Timed Purposeful Rounding for Fall Reduction Among Residents in the Skilled Nursing Facility

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Olurounke Remi-Johnson (Creator)
Institution
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Advisor
Crystal Epstein

Abstract: Background: In the elderly, falls can lead to serious injuries, hospitalization, or death. Research indicates that routine unit rounds are imperative for reducing patient falls. However, rounding has not been enough in reducing patient falls among people admitted to skilled nursing facilities (SNF). Time-sensitive nursing rounding is a more effective evidence-based strategy to reduce falls. Purpose: The purpose of the quality improvement project is to plan, implement, and evaluate the use of a Timed Purposeful Rounding (TPR) protocol by SNF staff. PICOT question: Does TPR (I) using the 4ps (pain, prompt voiding, positioning, and placement) reduce the incidence of falls (O) among residents (P) in a SNF over six months (T) compared to routine rounding (C)?Method: TPR involves hourly assessment of the patients for pain, prompt voiding, positioning of comfort, and placing belongings within reach. The project was guided by the John Hopkins Evidence-Based Practice (EBP) model. The setting was a 100-bed for-profit SNF. The sample included nursing staff RNs, LPNs, and CNAs. Incidence of falls per month over six months was used to measure the effectiveness of the intervention in reducing falls.Results: Implementation of TPR reduced falls by 53% over six months. Recommendation and Conclusion: Falls decreased significantly after the implementation of TPR. Practice sites should continue using TPR. I recommend that TPR be done for all patients, especially high-risk patients.

Additional Information

Publication
Dissertation
Language: English
Date: 2022
Keywords
hourly rounding, timed rounding, nursing home, elderly, frail adults

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