Purposeful hourly rounding:
a tool for patient safety
April M. Morris, MSN, RN-BC, NEA-BC
American Sentinel University
Introduction
 Falls continue to be a challenge in the health care environment
 Definition of a fall
 Fall risks
 Current fall preventative strategies not effective
 Hourly rounding as an intervention
 Current educational delivery methods not effective
Background
 Costs
 Prevalence
 Process
 Education
Purpose
 Reduction in fall rates and in other patient care areas
 Staff benefits
 Organizational benefits
Research Question
 What effect does educating nursing staff in the use of hourly rounding by
using constructivist strategies have on fall rates on a long-term care unit in a
southwestern U.S. hospital?
Hypothesis
 Ho: Providing education in an environment conducive for knowledge acquisition—defined
here as one that focuses on the intervention and the true purpose of hourly rounding—
would not significantly increase staff awareness and cause a decrease in fall rates
 Ha: Providing education in an environment conducive for knowledge acquisition—defined
here as one that focuses on the intervention and the true purpose of hourly rounding—
would significantly increase staff awareness and cause a decrease in fall rates.
Significance
 Fall related injuries
 Responsibility
 Benchmarking and performance
Theoretical Framework
Scope
 Southwestern U.S. hospital's LTC unit
 Nursing disciplines; RN (11),LVN (4) ,NA (9)
 Nursing staff participation size n=24
 Intervention available to all staff
Limitations
 Limitations
 Non-random sample
 Interventions viewed as “extra duties”
 Time constraints
Literature review highlights
 Educational interventions (Abualrub and Alhijaa, 2014)
 Simulation educational interventions (Godlock, 2016)
 Constructivist educational interventions (Hunters and Krantz, 2010)
Methodology
 For the purpose of this study, convenience sampling was used as sample
size was small and fixed.
 The study employed quantitative methods to capture information
Project Design
 Education as a intervention to reduce fall rates
 Included in normal work performance
 non-experimental, quantitative, and retrospective study
Data collection, management, and
analysis
 IRB approval
 MDS 3.0
 Nursing dashboard
Ethical considerations
 IRB Approval
 Citi Human Subjects Certification Course
 Beneficence
 Respect
 Justice
 Minimal risks
Table 4
Results
Chi-Square Tests
Pearson Chi-Square
Continuity Correctionb
Likelihood Ratio
Fisher’s Exact Test
Linear-by-Linear
Association
N of Valid Cases
aZero
Value
4,667a
3.429
4.806
4.573
df
1
1
1
1
Asymptotic
Significance
(2-sided)
.031
.064
.028
Exact
Significance
(2-sided)
Exact
Significance
(1-sided)
.062
.031
.032
50
cells (0.0%) have expected count less than 5. The minimum expected count is 7.5.
bComputed only for a 2 x 2 table.
Results
Discussion of meaning of results
 Impact on fall rates
 Post-intervention data
 Limitations
Significance of results to nursing
profession
 Active learning interventions could decrease rate of adverse events
 Decreasing pressure ulcers, call light usage, and prevents falls
 The data design provides a medium in which the project can be replicated
 Provides better patient outcomes
Recommendations for future work
 Educate fall prevention during orientation with new hires
 Use active learning strategies
 Conduct research on the topic of learning
 Allow nursing staff to conduct research
Summary
 With fall rates continuing to rise in hospital organizations, it is
imperative to ensure that staff is educated in a manner
that resonates with their learning style, previous learning,
and scope of practice. The purpose of this study was to
utilize a teaching method that will increase staffs’
awareness of the hourly rounding tool, thus, decreasing fall
rates on a long term care unit. Post intervention data
revealed a 50% decrease in fall rates when compared to
the same time frame in the previous year. This study has
proven that teaching staff based on constructivist
concepts will decrease fall rates on long term care units.