 

From a nursing perspective, clustering care has been a core fundamental practice for years.  Making the most of the time one is in the room decreases the number of call lights and workload on the team.  

From a patient perspective, knowing that someone will be in to check on them on a regular basis sets them at ease and allows for much needed rest in between rounds.  

1. Improve communication strategies  

Every interaction matters. 

Clear and compassionate communication is the bedrock of patient-centered care. Narrate your care to ensure the patient/family is informed and a part of the plan. 

A powerful example of this came from a patient who shared: 

“The monitor goes off multiple times a day, and staff buzz in and out fixing or silencing something, never saying anything to me in the bed.  I don’t know if something is wrong with me or the machine.” 

This example gives great perspective from the lens of the patient.  Patients andfamilies don’t know what they don’t know.  Make sure you communicate clearly and consistently throughout your shift.  Purposeful hourly rounds provide a great opportunity for this connection. 

The implementation of communication tools and service standards, such as AIDET (Acknowledge, Introduce, Duration, Explanation, Thank You), makes a significant difference. 

• Connect on a personal level – make reference to something specific about them, or something they have in their room, or on the TV 
• Use specific phrases – Use verbiage such as ‘plan for the day’ and ‘plan for the stay’ to include the patient/family as a partner in their journey. 
• Manage up – provide reassurance and build trust by letting patients and thefamily know “you came to the right place and we are going to take great care of you” 
• Sharing tenure, expertise, or even a fun fact about a colleague builds rapport and confidence. 
• Acknowledge everyone in the room – “and who do you have visiting you today?”  Family/friends/caregivers are a vital part of healing and recovery – make sure they know they are welcome and valued members of the team 

2. Leverage communication boards  

Communication boards (whiteboards or digital) are a simple yet powerful tool that significantly enhances communication, improves the patient and family experience, and supports nurse efficiency. 

When used consistently, whiteboards provide real-time updates on care plans, care team members, daily goals, and discharge information—helping patients feel more informed, engaged, and reassured.  

For nurses, whiteboards reduce repetitive questions, minimize miscommunication, and streamline shift-to-shift handoffs, ultimately decreasing cognitive burden and saving valuable time. 

This shared visual communication fosters trust, promotes transparency, and strengthens the partnership between patients, families, and the care team, leading to a more positive and connected care experience for everyone involved.

Here are ways you can leverage communication boards: 

• Set the expectation that communication boards are up to date 
• Update the board at the change of shift and during rounds 
• Get commitment from the entire team (nurse, provider, tech, case management, social work, therapy, etc.) to participate in the use of this effective tool to streamline communication 

3. Educate as you go – from admission to discharge 

From start to finish, be thinking about the patient’s transition.  Too often, discharge education happens within the last ½ hour of a patient’s stay.  

Optimizing time with patients and families, and educating them throughout your shift, is a best practice in preparing patients and families for transitions of care. 

Starting discharge education at the time of admission is a proactive approach that sets the stage for safe, smooth, and successful care transitions. 

By engaging patients and families early, the care team can align expectations, identify potential barriers, and reinforce key information throughout the hospital stay, rather than rushing to deliver it at the end.  

This ongoing communication empowers patients to better understand their care plan, medications, follow-up needs, and warning signs, leading to increased confidence and a reduced readmission risk. 

For nurses and care teams, early discharge planning supports interdisciplinary coordination, minimizes last-minute delays, and enhances overall efficiency. 

Ultimately, starting discharge education on admission is not just best practice—it’s a meaningful investment in continuity, safety, and patient-centered care. 

4. Close the loop with follow through 

Closing the loop with follow-through is one of the most powerful ways nurses build trust, demonstrate accountability, and reinforce the value of patient-centered care. 

When patients share concerns or requests, they are placing their trust in the care team, and timely follow-up shows that their voice was heard and matters.  

Even if the solution takes time or isn’t immediately available, circling back with an update provides reassurance and reduces anxiety. It also strengthens communication between patients, families, and the care team, helping prevent misunderstandings and repeat requests.  

For nurses, consistent follow-through isn’t just good practice—it’s a reflection of integrity, professionalism, and the kind of care we would want for our own loved ones. 

If a patient expresses a concern or request, follow up on it during the next round or earlier if needed. This builds trust and reinforces that nurse rounding is not just a checklist, but a commitment to their care. 

Here are a few tips to help close the loop: 

• Pull in the multidisciplinary team for needs that are  
• Revisit anything that you mentioned, checking back on.   
• For example: “You mentioned your IV site was bothering you earlier—I am going to take another look now, how is it feeling at the moment?” 
• Address concerns – own it and apologize when something does not go as planned 
• “I’m sorry to hear that was your experience last time – please know your feedback is important and I will share this with our leadership team.” 

 5. Be a natural leader 

Nurses are natural leaders, no matter their title or setting, because leadership in nursing is rooted in compassion, integrity, and action. 

Whether at the bedside, in the boardroom, or behind the scenes, nurses lead by example—staying positive in the face of challenges, advocating fiercely for their patients, and consistently doing the right thing, even when no one is watching.  

A few natural leader qualities: 

• Positivity – glass half full mentality 
• Benefit of the doubt culture – the belief that most people are good and trying to bring their best to work.  Assume positive intent with colleagues, leadership, and patients alike. 
• Bring solutions to challenges/issues your department is facing 
• Step one is identifying an opportunity/gap – natural leaders take the next step of coming up with and sharing ideas about potential solutions/fixes to enhance care delivery 

A natural leader brings calm to chaos, offers hope in the hardest moments, and treats every person in their care as if they were their own loved one. This unwavering commitment to excellence and empathy is what makes nurses not just caregivers, but everyday leaders who elevate healthcare from the inside out. 

Personalizing and optimizing purposeful nurse rounding is essential to delivering high-quality, patient-centered care. 

By improving communication strategies—such as using open-ended questions, active listening, and eye-level engagement—nurses can build trust and uncover what matters most to each patient. 

Leveraging communication boards reinforces transparency, keeps patients and families informed, and aligns the care team. Educating as you go transforms routine interactions into meaningful teaching moments, helping patients better understand their care and discharge plan. 

Closing the loop with timely follow-through on concerns or requests shows patients that their voices are valued and strengthens confidence in the care team. Throughout it all, nurses act as natural leaders—setting the tone with positivity, integrity, and a commitment to high-quality, compassionate, connected care.

Ashley Nelson, MS, BSN, RN, is a seasoned healthcare leader passionate about driving meaningful change for patients. With over 18 years of nursing experience, Ashley brings her expertise to NRC Health, where she serves as the Strategic Advisor of Nursing, contributing to innovative strategies that enhance healthcare delivery. A dedicated lifelong learner, Ashley holds a Master of Science in Nursing Education from the University of North Dakota. Her commitment to celebrating exceptional care while showing up with a drive for elevating the care experience is palpable. Her ability to connect with others as a storyteller and leader has made her a trusted advisor and motivator in healthcare.