Hourly rounding and fall prevention: A change process

Abstract

<p>Falls are among the most common and serious problems facing older adult patients living in nursing homes. The focus of this project was to implement an hourly rounding fall prevention protocol in a nursing home that provides care for older Military veteran patients. The purpose was to answer the following question: In veteran patients aged 65 years or older and living in a nursing home unit, how does implementing an hourly rounding fall prevention program compared to current traditional fall prevention programs affect fall occurrences within a six-week implementation period? The impetus of the project was that all three skilled-care units in the nursing home were experiencing high fall rates with adverse effects. The method of study involved a pilot study in a 34-bed unit and the implementation of the 3B: Scheduled Rounding Protocol adapted from the AHRQ toolkit. The &ldquo;plan, do, study, act&rdquo; model was integrated as a quality improvement process to test for change. A limitation of this study involves the use of a toolkit designed for hospital settings adopted in a nursing home setting, and a small sample size. Findings of this study indicated a reduced fall rate of 1.9 per 1,000 patient beds, and lower fall rates than in previous months. Competency evaluations indicated staff gained adequate knowledge in preventing falls. Application of evidence-based practice is fueled by the increasing public and professional demand for accountability in safety and quality improvement in health care settings.</p>