Effects of Nursing Rounds on Patients Fall Rates

The purpose of this study is to determine the effects of hourly rounding on patient falls, patient satisfaction, and patient call light usage. This is a replication of research which determined that hourly rounds conducted by nursing personnel decreased patient falls and call light usage and increased patient satisfaction. The study design is quasi- experimental. One unit will be used as its own control (4S). On this unit, hourly nursing rounds will be implemented by Registered Nurses, Licensed Practical Nurses, and Nursing Assistants. A second unit, 6S, will maintain current practices and data from this unit will be used to determine if there are any hospital-wide fluctuations for fall rates, patient satisfaction, or call light usage. Data for patient falls, patient satisfaction, call light usage, and reasons for call light use will be collected on both units using fall rate reports, patient satisfaction survey data, and the call light system.

Falls among hospital patients are a persistent problem, with 2.3 to 7 falls occurring in U.S. hospitals every 1000 patient days. Approximately 30-48% percent of these falls result in injury and 5 to 10 percent of them result in serious injury. Fall related deaths occurred at a rate of 46.2 per 100,000 in 2003. Hospital falls affect both young and old patients and many of them occur when the patient is alone or involved in elimination-related activities. Falls that result in injury may lead to an extended hospitalization and increased costs. Patients who fall and sustain injury are reported to have hospital charges of more than $4,200 higher than patients who do not fall. Hourly nursing rounds have been shown to decrease falls by 52%.

Hospitalized patients often require assistance with basic self-care tasks, such as using the toilet, ambulating, and eating; they ask for assistance by using the call light. Therefore, a patient's level of satisfaction with nursing care depends principally upon the patient's perception of how well the nursing staff has been able to meet his or her needs. The call light can be a lifeline for hospitalized patients, but it can also impose considerable demands on nurses' time. Several studies have documented the unfavorable effects of patients' frequent use of call lights on the effectiveness of patient-care management on inpatient units, which may already be compromised by staffing shortages.