Successful Implementation of Hourly Rounding to Reduce Falls

Abstract Background: Patient falls in healthcare settings have significant implications, contributing to extended hospital stays, increased medical costs, and adverse physical and psychological effects on patients. This study explores the impact of patient falls, the potential benefits of implementing hourly rounding, and the strategies to reduce falls and improve patient outcomes. Problem: A northern Californian hospital’s med surge/telemetry unit reported approximately 49 falls over the past two years. A quality improvement project was initiated to reduce falls and improve patient outcomes. The context section includes a microsystem assessment, purpose, and SWOT analysis, providing insights into the microsystem’s strengths, weaknesses, opportunities, and threats. Interventions: The intervention details the proactive and structured approach of hourly rounding. The project’s success is based on reduced falls. Outcome Measures: Our outcome measure was to reduce falls by 50% by July 31, 2024. The measure would reduce falls from four to two falls per month. Our process measure counted how many authentic hourly visits were completed. The team also tracked incremental overtime and nurse job satisfaction balancing measures. Results: During the project implementation, there were seven falls, only three of which were unwitnessed. No injuries occurred during this time. Conclusion: Total falls were not reduced during the project implementation, although unwitnessed falls were reduced by 50%. More research must be done to ensure the project’s longevity. Keywords: fall reduction, healthcare intervention, nurse leaders, quality improvement