Date of Award
Doctor of Nursing Practice (DNP)
Sarah Cartwright, DNP, MSN-PH, RN-BC, CAPA
Debbie Saber PhD, RN, CCRN-K
Deborah Sanford MBA, MSN, RN
Practice Problem: Falls significantly affect patients, resulting in temporary or permanent harm, even death. In a large acute care facility, patient falls increased from 444 in 2016 to 556 falls in 2019.
PICOT: In an adult inpatient hospital setting, does purposeful hourly rounding (PHR), compared to no rounding, reduce patient falls over a period of 30 days during the same time period from the previous year?
Evidence: Of the 360 articles reviewed, 12 articles, varying from evidence levels two (1), level three (4), and level five (7), supported PHR as effective in reducing harm from falls in adult hospital settings. The majority of this lower level evidence supported implementation of PHR as a pilot.
Intervention: PHR, shown to improve fall rates using the proper application of tools, specifically the Studer Group Purposeful Hourly Rounding LogSM (2020a), was implemented to decrease falls over a period of 30 days during the same period from the previous year, without the previously used bedside sitters.
Outcome: The falls rate for the baseline period was 4.11 falls per 1,000 occupied bed days; and 5.07 falls per 1,000 occupied bed days for the implementation period. The incidence rate ratios of the falls rate between baseline and implementation was 0.81 (x2(1) = 0.140, p = 0.708; 95% CI = [0.27, 2.42]).
Conclusion: In this EBP change project, PHR did not result in a decrease in patient falls; however, the potential ramifications from the clinical significance of PHR should be considered.
Savage, A. (2020). Reducing Patient Falls Through Purposeful Hourly Rounding. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https://doi.org/10.46409/sr.UOZB3951
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