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Effective nursing leadership positively impacts quality outcomes and organizational performance. This study is the first known to examine the impact of implementing structured nursing leadership rounds on staff satisfaction with leadership. Positive accomplishments included improved scores on 2 domains of the practice environment scale (PES) throughout the children’s hospital after leader rounding was established; however, unit-level survey results varied in statistical significance. The study was conducted during a time of significant nursing leadership changes throughout the children’s hospital. Additional studies with stable nursing leadership teams are needed to further examine the impact of structured rounding on nurses’ satisfaction with leadership.