fall precautions

Clinical Question

            Patients falls are the most common hospital adverse events. As nurses, we want to make a difference in our patient’s lives and to do so, the patient must be safe from falls, acquiring hospital infections, skin breakdown and more. Patient safety has become one of the most important issues in the healthcare field and can make a great impact on patient’s recuperation. “Every year in the United States, hundreds of thousands of patients fall in hospitals, with 30-50 percent resulting in injury.’’ The Joint Commission. (2015). That 30 to 50 percent of hospital falls result in serious injuries, the very place where patients should be safe. When hospitalized patients fall, they are at an increased risk for injury, which contributes to increased length of stays comorbidities, longer recoveries, and possibly longer periods of time out of the workforce.

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            Hourly rounding is very important as a nurse. Going in the patient’s room to check on them or to address their needs, not only can help prevent falls but can increase patient’s satisfaction surveys which can only benefit everyone including the hospital. Also, as nurses we cannot judge just by looking at the patient or “assume” that the patient does not need anything, sometimes patients appreciate the attentive care during their most difficult times in their lives. “According to a study, findings suggest hourly rounding by nursing personnel positively impacts: patient fall rates, call-light usage, and patient satisfaction. Patient fall rates decreased 23% on the experimental unit. Satisfaction scores also have the potential for showing long-term positive gains based upon patient feedback during rounds”. (Olrich, T., Kalman, M., & Nigolian, C. (2012)).

Population: The elderly population

Interventions: Hourly rounding to reduce patients falls

Comparison: Increased length of patients stay  

Outcome: Hourly rounding effectively increases patient satisfaction, decreased falls.  

The purpose of this paper is to use facts and research to show the effectiveness of hourly rounding in the hospital setting by implementing strategies for prevention of falls and increase in patient satisfaction.

Levels of Evidence

            In any research project, it is important to identify what kind of question is being asked in order to formulate an accurate solution. In the case of hourly rounding a “therapy” kind of question is asked. While the use of factual information is necessary, quantitative research has shown promising numbers to proof how hourly rounding makes a difference during patients stay in hospitals. Not only is quantitative research the best evidence to answer the problem, but Qualitative research focuses in a more detail and descriptive matter from someone else’s perspective and it can also be helpful method to determine if hourly rounding is indeed effective. Quantitative and Qualitative are both aid and supportive to the project to come to a more precise conclusion.

Search Strategy

            To find the best articles for this project, the search terms used were “Hourly rounding in the hospital settings” and “Is hourly rounding an effective patient safety strategy”. Trying to narrow down the search to best find sources with the most useful information was one of the limits encountered due to the years the articles were written. During the research, nothing after 2013 was found, for that reason google was used to find more up to date research and information. ProQuest, and the Joint Commission were also used, containing the most resourceful and up to date evidence. In addition, to select the adequate article for the project, reviewing and going over the information provided is essential in selecting the right article.

Two of the most important articles found that will provide guidance for the project was the study of Olrich, T., Kalman, M., & Nigolian, C. in a search of how effective is hourly rounding in preventing patients fall, decreasing call light usage, and increasing patient satisfaction surveys. The work of The Joint Commission was also found to be helpful in giving specific facts and most current information of how many patients fall on a yearly basis in a hospital setting.

Conclusion

            As nurses, working in fast paced specialty where they are always busy, it is hard to do hourly rounding; but prevention of patients fall must be a priority to ensure safety. Hourly rounding, done correctly can ensure, patient satisfaction as well as safety and better quality of care. After a patient is in the hospital it should be the very place where patients should be safe. By doing purposefully hourly rounding, it is not just an act of going in the room every hour, it is about connecting with the patient and the family and giving them a sense of hope and confidence that they are in good hands. 

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