Hourly Rounding: The Effects of Fall Rates in Adult Population in Acute Care Setting

Sheyla J. Pellicier Mercucci, Graduate Student

Abstract

Falls are one of fourteen categories of hospital-acquired conditions (HACs) listed by the Centers for Medicare and Medicaid Services (2020). Falls are costly and stressful for everyone involved; patients, families, nursing staff and physicians. According to the United States Department of Health and Human Services (2019), about seven hundred thousand to one million hospital admitted patients fall every year. The estimated cost of a fall is about fourteen thousand fifty-six dollars if an injury occurs and can extend patient’s hospital length of stay (LOS) to up to 6.3 more days (Joint Commission Center for Transforming Healthcare, 2019).

When a patient falls there is a sense of anxiety and fear related to the event that can lead to lack of activity and independence, mistrust and loss of strength. Most of the patients who fall are elderly, suffering from dementia, experiencing acute delirium, weakness, or are under the effects of prescribed psychoactive agents (United States Department of Health and Human Service, 2019). Healthcare providers must develop a plan of action to tackle the problem before it occurs. A fall is defined as unexpected drop to the floor with or without injury (United States Department of Health and Human Services, 2019). Falls are serious hospital acquired conditions and can lead to serious injuries or patient’s death.

Within the past two years there has been an increase of fall rates in the acute care units at a large Level I Trauma Center in Central Texas which have left nursing administrators and unit leaders searching for ways to reduce these events. A pilot project is needed to answer the following PICOT question: In adult population in acute care settings (P) how does hourly rounding (I) compared to not rounding (C) affect the incidence of falls (O) over a thirty-day period (T)? The pilot project goal is to decrease fall rates by fifty percent at the end of a thirty- day period.