Elderly patients in hospitals often have persistent clinical concerns related to patient falls. Each year, one out of four seniors have a fall, as reported by the CDC (2024). Nevertheless, fewer than 50% of them inform their healthcare practitioners about these occurrences. According to Vincent et al. (2023), weakened muscles, instability, and impaired eyesight are some of the inevitable age-related functions that make the elderly more likely to fall. The surroundings and treatment techniques within the hospital make this susceptibility even more apparent, with over 1 million hospitalizations related to falls (CDC, 2024). Injuries, higher healthcare costs, longer hospital admissions, comorbidities, and even mortality may result from falls, making this an increasingly pressing problem for patients, particularly in an older population.
Falls among elderly hospitalized patients constitute a huge problem in healthcare settings. These occurrences often result in serious injuries, including fractures, brain damage, and even death (Alanazi et al., 2023). Furthermore, falls lead to more prolonged hospital admissions and higher healthcare expenses and may significantly influence a patient’s quality of life and independence (CDC, 2024). Addressing this problem is crucial to improving patient safety and healthcare quality. As a result, healthcare practitioners must prioritize the implementation of fall prevention techniques for senior patients. Concentrating on preventive measures like deliberate hourly rounding may create safer settings to serve older patients and greatly enhance their health outcomes.
The goal of this evidence-based reform proposal is to establish purposeful hourly rounding. Staff members do regular, predefined patient evaluations (Gliner et al., 2022). Reducing the incidence of falls among older patients can help to improve patient satisfaction and safety (Kawar et al., 2024). Designed to give quick remedies, spot problems, and meet patient needs, intentional hourly rounding helps avoid falls. This proactive strategy reduces injuries and guarantees their needs are satisfied quickly and effectively, enhancing the patient experience.
A review of the existing literature found good evidence supporting the usefulness of targeted hourly rounding in minimizing falls. Researchers have repeatedly demonstrated that hospitals employing this strategy enjoy a considerable decrease in fall rates (Khawaja et al., 2023). Furthermore, patient outcomes improve, with reports of higher patient satisfaction and perceived quality of treatment (Kawar et al., 2024). The proactive aspect of hourly rounding aids in the early detection and reduction of dangers, making it a dependable technique for improving patient safety. This intervention may be reliably implemented thanks to the reviews and syntheses of this research that demonstrate its effectiveness.
Evidence-based approaches provide the foundation of the advised intentional hourly rounding technique. Regular, systematic patient inspection studies reveal significantly lower fall rates (Florentin, 2023), supporting the suggested methodology. This strategy is meant to lower patient falls and raise the standard of patient treatment. Proper following of best standards ensures the success and longevity of the intervention. Using evidence-based interventions guarantees that the approaches are scientifically robust and more likely to be successful in practical settings.
Three components make up the implementation plan to help ensure a flawless and efficient deployment. Emphasizing the concepts and practices of deliberate hourly rounding (Vincent et al., 2023), Phase 1 consists of intensive training and instruction for nursing staff. Getting staff members with the proper knowledge and abilities depends on this phase. Samide et al. (2022) describe Phase 2 as a pilot program that allows evaluating and refining protocols in selected wards. Under the direction of the results and comments of the pilot phase, Phase 3 consists of full-scale implementation all over the hospital. This systematic approach ensures early addressing issues and identification of best practices before a hospital-wide adoption.
The intervention centers on a methodical, intentional hourly round-through. Essential components of this process include routinely checking patient safety, attending to immediate needs, and thoroughly documenting every visit (Hakvoort et al., 2021). Under this progression, safety inspections examine the patient’s physical environment to find possible fall dangers. Responding to call lights, assisting with mobility, and ensuring the patient’s comfort to address their needs are also necessary. Moreover, solid documentation guarantees responsibility and facilitates monitoring of the measure’s effectiveness. This uniform approach helps physicians improve patient care and methodically lower the fall risk.
Reducing fall rates among senior citizens is the primary outcome measure of this intervention. This figure directly gauges how well the hourly rounding system stops falls (Decker et al., 2023). Improved patient satisfaction is a secondary goal to view if patients feel safer and more cared for. Another measure is to see the rate at which staff adheres to the rounding process, guaranteeing that the intervention is routinely and precisely implemented (Endrejat & Burnes, 2022). Moreover, data collection and analysis will help evaluate these results, providing a comprehensive picture of the program’s effect. Regular data monitoring helps ensure the intervention stays successful and points out areas needing development.
Detailed outcome measures include fall prevalence, patient satisfaction scores, staff compliance with the rounding protocol, and staff feedback (Gliner et al., 2022). The number of falls before and after implementation will be tracked to determine the fall prevalence. To determine how much better patients believe their care has improved, surveys will be used to collect patient satisfaction ratings (Considine et al., 2023). Audits and observations will assess staff compliance with the protocol, identify areas for improvement, and ensure proper procedures are followed. Staff feedback will be collected to understand their experiences better and make suggestions for improving the protocol. These specific metrics help stakeholders determine the full impact of the intervention and direct their efforts to improve it.
Besides players’ roles and responsibilities, the practical application of the purposeful hourly rounding approach also depends on interprofessional cooperation. Considine et al. (2023) state that doctors offer medical oversight and encouragement as nurse personnel run the rounds. On the other hand, administrators ensure that suitable tools are distributed and the initiative is included in the hospital’s flow-through (Samide et al., 2022). Another vital aspect is monitoring and assessing the program’s effectiveness, spotting areas for development, and guaranteeing adherence to safety criteria—all of which patient safety officers handle (Vincent et al., 2023). Each of these parties offers unique skills and perspectives; hence, cooperation is essential for the project’s success.
The success of the hourly rounding intervention depends on effective communication with stakeholders. For success, regular meetings and updates must be conducted to inform them of the status of the implementation, challenges, and successes (Florentin, 2023). Through honest and open communication, all the involved parties can better contribute knowledge and resources. Promoting open channels of communication and building trust and cooperation is, therefore, very important to reach the desired outcomes and maintain the intervention running.
Implementing the purposeful hourly rounding approach calls for several essential tools. Research holds that training resources must be developed to teach nursing staff members the concepts and methods of the protocol (Florentin, 2023). The study further illustrates that staffing changes might also be needed to satisfy the rising hourly rounding needs. Moreover, strategies for tracking and recording cycles are required to guarantee compliance and evaluate program performance (López-Soto et al., 2023). The effective use of the intervention depends on these resources and their long-term sustainability. These resources will help employees apply the rounding technique correctly and get the expected outcomes.
The evaluation strategy calls for baseline, interim, and final assessments to help determine the intervention’s effectiveness. This study will make combined use of quantitative and qualitative data. While qualitative data includes feedback from staff and patients, quantitative data comprises fall rates and patient satisfaction ratings (van den Ende et al., 2022). Initial fall rates and satisfaction levels will be found through baseline tests. In interim reports, assessors can observe development and identify developing problems. Following this procedure, the final evaluations will present a whole picture of the effectiveness of the intervention and assist in making the required adjustments. This all-around assessment approach guarantees that every intervention component is closely examined so that necessary modifications can be made.
Ongoing education and training for nurses is crucial to the long-term viability of the intended hourly rounding intervention. According to Lopez-Soto et al. (2023), regular monitoring and evaluation will assist in tracking progress and identifying areas that require improvement. Consequently, these proposals should be integrated into hospital policies and standard practices to make rounding a regular part of patient care. Achieving long-term patient safety and satisfaction improvements requires firmly establishing the intervention as part of the organization’s culture and practices.
The suggested change solves the central problem of falls among elderly hospital patients by including deliberate hourly check-ins. The evidence powerfully supports the effectiveness of this approach in improving patient outcomes and lowering fall rates. Emphasizing patient safety and showing a solid dedication to continuous improvement will help stakeholders create a healthcare environment that is safer and more efficient for elderly patients, ensuring the efficacy of this intervention by employing rigorous assessment methods and clearly defined roles and responsibilities. We must cooperate to carry out this improvement, which will significantly affect patient treatment.
Alanazi, F. K., Lapkin, S., Molloy, L. J., & Sim, J. (2023). The impact of safety culture, quality of care, missed care and nurse staffing on patient falls: A multisource association study. Journal of Clinical Nursing, 32(19-20). https://doi.org/10.1111/jocn.16792
Centers for Disease Control and Prevention (CDC). (2024, May 6). Older adult fall prevention: Facts about falls. Retrieved from https://www.cdc.gov/falls/data-research/facts-stats/index.html
Considine, J., Berry, D., Mullen, M., Edmore Chisango, Melinda Webb-St Mart, Michell, P., Peteris Darzins, & Boyd, L. (2023). Nurses’ experiences of using falls alarms in subacute care: A qualitative study. Plos One, 18(6), e0287537–e0287537. https://doi.org/10.1371/journal.pone.0287537