Tuesday, January 14, 2020

Hourly Rounding & Fall Precaution Essay

Falls are a common occurrence among medical, surgical and elderly patients in hospitals. One of the largest categories of reported adverse events in hospitals are patient falls, which are estimated to cost more than $20 billion a year. (2010 Lippincott Williams &Wilkins, Inc.) Prevention is the best method to decrease the number of falls and reduce hospital cost and increase patient satisfaction. One of the best ways to prevent falls is patient hourly rounding. Hourly rounding means intentionally checking on patients at regular intervals continuously to ensure patients’ needs has been met. Attending to patients’ comfort, safety, and environmental needs may prevent adverse events like falls and contribute to patients’ satisfaction. There is study which evaluates the effectiveness of hourly rounding to reduce the rate of falls. Purpose: The purpose of this study was to determine the effect of hourly rounding on fall rates and patient satisfaction in patients. Metho ds: MEDLINE and CINAHL were the search engines. Key search words were hourly/patient rounding, falls, call lights, and patient satisfaction ( Margo A 2009). Evaluations were conducted in all hospital units, telemetry, medical/surgical and orthopedic. Reports were retrieved .In 5 of 6 studies (83%) that examined use of call lights, the use was reduced. (Meade C 2006) reported that nurses were summoned 12 to 15 times daily to respond to non-urgent needs such as toileting, positioning, or pain relief. By nurses’ anticipating these needs through making rounds, patient care may be interrupted less with non-urgent calls. Fall rates were reduced in 7 of 9 studies (77%) in which falls were evaluated. In one study, (Kalman M 2008) making rounds did not affect the rate of falls, and in another study ((Bourgault A 2008) the rate of falls increased. Other studies uncovered less use of restraints (Assi M 2008) and attendants when making rounds was instituted. In 8 of 9 studies (88%), researche rs discovered improvements in overall patient satisfaction (Medsurg Nurse. 2008) .They were more satisfied with anticipation and attention to personal needs, timeliness of nurses’ response, and management of pain. Patients who had frequent admission to the hospital noted the difference after implementation of hourly rounding. They perceived the nursing staff to be more attentive. Available evidence  represent that making rounds is appropriate, safe, and useful for practice and has positive impact to decrease rate of falls and increase patient satisfaction. Conclusion: Decreasing patients fall and increasing patient satisfaction are important goal in any organizations .In this study hourly rounding has improved patient satisfaction and decreased rate of falls in patients significantly, however higher quality study designs are needed to assess the effect of hourly rounds in a variety of settings, including units with a history of good outcomes, to determine what promise making rounds holds for further improvements (Meade C 2006). The study of hourly rounding is very significant to the nursing. Many studies reviled the importance of hourly rounding and it is an interdisciplinary practice in most of the institutes. Making hourly rounds can be viewed as a bundle of interventions that promote not only comfort but safety of both patients and nurses (Mosby,2008).Hourly rounding helps nurses to anticipate and evaluate the needs of patients ,addresses the 4ps (pain , position , potty , possessions) and additional comfort needs . Research about hourly roundi ng shows it is effective in increasing patient satisfaction, increasing nursing satisfaction and increasing quality by reducing fall rates. Hourly Rounding & Fall Precaution Falls are a common occurrence among medical, surgical and elderly patients in hospitals. One of the largest categories of reported adverse events in hospitals are patient falls, which are estimated to cost more than $20 billion a year. (2010 Lippincott Williams &Wilkins, Inc.) Prevention is the best method to decrease the number of falls and reduce hospital cost and increase patient satisfaction. One of the best ways to prevent falls is patient hourly rounding. Hourly rounding means intentionally checking on patients at regular intervals continuously to ensure patients’ needs has been met. Attending to patients’ comfort, safety, and environmental needs may prevent adverse events like falls and contribute to patients’ satisfaction. There is study which evaluates the effectiveness of hourly rounding to reduce the rate of falls. Purpose: The purpose of this study was to determine the effect of hourly rounding on fall rates and patient satisfaction in patients. Methods: MEDLINE and CINAHL were the search engines. Key search words were hourly/patient rounding, falls, call lights, and patient satisfaction ( Margo A 2009). Evaluations were conducted in all hospital units, telemetry, medical/surgical and orthopedic. Reports were retrieved .In 5 of 6 studies (83%) that examined use of call lights, the use was reduced. (Meade C 2006) reported that nurses were summoned 12 to 15 times daily to respond to non-urgent needs such as toileting, positioning, or pain relief. By nurses’ anticipating these needs through making rounds, patient care may be interrupted less with non-urgent calls. Fall rates were reduced in 7 of 9 studies (77%) in which falls were evaluated. In one study, (Kalman M 2008) making rounds did not affect the rate of falls, and in another study ((Bourgault A 2008) the rate of falls increased . Other studies uncovered less use of restraints (Assi M 2008) and attendants when making rounds was instituted. In 8 of 9 studies (88%), research ers discovered improvements in overall patient satisfaction (Medsurg Nurse. 2008) .They were more satisfied with anticipation and attention to personal needs, timeliness of nurses’ response, and management of pain. Patients who had frequent admission to the hospital noted the difference after implementation of hourly rounding .They perceived the nursing staff to be more attentive. Available evidence represent that making rounds is appropriate, safe, and useful for practice and has positive impact to decrease rate of falls and increase patient satisfaction. Conclusion: Decreasing patients fall and increasing patient satisfaction are important goal in any organizations .In this study hourly rounding has improved patient satisfaction and decreased rate of falls in patients significantly, however higher quality study designs are needed to assess the effect of hourly rounds in a variety of settings, including units with a history of good outcomes, to determine what promise making rounds holds for further improvements (Meade C 2006). The study of hourly rounding is very significant to the nursing. Many studies reviled the importance of hourly rounding and it is an interdisciplinary practice in most of the institutes. Making hourly rounds can be viewed as a bundle of interventions  that promote not only comfort but safety of both patients and nurses (Mosby,2008).Hourly rounding helps nurses to anticipate and evaluate the needs of patients ,addresses the 4ps (pain , position , potty , possessions) and additional comfort needs . Research about hourly rou nding shows it is effective in increasing patient satisfaction, increasing nursing satisfaction and increasing quality by reducing fall rates.

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