title: A systematic review: barriers to hourly rounding.
abstract: OBJECTIVE
  The purpose of this review of the literature is to identify a comprehensive list of the barriers that impact the effective implementation and sustainment of hourly rounding on the adult inpatient medical or surgical unit.
  
  
  BACKGROUND
  Despite the benefits associated with hourly rounding, challenges with the implementation and sustainment of this intervention have been reported on medical-surgical units. Some hospitals have multiple campaigns to implement rounding, yet sustainment eludes them.
  
  
  RESULTS
  Four databases were searched independently by two reviewers. Articles were screened according to the inclusion/exclusion criteria and 20 articles resulted.
  
  
  RESULTS
  Clear themes of barriers emerged across the literature consisting of: workload issues, burdensome rounding logs, missing staff buy-in, patient acuity levels, lack of adequate staff education and a lack of sustainability.
  
  
  CONCLUSIONS
  The barriers identified are all directly related and perceived by the front line staff that is performing hourly rounding. The barriers identified may be limiting the organisation's ability to sustain the hourly rounding process.
  
  
  CONCLUSIONS
  Leaders can utilise this information to analyse and create successful options to overcome these barriers before, during and after the implementation process. Further studies are needed to identify targeted strategies to alleviate these barriers.
authors.affiliation: St Vincent's Medical Group, Indianapolis, USA.|University of Indianapolis, Indianapolis, USA.|Orthopaedics/Neurosciences Unit, Franciscan St Francis Health, Indianapolis, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Toole
authors.affiliation: University of Indianapolis, Indianapolis, USA.|Orthopaedics/Neurosciences Unit, Franciscan St Francis Health, Indianapolis, USA.
authors.forename: Tamara
authors.initials: T
authors.lastname: Meluskey
authors.affiliation: University of Indianapolis, Indianapolis, USA.|Orthopaedics/Neurosciences Unit, Franciscan St Francis Health, Indianapolis, USA.
authors.forename: Norma
authors.initials: N
authors.lastname: Hall
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D007588:Job Satisfaction; D009732:Nursing Care / Q000379:methods* / Q000458:organization & administration; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D017060:Patient Satisfaction; D015397:Program Evaluation; D058996:Quality Improvement / Q000458:organization & administration; D016526:Workload
keywords: barriers; challenges; hourly rounding; intentional rounding; sustainment