How Is Fall Prevention Annotated Bibliography

The aim of this study was to determine whether the nurse on the acute hospital floor missing nursing care interventions leads to a greater number of patient falls, using actual fall rates gathered from the study hospitals and controlling for nurse staffing (hours per patient day) levels. The related research questions were as follows: (1) Do nurse staffing levels predict patient falls? (2) Does missed nursing care mediate the effect of staffing levels on patient falls?

Prior to the hourly rounding implementation, all the clinical staff (staff involved in patient care) will attend an hour workshop, which will cover the advantages and significance of hourly rounding to patient safety, reduction of falls, increase patient satisfaction, improved health outcomes, and financial impact to the organization. A video on how to do the hourly rounding properly and what behavior to avoid will be shown. After the workshop, the staff will do return demonstration, playing the role of the staff, while being checked off to ensure that the expectations during hourly rounding are met. This includes how to properly introduce oneself to the patients, informing the patients that the staff will be rounding every hour till 2200 then every two hours till 0600, to address their pain, possession, position, and potty needs. By performing return demonstrations, the validators (nurse managers, educators) will be able to ascertain that the staff understood and will

Rounding allows nurses to gather information in a structured way. It’s proactive, not reactive like call light responses. It’s a great way to get a handle on patient problems before they occur. It’s all about providing the best patient-driven health care… The great thing about hourly rounding is that it doesn’t benefit only the patients. (¶ 4).

Hourly rounding also known as intentional rounding or comfort rounding is an initiative that hospitals nationwide are beginning to implement. Hourly rounding should be purposeful. “Hourly rounding is a systematic proactive nurse-driven evidence based intervention to anticipate and address needs in hospitalized patients” (Deitrick, Baker, Paxton, Flores, & Swavely, 2012, p.13). “Purposeful nurse rounds encompass a practice where nurses attend to and document scheduled patient reviews at pre-determined and regular intervals (hourly or second hourly)” (Lyons, Biunero, & Lamont, 2015, p.31).

Hospital falls are extremely common. In a study that was conducted to describe the epidemiological nature of hospital falls, they found that that about 183 of 1,300 patients fell during the period of study. Hospital falls are more common in the elderly where the average age of the patients who had fallen was found to be 63.4%. Many of the falls were unassisted (79%) and they had occurred while the patients were in their own rooms (85%). Generally, the number of falls in hospitals ranges from 2.3-7 falls per 1,000 patient-days and it was found that 30% of the falls that happen in hospitals result in injury with 4-6% leading to serious injuries ADDIN EN.CITE Hitcho20041043(Hitcho et al., 2004)1043104317Eileen B HitchoMelissa J KraussStanley BirgeWilliam Claiborne DunaganIrene FischerShirley JohnsonPatricia A NastEileen CostantinouVictoria J FraserCharacteristics and Circumstances of Falls in a Hospital Setting: A Prospective AnalysisJournal of General Internal MedicineJournal of General Internal Medicine732-7391972004( HYPERLINK l "_ENREF_2" o "Hitcho, 2004 #1043" Hitcho et al., 2004). Some of the serious injuries include subdural hematomas, fractures, excessive bleeding and in some extreme cases, death ADDIN EN.CITE Belechri20021044(Belechri, Petridou, & Trichopoulos, 2002)1044104417Belechri, M.Petridou, E.Trichopoulos, D.Bunk versus Conventional Beds: A Comparative Assessment of Fall Injury RiskJournal of Epidemiology and

The incidence of falls on the medical surgical unit remains consistently higher than the other Advocate hospitals on the medical surgical units during the past two years. Research has shown that patient who had a stroke were 50% more to fall within the next 6 months, psychiatric related conditions in one study contributed to 90% of falls, and and not having personal items and needing to go to the bathroom lead to 50% of falls. In my current position, we implemented “hourly rounding” for over a year with falls rates higher than other Advocate Hospitals but recently we decided to add to our “hourly rounding” and adding the four “P’s”. These four “p’s” include asking if patient if they need to “potty”, if they need help to re- “position” themselves, if they are in “pain” and need medication, and if they have everything of their “possession’s” within reach or if they need anything brought closer to them.

I found a great research article for my clinical question/PICO(T). Hourly Rounding: A Replication Study is about a medical-surgical CNS, a geriatric CNS, two nurse managers, a nurse researcher, and a statistician at a northeast hospital that studied the “effect of hourly rounding on fall rates, call light usage, and patient satisfaction in an inpatient medical-surgical patient population” (Olrich, Kalman, & Nigolian, 2012)”. According to the authors, falls decreased only when rounding was done hourly. They found a 23% reduction in falls (Olrich, Kalman, & Nigolian, 2012)”.

If patient safety is the most important issue in Health Care facilities then how come hospital inpatient falls continue to be the most reported of all accidental falls (Tzeng & Yin, 2009)? Throughout the years, hospitals continue to make changes to decrease the risk of accidents and increase the quality of patient safety. With research studies and improvements made, patient falls still hold the largest portion of reported incidents in hospitals (Tzeng, & Yin, 2008). According to Tzeng & Yin (2008), “fall prevention programs apparently do not effectively reduce inpatient fall rates because of human factors and ergonomics in a hospital environment (p.179, para. 2). The two studies reviewed in this paper were performed with the hopes of

This article discusses such preventative measures such as visual cues that show a patients risk for falling. Having the fall risk of the patient posted using a sign, and using yellow wristbands that read fall risk to alert personnel to a patients risks for falls. One area this article talks about is the benefit of patients participating in a nurse led preoperative education session that reviewed risk factors for falls. These preoperative classes cover such things as calling for help before getting out of bed. These preoperative classes also talked about preventing postoperative falls. This

While the concept of hourly rounding in not new, hospitals are trying to find new ways of reintroducing the concept of it. Hourly rounding is a great policy priority; however, as you have mentioned, staff resistance and noncompliance could be major obstacles with the implementation of this policy. According to Hutchings (2012), “hourly rounding or intentional rounding had negative connotations; for many staff it was prescriptive and insinuated that care was inadequate” (p. 12). After visiting many hospitals and looking at the different models of rounding that they have, Hutchings stated that she was able to develop and implement her “Caring around the Clock” policy at the Nottingham University Hospitals Trust. The author stated that it was

Based on documented studies, it is found that many of the patients are not satisfied with the quality and delivery of the health care services. The key reason for the dissatisfaction of patients is the casual behavior of some of the medical professionals and inadequate monitoring practices. Research has indicated a definitive problem in treating and monitoring the patients. The method of hourly rounding seems to be a practical approach to minimizing and completely eradicate the issue of patients ' dissatisfaction. Through practicing and conducting hourly rounding on a regular basis, the health care institutions and associated stakeholders believe that health care professionals can be efficiently encouraged towards their daily tasks. The hourly rounding is about assessing and examining the conditions of patients on an hourly basis. This is not only assisted in decreasing the increasing number of complaints from patients and their families, but will also help in retaining the good reputation of a health care industry. The examination of hourly rounding within some medical institutions demonstrates that hourly rounding provides the associated nurses and professionals with adequate education regarding the purpose and process of attention and health care services. With time, hourly rounding has been able to incorporate some significant elements in it, which include effective communication, administering, and patient satisfaction. Hourly rounding now days is seen as an effective

The study’s findings revealed that of the 183 patients that fell while hospitalized, the average age was 63.4 with the ages ranging from 17 to 96. It also discovered that many of the falls were unassisted, occurred in the evenings and in the patient’s hospital room, and had fallen during ambulation. It was also discovered that falls related to elimination increased the risks for injury. Out of the medical, cardiology, neurology, surgical, oncology, orthopedic, and women/infant units that were included in the study, the medical and neurology units had the highest incidence of falls. These units also had the highest patient to nurse ratios (Hitcho et al., 2008). These findings also determined that falls occurred when patients were unassisted, ambulating, and were related to elimination needs. Because of these findings, prevention measures should focus on increasing staff assistance while patients are ambulating and supervised/assisted toileting schedules need to be provided. The findings can be applied to all areas of nursing. Despite prevention efforts, threats to reimbursement, and good intentions, falls still remain a serious and costly

Today it is a requirement of the Joint Commission for all healthcare facilities to have a fall-prevention program in place. Facilities are also required to conduct an ongoing evaluation of the program (Hubbartt, Davis & Kautz, 2013). Most prevention programs include the use of a bed alarm, but can bed alarms alone prevent falls? This paper will investigate the use of a bed alarm being used as the only tool to prevent falls. It is often found that even when a bed alarm is sounded the patient has already fallen before any nursing personal can get into the room. This paper will also investigate the use of other prevention measures that can be used independently or in conjunction with bed alarms to work toward decreasing the number of

The study highlighted that randomised controlled trial was used to compare the universal multiple intervention and the multiple targeted intervention in lowering the incidences of bedside falls in the hospital. It has a significant role in decreasing the incidences of falls. falls recorded based on daily monitoring of the EHOR. The group with usual care only has the highest numbers of falls rate compared to the intervention group with fewer incidences of falls. In addition, the research emphasises that Hendrick II Risk Model was the most sensitive, accurate and specific tool in identifying patient’s risk of falls. Additionally, this tool helps the nurses to provide better patient-centered education on falls prevention. The study has also outlined

Program evaluation describes outcomes related to the implementation of hourly nurse rounding in one medical-surgical unit in a large community hospital.