Incorporating Rounding into an Fall Prevention Evidence-Based Guideline

Monday, 7 July 2008: 10:50 AM
Juli Maxworthy, DNP, MBA, RN, CNL, CPHQ , Quality, Saint Francis Memorial Hospital, San Francisco, CA

Learning Objective 1: The learner will be able to understand how rounding can decrease patient falls in the acute care setting.

Learning Objective 2: The learner will be able to describe aspects of the development of an evidence based guideline.

Falls are a painful issue for both patients and the health care institutions in which they occur. Many organizations are utilizing everything and anything ever created in an attempt to decrease falls within their walls. Many of these interventions are not grounded in research and could possibly cause harm. Many literature articles report that falls in hospitals occur when the patient's own (intrinsic) risk factors converge with a current illness episode and their co-morbidities, which can be made worse by external (extrinsic) risk factors posed by the hospital environment. Utilization of a proven fall risk assessment tool along with other identified key strategies (including routine rounding) is essential to keeping patients safe. Rounding, which has been a part of nursing care for over 150 years, is a means of keeping patients safe and feeling cared for, and provides an opportunity for the nurse to connect with his/her patient. Florence Nightingale is remembered as the lady with the lamp for her around the clock rounding of Crimean war soldiers in order to assess their current condition and proactively address their potential needs. It is reasonable to believe that there would be a decrease in falls if a patient is having their basic needs assessed on a regular and proactive basis (repositioning, pain needs, and toileting). This session will focus on the work done in developing a fall prevention evidence based guideline which incorporates rounding as a strategy to keep patients safe.