The PICOT question
In patients in an acute care unit, does hourly rounding compared to not rounding decrease patients’ falls in 90 days?
- P-patients in an acute care unit
- I-hourly rounding
- C-not rounding
- O-decrease in patient falls
- T-90 days
The practice issue, its scope, the need for change
The practice issue is that the rate of falls among patients in acute care units is rather high due to various reasons (Miake-Lye, Hempel, Ganz, & Shekelle, 2013). Having an acute illness, finding oneself in an unfamiliar environment, receiving too much medication, and is equipped with many catheters and tubes make patients highly exposed to falls (Choi & Boyle, 2013). The ability to prevent patient falls is considered as a measurement of nursing care quality.
According to research, falls belong to the most common negative occurrences among hospitalized patients. Nearly one-third of patient falls lead to serious injury or even more dramatic, lethal outcomes (Choi & Boyle, 2013). The rates of patient fall differ depending on the unit. The rates noticed in intensive care units are lower if compared to rehabilitation and medical units (Choi & Boyle, 2013). Still, falls in this hospital department are more dangerous than in other units because of the nature of the health problems of the patients.
What needs to be changed is the methods of preventing patient falls in acute care units. To achieve better patient outcomes, an intervention is suggested. During 90 days, hourly rounding will be performed by nurses. It is expected that such an approach will establish better communication between patients and nurses. Moreover, if rounds are done every hour, nurses will be able to notice patients’ needs better and avoid any issues that may lead to falls. After 90 days, a comparison will be made between fall rates of the patients whose wards there were hourly rounding and those in whose wards there was a less frequent rounding. It is expected that after comparison, the first group of patients will demonstrate a decrease in the number of falls.
Evidence that must be gathered
To investigate the matter thoroughly, I will perform the following types of search: asking about patients’ preferences, investigating nursing guidelines and standards, and doing a literature search. Each of these aspects will help me better analyze the issue of patient falls in acute care units.
Inquiring about patient preferences will allow me to see what patients think about nursing care in acute care units and what they consider to be the most effective methods of preventing falls. Patients will share their experiences and express their opinions on the most effective frequency of nursing rounds.
Investigating guidelines and standards will help me analyze the most common practices employed by nurses to reduce patient falls. Also, standards and guidelines will give insight into the methods that are considered most effective by professionals and healthcare authorities.
A literature search will help me to answer the questions that interest me most regarding the PICOT question. I will look for surveys focused on patient falls and patient satisfaction. Also, I will investigate nurses’ opinions on preventing patient falls in acute care units.
Search terms
The following search terms will be used: patient falls, patient fall prevention, patient fall in the acute care unit, nursing rounds as a method of preventing patient falls.
To narrow the search, I will filter publication dates for the last five years and scholarly or peer-reviewed journals. Also, I will keep a list of keywords that I used. Narrowing the search requires using quotation marks to keep search words together as a phrase.
References
Choi, J., & Boyle, D. K. (2013). RN workgroup job satisfaction and patient falls in acute care hospital units. The Journal of Nursing Administration, 43(11), 586-591.
Miake-Lye, I. M., Hempel, S., Ganz, D. A., & Shekelle, P. G. (2013). Inpatient fall prevention programs as a patient safety strategy: A systematic review. Annals of Internal Medicine, 158(5), 390-396.