Quality Improvement Initiative Preventing Patient Falls

Quality improvement is a systematic methodology that healthcare organizations use to identify areas where performance can be potentially improved. Different approaches get utilized to gather and analyze data; these techniques, in turn, give context for any prospective future alterations. The provision of health services that are both cost-efficient and reliable can get accomplished via various performance improvements (Fiani et al., 2020). In addition, better improvement initiatives lead to increased patient satisfaction (Neri et al., 2020). The inpatient department, in particular, is an area where quality is improved in addition to the overall hospital environment. The observation of patients in inpatient settings must get improved urgently to reduce the frequency of falls and the bad results linked often with them. The paper discusses patient falls in hospitals and the potential benefits of implementing an hourly rounding program as a quality improvement initiative based on evidence-based practice to better monitor patients and provide higher-quality treatment.

Overview and Setting of the Problem

This examination focuses on the problem of inadequate patient safety due to a high incidence of patient falls. Specifically, the concrete term “patient falls” refers to patients who unexpectedly fall to the ground, which may lead to injuries like fractures and lacerations. Every year, approximately between 700,000 and 1,000,000 slips occur in hospitals across the United States (King et al, 2018). In fact, a third of the incidents in healthcare settings are considered to be preventable.

The clinical environment of extensive medical facilities in the United States is where the most patient falls occur, and this tendency is projected to continue. As many as 20% to 30% of older persons who fall and get wounded in the United States receive severe injuries (Bárbara-Bataller et al., 2018). Increased use of healthcare resources and rise in the level of pain among patients who are victims of falls are some of the negative effects of patient injuries. As a consequence, patients who suffer harm due to trauma may sue healthcare institutions for compensation, which adds financial strain. As a result, hospitals with a high fall rate have a poor reputation, which suggests that they do not attract as many patients as those with lower falls overall. Consequently, it is imperative to discover a solution to this problem and ensure patient safety.

Quality Improvement Initiative

To guarantee patient safety and limit the frequency of falls in the inpatient sections of hospitals, a quality improvement project in the type of hourly rounding must be implemented. This project is vital because it meets the requirement for effective monitoring of people, especially those who have mobility issues. Hourly rounds help identify and aid anyone at risk of falling, preventing them from being exposed to any unforeseen descents. In particular, patients who get injured because of a lack of effort to prevent falls and ensure their safety might increase their treatment costs as a consequence of rehospitalizations (Bates et al., 2021). As a consequence of improved patient well-being, hourly rounds are essential to provide higher satisfaction levels for the individuals who get them. Improvements in patient wellness, individual satisfaction, patient readmissions decrease, and therapy outcomes are all projected due to the hourly rounding effort. This methodology was emphasized as the initiative with the greatest potential to improve individual safety in healthcare facilities because of the wealth of data available to support its implementation.

Results of Previous Research

Results of the previous research can potentially add value to the general discussion of the question. An abundance of previous and subsequent studies has shown that hourly rounds may assist in avoiding falls among patients and improve overall patient safety (Grillo, Firth, & Hatchel, 2019). In addition, it was revealed that the incidence of patient falls was reduced and that quality care was ensured to illustrate the influence of hourly rounding (Grillo, Firth, & Hatchel, 2019). Furthermore, hourly rounding was one of the most effective techniques for reducing falls and improving patient safety in a clinical setting (Bell, 2020). The results of the first research corroborated this conclusion. Another advantage of the method is that it got discovered in previous research to increase patient satisfaction over time. In addition to ensuring patient safety, researchers found that hourly rounds contributed to better patient outcomes and increased patient satisfaction (Bertino-Lapinsky, 2021). Moreover, hourly rounds increased employee happiness, which was a positive finding (Obiogbolu, 2021). However, hospitals that do not actively implement the concept of hourly rounding are missing out on the full benefits of the practice (Brosinski & Riddell, 2020). Because of this, it is essential that the proper techniques for implementing the quality improvement initiative of hourly rounding be thoroughly investigated before implementation.

Implementation of the Quality Improvement Initiative

Several steps must be completed before an hourly rounding technique may be used to improve quality. Firstly, it is essential to emphasize the presence of new nursing staff members who will be accountable for hourly rounds are a critical component of this process. Hourly rounding is notable since it includes visiting different hospital wards at frequent intervals of one hour. Secondly, identifying the staffing needs and, as a result, the additional nursing personnel that must get employed is required. It is time for staff members to learn how to put the hourly rounding approach into practice and take advantage of its benefits for both patients and the institution as a whole.

The real hourly rounding effort is carried out in the third step; this is the time of day when nurses visit patients in their inpatient wards irrespective of whether or not they have rung the bell, and they do so regularly. Nurses should have rotations that are as flexible as feasible since hourly rounding is performed at all hours of the day and night. As a result, patients may be certain that they are constantly under the watchful eye of medical professionals. Finally, after implementing the hourly rounding technique, the next step is to evaluate the outcomes. This assessment aims to determine whether the procedure has met the predetermined objectives.

Evaluation of Qualitative Improvement

Deliberate hourly rounding implementation will be more successful if it involves a varied group of people. To ensure that patients’ needs are met, health care providers are expected to analyze the difficulties created by falls in care settings and take action to implement the initiative of effectively meeting those needs. Hourly rounding processes are necessary to ensure that the all the processes and procedures function smoothly. The multidisciplinary team should conduct research and compile statistics in order to argue for a shift in nursing practice that focuses on establishing hourly rounds to reduce the number of patients that fall. The medical personnel should evaluate patient comments, and an hourly rounding method should be implemented. The personnel at the hospital should have regular meetings to examine the progress that has been made with the intervention, and new methods should be devised and implemented. Moreover, the hospital facilities under examination should install rounding logs that must be recognized by medical personnel during hourly rounds.

Variables, Hypothesis Test, and Statistical Test

There will be an evaluation of patients in the form of hypothesis testing at a hospital as a section of the experiment. This test is required to see how fall rates are changed by staff workers rounding on patients every hour instead of every four hours. Numerous research on hourly rounding approaches is expected to show that they positively impact the frequency of injuries due to slips and falls. Hourly rounding approaches are widely used, and these studies must have bolstered their legitimacy (Brosinski & Riddell, 2020). Concerning the representation of the issue as a ratio, an independent variable, hourly rounding approaches will be critical to reducing instances categorized as falls, which is the dependent variable.


The purpose and intent that drive rounding’s success cannot be achieved by simply looking a patient in the eye and asking, “How are you doing?” accompanied by a hasty marking on a whiteboard or rounding sheet. A rounding with purpose is a work technique that uses a checklist of approaches to achieve optimum results in a sanitary, pleasant, and safe setting to frame the time that person spends with the patient. Purposeful rounding may get used to achieve this. Both the frequency of falls and the severity of the injuries they cause may be reduced. When amending the new clinic policy for fall prevention, nurses’ and patients’ interpersonal communication and collaboration were two of the most important considerations. Perhaps more study time is needed to see if or not an identical program that is evaluated over a long time might help reduce patient falls.


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