Introduction

Patient’s safety is a primary objective that nurses strive to achieve within the healthcare industry. The guiding principle that compels nurses to provide quality care to patients in the medical ethics that requires all medical professionals to avoid harming the patient.  Currently, most healthcare organizations have invested a lot of resources to cater to the safety of patients with an aim to create an excellent organizational reputation. Despite all the efforts dedicated towards quality healthcare provision, there are still major healthcare issues that are being experienced, and this encompasses medical errors, wrong-site surgery and patient falls. Research studies have shown numerous concerns about patient safety, and among the recognized issues we have the recurrence of falls. The research paper will mainly focus on falls which is one of the most regular patients’ safety measures addressed by numerous medical institutions. The project aims to critically demonstrate the importance of hourly rounding as an effective strategy to prevent patient falls.

Background of the Problem

Working as a medical nurse practitioner in the unit of medical surgery with three years of experience falls was a significant issue of concern. In most hospitals, nurses are concerned about the quality of care which is been provided to the patients. The significant implication in the efforts to deliver excellence to the patient’s falls which negatively affect the quality of patient care. Major issues that affect our hospitals adversely affect the quality of life for the patients. More extended hospital stays have been reported following occurrences of hospital falls. Apart from the long hours of hospital stay, the quality of life for the patients and their families is also adversely affected. The issue of falls among hospital patients has become an increasing trend in hospital settings, and this is why it calls for the attention of most research studies that aim to improve on the quality of patient care. Since the trend is on the rise and minimal efforts are directed towards the management of hospital falls, the research project aims to provide the best alternatives to the nurses which will assist in aiding patient safety and care. Chart audits were performed in major hospitals to examine the sources of the falls, and it showed that nurses were not paying attention to strategies that can control falls even in situations where a patient has a fall risk of 4 or higher. There are certain circumstances when the nurses should recognize the causes of the fall and explore the best strategy to manage the issue, but very minimal efforts are being directed towards the prevention of such falls. The challenge was experienced even during the hourly rounding where nurses could not apply appropriate fall prevention. The suggested barriers to falls strategies encompass possession of personal belongings, potty position, not enough lighting, pain, cluttered floors, navigate system and not answering call lights within the right time.  Falls are major health concern especially for the aging adults in the surgical unit. According to the report by the World Health Organization (WHO) of 2016, 20% to 30% of inpatients fall at least once during their hospital stay. Patients in the acute section experience an increased number of falls, and this is approximated to be between 30% to 51% of dangerous falls. Falls and injuries associated with falls result in increased healthcare costs and adverse impact on the quality of life.

Review and Summary of Relevant Literature

Numerous researches have been conducted to certify that the application of hourly rounding is essential in the prevention of patient falls. Wash et al., (2018) in research indicated that the use of hourly rounding in hospitals has resulted in a decrease in the number of falls by 28%. Another study that was conducted by Lowe and Hodgson, (20112) for two weeks showed that when the hourly rounding was used in hospitals, there was no any incidence of fall reported within the hospital setting. In another study by Kraft (2013), the level of falls in a hospital located in Fargo was minimized by 25% at the end of the year.  Only two of the 4Ps were included in the study and this included proximity and potty. Other research strategies were applied in the prevention, and they included proper communication, risk levels of falls and staff training. When the approaches were used, it was reported that the rate of falls among the patients reduced and this time it decreased from 7 falls for every 1000 patient’s days to 2.4 falls for every 1000 patient’s days.  The study which was conducted by Fisher, Horn, and Eliot indicated that the use of hourly rounding serves to reduce the rate of falls and improve on the accountability of the nursing staff. Another research study that was conducted in the following year revealed that the use of hourly rounding resulted in increased efficiency of nurses and also reduced hospital interruptions. Jonhson Hernadez, (2015), showed in his studies that hourly rounding occurred in empowerment inpatient care centers hence leading to increased patient satisfaction within the acute setting. Daryl Dyck et al. (2013) supported the fact that hourly rounding is an essential tool that comprehensively supports the patient’s safety and fall prevention. Goldslack et al. recognized the active, involvement of hospital leaders in the hourly rounding., (2015) to be a contributing factor in the effectiveness of the tool. A study conducted by Brown, (2016) acknowledges decision making as one of the core benefits of increased use of hourly rounding.  An hourly rounding that is undertaken with a significant focus is likely to reduce the rate of patient falls and hence empowering them towards a similar goal of reducing falls. Ultimately, there was a shared objective of the studies performed by all the researchers which showed that hourly rounding is a significant tool in the control of potential falls. The only significant difference observed in the reviews is the methods of implementation where for specific studies all the 4 Ps were used but in some only two or 3 of the 4P were used.  The lack of knowledge on some of the best strategies to be applied to prevent falls among the patients contributed to the ineffectiveness of patients care.  Nurses within the hospital setting sometimes lack ethical conduct and hence do not possess the attitude for caring and this resulting in an increased rate of falls within the hospital.

Statement of the problem

Patient safety is at the forefront of all the patients who are obtaining care within healthcare centers. There are different types of falls that nurses are not able to understand within the hospital setting increasing chances of injuries and morbidity.  Fall is a broad topic, and it must be conceptualized within the surgical unit of the hospital. Hospital patients are adversely affected by increased falls resulting in increased length of hospital stay, high healthcare costs and may also result in morbidity among the elderly. Within the surgical section, falls have increased in falls which are approximated to be 10-15 falls monthly. Capstone projects aim to demonstrate the relevance of hourly rounding in the reduction of falls and also to improve the quality of life among patients to reduce the length of hospital stay.

The significance of the project

The primary goal of the Capstone project is to reduce the rates of fall by 50% within two months of the project execution. The project also intends to improve the quality of life by avoiding injuries that can be sustained during falls. The length of hospital stay is expected to decrease, and this will reduce HealthCare cost for family members. Nurses will be able to attain education on strategies to be implemented on fall prevention.

Method

The methods applied in the course of the study encompassed design, sample collection, and setting. The participants were chosen within the healthcare setting, and they were supplied interview questions.

Design

Interviews were conducted to examine the importance of hourly rounding in preventing falls and also to evaluate areas where education was needed.  A descriptive qualitative method was used to interview nurses when all the 4 P’s were used during hourly rounding.  A qualitative approach was applied since nurses are in direct contact with the patients.

Sample and setting

The Capstone project will be carried out in a medical, surgical unit where nineteen nurses were divided into three groups to participate in the interviews.  The needed resources comprise of nurses, supporting staff, managers and interviewing resources. Prevention risk scale was used as an instrument to examine the accuracy of the prevention strategies.

Methods and procedures

The technique used was a descriptive research design through an interview. The nineteen nurses were supplied with questionnaires with open-ended questions about the strategies used in the prevention of falls.  The fall rates from 3 months before the execution of the new hourly intervention were compared to data collected three months after the exercise. A multidisciplinary falls collaborative group was established to plan, execute and evaluate the fall prevention strategies to include hourly rounding. The nursing staff was allowed the opportunity to identify particular care measures to address ways to improve interventions.

Results

The results section addresses some of the significant findings by the Cornerstone project after interviewing the nurses within the hospital setting.

Major findings

The cornerstone project focuses on the promotion of a culture of safety while creating fall prevention programs. The nursing staff was often performing hourly rounds, but it was investigated that the rounds were not documented using a significant rounding process. Implementing a necessary hourly rounding program emphasizes the vital role that nurses play in the promotion of patient safety, quality care and providing the patient outcome.

Strengths and weaknesses

The cornerstone project showed an increased commitment to reducing falls and fall-related injuries.  Nursing leadership provided the relevant support that resulted in the improvement of the interventions. The major limitation of the project was the short three month trial period since this is expected to be at least six months.

Implications for Nursing

While evaluating the effect of hourly rounding project, it is imperative to consider the application of nurse leadership rounds, educational programs and unit dashboards to highlight project outcomes. Incorporating nurse leadership rounds on a regular occasion give the nurse leaders an opportunity to obtain feedback within the expected time regarding the success of the strategies.

Conclusion

Purposeful hourly rounding is the activities that all inpatient nursing staff performs to demonstrate a significant impact on patient outcomes.  Hourly rounding is a substantial component of an effective multifactorial prevention program. Hourly rounding was examined in the project concerning the result of decreasing falls and injuries from falls, and this can be applied while measuring other nursing-sensitive indicators in all inpatient population. It is the role of all the nurses to translate knowledge into practice by using all their skills to promote better strategies for fall prevention.

 
Do you need high quality Custom Essay Writing Services?