Nurses Hourly Rounding Response Time For Reducing Risk Of Falls Among Elderly Patients Essay

Improving the quality of care and patient safety is one of the top priorities of many hospitals and organizations. Likewise, best practice recommendation is a way of advancing measurement and improvement around falls prevention in the hospital. Frailty, Confusion, Dementia, and Co-morbid illnesses of older adults make them susceptible to falls. Evidence practice for falls allows nurses to be more sensitive and play a key role in this component of patient care in order to prevent falls in elderly patients. The first best practice that I found is the hourly rounding. According to Hicks (2015), hourly rounding is a good way of meeting the patient’s needs and improve the patient’s safety and prevent falls in the hospital. Hourly rounding consists of checking the patient’s environment for safety and addressing the four P’s (Pain, position, potty, possession). When hourly rounding is done by staff, they are also informing the patient the time the staff will be back and this tends to alleviate the patient’s anxiety. The second best practice is the safety huddle. Goldenhar et al (2012) states that safety huddles improve patient safety thru staff collaboration, effective communication, and team work. It is completed before the beginning of the shift and post-fall incident to address safety issues and staff concerns. Safety huddle is good way of ensuring that staffs are well aware of the patients, review past events, coordinate patient care, and share plans. The third best practice is bedside reporting. According to Maxson et al (2012), nurse to nurse bedside reporting allows continuity of care and it encourages patients to be more involved in their care. Bedside reporting improves patients’ safety by intercepting errors and prioritizes care when verbal and visual report is given by the previous

Patient falls in hospitals are a critical problem and are used as a standard metric of nursing care quality. According to the Joint Commission, thousands of patients fall in hospitals each year. Approximately 30-50% of falls result in injuries and prolonged hospital stays. Any patient in a hospital is at risk for falling and certain measures should be in place to prevent this. Preventing falls and injuries are not only important for the patient, but also for their families, the hospital, health care team, and insurance companies. It is estimated the average cost of a hospital admission due to a fall is $20,000 and by 2030, an estimated $54 billion will be spent on health care costs due to falls. The purpose of this paper is to explore the risk factors of falls in hospitals and interventions used to combat this problem.

Problem: Patient falls have long been a common and serious problem in hospitals across the nation, causing

The aim of this study was to determine whether the nurse on the acute hospital floor missing nursing care interventions leads to a greater number of patient falls, using actual fall rates gathered from the study hospitals and controlling for nurse staffing (hours per patient day) levels. The related research questions were as follows: (1) Do nurse staffing levels predict patient falls? (2) Does missed nursing care mediate the effect of staffing levels on patient falls?

Falls among any individual can cause significant trauma, often leading to an increase in mortality. According to the Centers for Disease Control and Prevention (2012), one in every three adults over the age of 65 falls each year. Long-term care facilities account for many of these falls, with an average of 1.5 falls occurring per nursing home bed annually (Vu, Weintraub, & Rubenstein, 2004). In 2001, the American Geriatric Society, British Geriatric Society, and the American Academy of Orthopaedic Surgeons Panel on Falls Prevention published specific guidelines to prevent falls in long-term

In the healthcare system, Core Measure sets are used to measure quality care. It consists of pneumonia, heart attack, immunizations, emergency department, sepsis, for infection prevention, and others. Evidence-based treatments are used to prevent occurrences using structures, processes, and outcomes. In nursing, they have adopted a similar method of performance measures, known as nursing-sensitive indicators. It includes falls, and this indicator is implemented in each unit of the hospital and managed by the manager and educator along with others like CAUTI and CALBSI. According to the American Hospital Association article (2015) “Falls with Injury,” Patient falls-an unplanned descent to the floor with or without injury to the patient affects between 700,000 and 1,000,000 patients each year.”

The results of the study showed that significant increase in patient satisfaction scores, decreased call light usage, and reduction in patients fall rates. One-hour rounding shows higher satisfaction than two hour- rounding. Hypothesis supported the study because the research shows rounding can reduce patient call light usage (Meade, Bursell, Ketelsen , 2006). The theoretical framework that forms the basis of the research is that consistent nursing rounds can meet the basic needs of patient and ultimately reduce call light use and [pic]improve management of patient care while also[pic] increasing [pic]patient satisfaction and[pic] safety.

Nurses help to ensure patient safety, which includes preventing falls and fall-related injuries (Quigley, Neily, Watson, Wright, & Strobel, 2017). The general population is at risk for falls and fall-related injuries, more specifically the elderly, 65 and over (Quigley, Neily, Watson, Wright, & Strobel, 2017). Patient falls are one of the top events for hospitals and long-term care facilities due to loss of physical function or cognition (Quigley, Neily, Watson, Wright, & Strobel, 2017). Fall-related injuries are a serious health issue for the elderly population (Quigley, Neily, Watson, Wright, & Strobel, 2017). Nurses make a major contribution to patient safety by assessing fall risk and designing patient-specific fall prevention

Brittany Nix- This writer believes a key point or concern for health care professionals is how to keep the middle age group safe while maintaining privacy and independence. In comparing the first research to the current, data findings revealed the incidence of falls in middle-aged inpatients were similar to older inpatients. Far too often this writer feels the nursing profession stereotypes the older population while overlooking the risk in middle aged adults. This writer believes this research challenges nursing professionals to implement individualized fall prevention for patients, regardless of

Hourly rounding is a strategy involving nurses and other health care staff to regularly “check in” on patients every hour. Because nursing staff is not reacting to call lights, patients are more content and happy; therefore nurses feel they are doing a better job helping their patients (Studer, 2007). Research has shown that rounding every hour lowers patient’s use of call lights and resultantly decreases the workload of the nurse (Leighty, 2007; Meade, Bursell, & Ketelsen, 2006; & Tipton, 2008). Performing hourly rounds has contributed to 20% less walking per shift

Falls are considered a leading cause of mortality and injury among older adults and majority of the falls occurs while hospitalized. One would think being in the hospital would be one of the safest places for older adults as far as fall prevention is concern due to the fact that hospitals provide staffing around the clock for patients but more and more falls have been occurring in the hospital especially in the older adult population. Fall is an unintended descent to the ground. It raises public and family care liability; it also decreases patient’s functioning because it causes pain and suffering, and increases medical costs (Saverino et al, 2015). The Center for Disease Control

Hourly rounding also known as intentional rounding or comfort rounding is an initiative that hospitals nationwide are beginning to implement. Hourly rounding should be purposeful. “Hourly rounding is a systematic proactive nurse-driven evidence based intervention to anticipate and address needs in hospitalized patients” (Deitrick, Baker, Paxton, Flores, & Swavely, 2012, p.13). “Purposeful nurse rounds encompass a practice where nurses attend to and document scheduled patient reviews at pre-determined and regular intervals (hourly or second hourly)” (Lyons, Biunero, & Lamont, 2015, p.31).

I am well acquainted with hourly rounding. My organization has tried numerous times to implement hourly rounding and for many reasons, the effort is never hardwired. Although the implementation of hourly rounding is very effective as proactive way to prevent falls many organization struggles with sustaining rounding. Some of the barriers are lack of staff buy-in, acuity levels, staffing, and poor documentation workflows (Toole, Meluskey, & Hall, 2016). In our post-fall huddles, one of the questions asked is, when was the patient last seen. In many cases, it is more than an hour. If the patient has more contact with the staff, the risk of falling is less. One new technology that we are about to roll out is a new call system that will track

A fall can make wide spread consequences on the health service or can be affected seriously by the increased health care utilization. Among the fallers approximately 30% of falls result in physical injury leading to extensive hospitalization with significant hospital expenses (Tzeng & Yin 2010). Preventive care phases can support health services to regulate the spare expenditure to a greater extend. A fall in hospital consequently affects the nursing staff, which lead to impaired job satisfaction, additional work load and startling time consume. As the front line of care, nurses can prevent falls and reduce fall injury rates in acute care unit with available resources (Dykes et al. 2013). This literature review aims to assess the efficiency of planned interventions to reduce the incidence of falls in acute medical units. The discussions of the main findings of the review as well as the recommendations for further research are revealed to conclude this study.

From the study, nurses agreed it was their responsibility to assess patients’ fall risk status each shift (86%) and to implement interventions for high-risk patients (90%) (Barker et al., 2017). Staff perceived the 6-PACK program is suitable and for the most part practical and beneficial (Barker et al., 2017).