HOURLY ROUNDING IN IMPROVING PATIENT SAFETY IN GERIATRIC POPULATION
Aim: Unintentional patient fall clinical economic burden cannot be contested. The increased incidences of geriatric patient falls combined with the impacts of nurse shortages results to increased staff workloads. In turn, the increased workloads are associated with noncompliance with patient safety interventions and basic falls preventive measures. The shortage of nurses, increased of patient acuity, and time constraints increase the probability of creating a stressful environments with low compliance of fall prevention protocol, leading to fatal fall related injuries and mortality.
Methodology: This mixed research paper explores on the evidence based practice for fall prevention strategies are significant to nurse profession because they will significantly reduce unintentional patient fall incidences, and lower workloads that cause increased nurse burnout.
Results: Evidence based study indicates that hourly rounding promote patient safety, quality of care and patient satisfaction. The evidence based practice outcome have been documented in systematic reviews that it results into reduction of patient falls by 52%, use of call lights and bells by 37%, pressure ulcers by 14% and increases patient satisfaction by 12%.
Conclusion: The proposed recommendation is to initiate hourly nurse rounding program in geriatric population ward. Hourly rounding is a systematic nursing intervention that is designed to address the needs of hospitalized geriatric population using an approach that reduced patient falls and related complication.
Patient falls are strong indicators of quality of care that is often used to monitor quality performance within departments, local and national level. The physical injuries include bruising, pain, scratches, lacerations, fractures and intracranial bleeding. Patient falls and related injuries not only affect patient safety, but also damages hospitals reputation. Hourly rounding has positive impact on healthcare facility in four major variables namely a) reduction of patient fall, b) low emergency care due to fall related injuries, c) reduce hospitalization days and d) increase patient outcomes (Lee et al. 2013).
Therefore, this paper explores whether “In geriatric patients admitted in the orthopedic ward, is use hourly rounding’s (I) or call light use (C) more effective in improving patient safety, in six months (T)?” (Bennett, Ockerby, Stinson, Willcocks, & Chalmers, 2014).
Patient falls and injury prevention still remains a considerable challenge across the care continuum. Hourly rounding is an effective and wining strategy. Once approval and training is done, the nurses will be expected to make purposeful rounds after every hour between the A shift (0600hrs-2200hrs) and after every two hours during the B shift (2200hrs-0600hrs).
The proposed solution of hourly rounding in the orthopedic ward is expected to reduce patient falls by 50%, reduce skin breakdowns by 14% and increase patient satisfaction by 12%. The solution is also expected to contribute to increased teamwork and efficiency in addressing patient safety matters (Dunne, Gaboury, & Ashe, 2014).
Initiating change in any organization is a complex process. Introducing hourly rounding within a healthcare facility is a potential solution to patient safety problems such as patient falls and pressure ulcers. Although research on effectiveness of hourly rounding fall-prevention programs has proliferated in the recent past, it is still unclear if most organizations are willing or have the capacity to adopt and use this evidence based practice. This calls for an effective change model that will facilitate unfreezing old practices, introduce new ones and facilitate the process of refreezing the new evidence based practice (Neumeier, 2013).
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