Project Title
Reducing Falls and Enhancing Patient Safety: The Role of Purposeful Hourly Rounding in Rehab Units
Date of Award
Summer 2023
Document Type
Final DNP Paper
Degree Name
Doctor of Nursing Practice (DNP) in Adult-Gerontology Acute Care Nurse Practitioner
Department
Nursing
Faculty Chair
Douglas Stephens
Preceptor
Barbara Rees
Mentor
Lori McGrath
Abstract
Background: This Doctor of Nursing Practice (DNP) project aims to evaluate the impact of purposeful hourly rounding (PHR) on fall rates and patient outcomes over eight weeks. Fall rates for the rehabilitation unit were examined at the facility, showing 5.19 falls per 1,000 patient days, while the national average is around 3.0 falls per 1,000 patient days. Falls in the hospital are often preventable events. Ensuring the staff in the rehab unit were adequately trained on the use of purposeful hourly rounding (PHR) offers an approach that may reduce the number of these largely preventable events.
Purpose: Purposeful hourly rounding is a proactive and structured approach to patient care that involves regularly checking on patients and addressing their needs before they arise, which can prevent falls and other adverse events. The purpose of implementing PHR in the rehab unit is to decrease the fall rate among patients. Improving patient safety, reducing the risk of injuries from falls, and potentially decreasing the time length of hospital stays for patients are all positive effects of successfully implementing PHR.
Methods: A pre-post study design with a pre-post comparison group was employed. An assessment was performed on the fall rate in the rehab unit and identifying the factors contributing to the high fall rate. This student provided in-person education to the rebab staff on PHR. Information on how to document and track interventions completed was provided to staff. Data was collected on fall rates and compared between patients who received PHR and those who received patient and family education about fall prevention. Descriptive statistics, including means and frequencies, were used to analyze the fall rates. The sample size consisted of 30 patients for the study.
Results: Implementation of the DNP project was conducted in an eight-week project. There were seven falls in the rehab unit, with an average of 17.8 patients per day. The rate of falls decreased from an average of 5.19 falls per 1,000 days to 4 falls per 1,000 patient days following the implementation of PHR. The rates represent a reduction in fall rates of approximately 22.91 percent. According to the descriptive data, PHR reduced the rate of falls in the rehab unit. Decreased fall rates indicate that PHR can improve patient safety and reduce fall-related injuries.
Conclusion: Implementation of PHR reduced the rate of falls in the rehab unit by approximately 22.91 percent over eight weeks. These findings are consistent with previous research demonstrating the effectiveness of PHR in reducing falls in other healthcare settings. Additionally, this project can improve patient satisfaction, reduce length of stay, and decrease healthcare costs. Further research is needed to determine the long-term sustainability of these results and further investigate PHR's impact on other important patient outcomes.
Recommended Citation
Hughes, Jeffrey, "Reducing Falls and Enhancing Patient Safety: The Role of Purposeful Hourly Rounding in Rehab Units" (2023). Doctor of Nursing Practice Projects. 116.
https://digitalcommons.jsu.edu/etds_nursing/116