Objective To evaluate the effectiveness of an near field communication (NFC) based intelligent, tiered clinical nursing rounding system.Methods A total of 1,000 patients admitted to the neurosurgery department from January 2023 to December 2024 were selected and assigned to preimplementation (control) and postimplementation (intervention) groups of 500 patients each according to system deployment.The control group received conventional nursing rounds.The intervention group used a self-designed nursing rounding system driven by NFC technology.Outcome measures included missed round rate, rounding efficiency (time per rounding record), rounding record error rate, and patient satisfaction; comparisons were made between groups.Results Compared with the control group, the intervention group demonstrated significantly lower missed round rate, shorter time spent per rounding record, and reduced rounding record error rate (all P＜0.05).Patient satisfaction score in the intervention group was significantly higher than that in the control group (P＜0.05).Conclusion The NFC based nursing rounding system optimizes the nursing rounding workflow, reduces the risk of missed rounds, and improves nursing efficiency and patient satisfaction.