Effect of Hourly Rounding in the Prevention of Falls in a Medical-Surgical Unit
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Hi writer, you wrote my proposal for this project, I added the proposal, the rubric, and an example too. please follow the instructions I sent, I sent a direction on how I want the paper written.
I added an example also, you can skip the tables in the examples I added.
Effect of Hourly Rounding in the Prevention of Falls in a Medical-Surgical Unit
Student’s Name
Institution
Course Number and Name
Instructor’s Name
Date
Executive Summary
The risk of patient falls threatens patient safety and puts the hospital at the risk of financial losses. In a medical-surgical unit, the risk of falls is higher when compared to other units. As such, nurses working in a medical-surgical unit need to be vigilant. This project involved the implementation of hourly rounding to prevent falls in the medical-surgical unit. This change was necessitated by the increasing rates of falls in the unit despite the current use of bed exit alarms. The implementation was a four-week process that cost the hospital $1600 for nurse training and educational materials.
As a result of this project, the unit experienced a 14% decline in patient falls. There were fewer cases of fall-related injuries, and the hospital plans on expanding this project into other high-risk units. Given that hourly rounds present nurses with a risk of burnout from an increased workload, additional support is needed to ensure they remain vigilant to make the project sustainable.
Effect of Hourly Rounding in the Prevention of Falls in a Medical-Surgical Unit
The risk of falls in a medical setting threatens patient safety and increases the cost of healthcare. While patients in any medical unit, such as intensive care units and medical-surgical units, are at risk of falls, those in a medical-surgical unit face the greatest risk of falls. According to Cuttler et al. (2017), the rate of patient falls in the medical-surgical unit is between 3.67 and 6.26 falls per 1000 patient days. When these falls occur, patients experience damage in terms of poor health outcomes. As Cuttler et al. (2017) indicate, about 20% of all falls in a medical-surgical unit result in injuries. Patients experience conditions such as bruises, lacerations, fractures, head injuries, and in extreme cases, death. Patients’ falls in healthcare organizations contribute to about 85% of healthcare-associated medical conditions (Cuttler et al., 2017). As such, there is a need to prevent patient falls in medical-surgical units and beyond. Nurses are responsible for ensuring patient safety by protecting these patients from falls. The goal of this project was to identify and recommend a fall prevention strategy that can be implemented in a medical-surgical unit to enhance patient safety through fall prevention. The proposed strategy was hourly rounding which has been supported by evidence as a best practice in fall prevention.
Statement of the Problem
While working at a medical-surgical unit, it became evident that patient falls were at an all-time high. Many patients were experiencing falls despite the current use of bed exit alarms. Yet, many times, nurses arrive at the patient’s bed when it is too late, and the patient has already made attempts to exit the bed, resulting in a fall. In addition, it became apparent that the hospital was incurring additional costs when treating fall patients. The hospital has to cater to the cost of fall-related injuries treatment because the Centers for Medicare & Medicaid Services (CMS) does not reimburse hospitals for treating injuries and conditions arising from hospital falls (Staggs et al., 2020). An internal patient safety review revealed that the bed exit alarms were no longer serving their purpose because there were still high patient falls and high cost of care incurred from treating fall injuries. This prompted the need for change to ensure a more effective fall prevention strategy was implemented.
Brief Literature Review
As Cuttler et al. (2017) indicate, patients in a medical-surgical unit suffer from mobility issues, significant side effects from their medication that can alter their mental alertness, and require frequent toileting. All these factors increase their risk of falling. The use of bed exit alarm has been the current practice in the medical-surgical unit because bed exit alarms alert nurses when the patient wants to exit their beds (Staggs et al., 2020). However, the reliance on bed exit alarms has been ineffective in reducing patient fall rates because, according to LeLaurin and Shorr (2019), bed exit alarms give nurses a sense of security which prevents them from regularly checking the patients. This makes it more likely for them to go for long hours without checking the patients. However, hourly rounding ensures that nurses are in regular contact with patients and can meet their regular needs. Burdick et al. (2017) indicate that hourly rounding improves patient safety, while Gliner et al. (2022) reveal that it reduces the risk of falls by up to 21%. It also increases contact between nurses and patients, thus reducing the risk of falls (Sun et al., 2020). As such, hourly rounding has the potential to address the issues caused by bed exit alarms because it enhances nurses’ responsiveness.
Change of Current Practice
My project introduced hourly rounding as the best practice for reducing fall rates in the medical-surgical unit. Specifically, instead of waiting for a bed exit alarm to alert them about a patient, nurses in the unit now make hourly rounds, and this has ensured that patients’ needs are responded to promptly. As a result, patients are not making attempts to exit the bed on their own because a nurse comes to check on them every hour, which has reduced patient falls.
Steps Involved In Implementation
To implement the project, the following steps were involved:
* Gaining leadership support
* Gaining nurses’ buy-in
* Training of nurses
* Incorporation of hourly rounding into nurses’ daily/routine practice
Selected Theory
Kolcaba’s theory of comfort was used to guide this project. This theory is based on the premise that meeting patients’ basic needs through nursing interventions increases patients’ comfort and willingness to seek medical help (Ortuno & Florczak, 2017). In the case of this project, regularly meeting patients’ needs to use the toilet, change their positions on the bed, or providing them with water when they feel thirsty would increase their comfort and remove any form of distress that might prompt them to leave the bed without assistance from a nurse. As such, patient falls would be reduced because they are comfortable and lack the need to exit the bed on their own. The advantage of this theory is that the variables it uses to describe patient comfort can be measured and controlled through appropriate nursing interventions (Ortuno & Florczak, 2017), such as hourly rounding. However, it is difficult for nurses to identify and meet all the comfort measures, especially when the nurses’ workload is high. At this point, patients would continue being in distress.
Impact of Hourly Rounding
The implementation of hourly rounding at the medical-surgical unit increased nurses’ efficiency in meeting the needs of patients. There was increased contact between nurses and patients in the unit. As a result, patient falls declined significantly, and consequently, the number of fall-related injuries declined. Also, the length of hospital stay declined. These outcomes were in line with the findings of Cuttler et al. (2017), who indicate that hourly rounding reduces fall-related morbidity and length of hospitalization in the medical-surgical unit. Hourly rounding also impacted the hospital because it reduced the cost incurred by the hospital in treating fall-related injuries.
Implementation Plan
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