Rounding with a Purpose: Reducing Falls in Geriatrics Residing in a Community Living Center

Abstract

Practice Problem: Falls among geriatrics continue to be a significant concern for healthcare organizations and one of the costliest healthcare problems attributed to increased morbidity and mortality rates. Falls rates in residential dwellings such as nursing homes and community living centers (CLCs) continue to rise despite fall prevention efforts. PICOT: The PICOT question that guided this project was In geriatrics, age 65 or older, who reside in the Community Living Center (P), how does one-hour purposeful rounding (I), compared to rounding without structured set time intervals (C), affect fall reduction rates (O), within eight weeks (T)? Evidence: In fifteen high-quality articles that fit the inclusion criteria and contained evidence-based practice (EBP) literature, there was overwhelming support that the use of purposeful rounding was an EBP initiative to reduce falls. Intervention: One-hour purposeful rounding was the primary intervention for this change initiative project. Purposeful rounding is a nurse-driven, proactive approach that improves staff communication and promotes patient-centered safety interventions to reduce preventable events such as falls. Outcome: There was both statistical and clinical significance in fall rates with the use of one-hour purposeful rounding in the CLC as fall rates dropped to 3.06 falls per 1,000 bed days of care post-implementation compared to 10.48 falls per 1,000 bed days of care pre-implementation. This resulted in an alpha value of p = .031 and clinical significance of improved health outcomes, reduced morbidity and mortality, and overall improved quality of life for the geriatric residents residing in the CLC. Conclusion: Initiating the practice of one-hour purposeful rounding effectively improved fall rates in the CLC. It had a statistical and clinical significance for improvement among the geriatrics, age 65 or older, who resided in the CLC.