Background
Older patients above the age of 65 are at higher risk of patient fall in hospitals and settings because of age-related issue and mobility issues. A fall is a sudden, unintended, descending movement of the body towards the floor or other surface, excluding falls resulting from violent blows or deliberate actions. Patient falls occur in hospitalized patients of all ages, in residences and among those who receive home care, and they can cause serious injuries, disability and in some cases death (Brosey & March, 2015). Nurses are expected to respond to alarms, and if there is no alarm fatigue, it is more likely that there will be no delay in response, and this improves patient safety. Nurses seek to improve outcome and quality of care, and one way to do this is by reducing the risk of patient falls and responding to call light. Parenting patient falls will improve the well-being of patients, improves the quality of care, patient safety and is associated with lower hospital costs.
Questions
What influences the hospital fall prevention strategies?
This requires information from the staff and the hospital standards to identify policies on fall prevention and who monitors the effectiveness of these policies. A survey provided to nurses and the nurse managers would help to identify the fall prevention strategies and their effectiveness.
What affects detection and monitoring of patient fall?
Health practitioners, especially, nurses are expected to monitor and report patient falls and how often they occur, which makes it easier to analyze the causes of patient falls and identify the most appropriate patient fall strategies. This information is based on responses from the nurses.
Do purposeful hourly rounds affect the patient’s call lights?
Well structured hourly rounds allow nurses to check on patients regularly and they address patent issues based on what the information they have. When properly implemented the hourly round program can reduce the need for call lights and improve health outcomes.
Does hourly rounding affect patient safety satisfaction?
Elderly people tend to have reduced mobility and poor coordination when compared to younger patients, while they require more medical attention depending on their contusive status and health needs. If there are regular hourly rounds, it is easier to demine whether there is a risk of falls and deal with the issue. This is analyzed by getting feedback and responses from the patients.
Does hourly rounding affect reduce the patient fall rate?
Age is one of risk factors that increases patient fall during hospitalization, and the impact of rounding is analyzed by considering whether there is a significant change in patient fall rate after implementing hourly rounding. This is the most relevant question linked to the topic as the aim is to evaluate the effectiveness of hourly rounds in reducing patient falls and improving patient safety. There are patient risk factors associated with the risk of falls and need to be identified where there is also monitoring of the patient progress.
PICOT
P– (Patient, population): Older patients in long term facility
I– (intervention/issue): Structured hourly rounding
C– (Comparison): Use of call lights
O– (Outcome): Decreased falls and fall-related injuries
Possible keywords
Patient fall, patient safety, elderly/ older patients, hourly rounding, intentional rounding, fall injuries, call light usage, patient satisfaction, patient fall prevention, risk assessment patient readmission rates
Identifying patients at risk of falls requires considering individual risk factors like the cognitive state, history of falls in previous hospitalizations, medications, age, altered vision, and reduced mobility. Hourly rounding is likely effective since there is reevaluation of the risk of patient falls at various times throughout the time the patients hospitalized. The nurses attend to the immediate and needs of patients, and evaluate the general measures of prevention and supervise the activities indicated in patient fall prevention protocols and standards (Al Danaf et al., 2018). The risk of falls as one of the goals to improve patient safety in hospitals, and there are additional costs associated with patient falls including that the treatment of fall related injuries and staying longer in hospitals. Patient falls remain a persistent problem in hospitals yet implementing a more structured rounding approach may increase patient safety and reduce risk of fall and injuries such as falls and hip fractures (Ryan et al., 2018). Ideally, implementing preventive strategies should involve multiple interventions while health practitioners should be encouraged to report all falls or notify the relevant authorities.
Reference
Al Danaf, J., Chang, B. H., Shaear, M., Johnson, K. M., Miller, S., Nester, L., … & Aboumatar, H. J. (2018). Surfacing and addressing hospitalized patients’ needs: Proactive nurse rounding as a tool. Journal of nursing management, 26(5), 540-547.
Brosey, L. A., & March, K. S. (2015). Effectiveness of structured hourly nurse rounding on patient satisfaction and clinical outcomes. Journal of Nursing Care Quality, 30(2), 153-159.
Ryan, L., Jackson, D., Woods, C., & Usher, K. (2018). Intentional Rounding–an integrative literature review. Journal of advanced nursing.