Date of Award

Summer 2020

Document Type

Final DNP Paper

Degree Name

Doctor of Nursing Practice (DNP)



Faculty Chair

Dr. Laura P. Walker


Falls are a pervasive and persistent problem in all healthcare settings, with adverse clinical, social, and economic outcomes for patients, staff, and institutions involved. The systematic process of purposeful rounding is an intentional act conducted with a clear purpose for the patient's benefit. Prevention of inpatient falls remains a challenge for nurses. Despite fall prevention efforts by nurses, the rate of patient falls in the acute care setting is a major safety concern. A Doctor of Nursing Practice project was crafted and implemented to educate nursing staff on purposeful hourly rounding and apply the 4 P's (pain, positioning, possessions, and potty) to decrease patient fall rates on a medical-surgical unit. Staff education took place pre-implementation, and the staff was able to acknowledge an understanding of the material. The purposeful hourly rounding program was effective in decreasing the fall rate from an average of 2 to 0 falls per 1,000 patient days for two consecutive months. Results from this project support the use of the Studer Group's Hourly Rounding tool with evidence-based targeted interventions to decrease fall rates. This was a 99% improvement over the last reported year of falls. Ongoing monitoring of subsequent interventions implemented by the staff to prevent falls and frequent dissemination of unit-specific fall data is needed to ensure fidelity to the protocol. More information is needed on the context of falls to evaluate patient safety practice.

Included in

Nursing Commons



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