How does hourly rounding compared to no hourly rounding impact patient safety (fall) in an acute care setting?
Nur505 Assignment/Research Summary Table
Author (year) Purpose Sample/Number of Participants (provide descriptive statistics) Design Level of Evidence Findings (provide any inferential statistics) Limitations
Krepper et al. 2012 Evaluation of a standardized hourly rounding process Convenience sample Two 32-bed cardiovascular units surgery nursing units Quasi-experimental III-Evidence obtained from well-design controlled sample without randomization No significant difference in number of falls between the control group and the experimental group. The study however the study noted an increase in number of call lights (9% on for the control group and 3% on the experimental group The difference in Patient co morbidities was not taken into consideration.
Falls are not frequent therefore it was not possible to confirm the relationship between hourly rounding and falls.
Olrich et al. (2012) Determine the effect of hourly rounding on fall rate, call light usage, and patient satisfaction All patient discharge from 2 medical surgical units within a period of one year (N=4418)-convenience sample Quasi-experimental on 2 med/surg units which both served as control group control (data collected prior to implementing Hourly rounding) and experimental group III-Evidence obtained from well-designed controlled sample without randomization Result yielded a decrease in fall rate 3.37/1000 to 2.6/1000.
Call light Call light usage and patient satisfaction did not improve Small sample size and no randomization. The experimental group had a patient that was suffering from delirium who hit the call light 187 times and did not need anything. This impacted the call light data during 2 weeks of the intervention
Saleh et al. (2011) The effects of nursing rounds on patient call light use, bed sores, fall, and satisfaction level 104 male patients from a stroke unit-convenience sample Quasi-experimental nonequivalent groups III-Evidence obtained from well-designed controlled sample without randomization Fall incidence was reduced to 4 vs 25 (pre-intervention) with p< 0.01. Pressure ulcer decreased from 2 to 1, and patient satisfaction increased by 7.5% (p>0.05)
Sample is small, no randomization
Patterson (2012) Hourly rounding effectiveness on a high-dependency (HDU) 41 charts of patients from a HDU-convenience sample Pilot study with chart audit and comparison 4.5 weeks before trial, 2 weeks trial, and 8.5 weeks post trial IV-evidence is obtained by comparing two groups, however, no statistical analysis reported no event of patient harm noted during the 2 weeks trial period compared to 2 events pre-intervention and 3 events post intervention Small sample size. Intervention period was only 2 weeks compared to pre-intervention period 4.5 weeks) and post-trial period (8.5 weeks)
Summary
Patient safety is a top priority to all members of the healthcare team. As a team member, nurses are responsible for carrying out interventions that aim to ultimately do no further harm and protect the safety of our patients within our care. One of the foremost concerns for nursing practice is the risk of patient falls. One of the recent practices that have been stipulated to prevent patient falls in the hospital is hourly rounding. In this paper, we will be analyzing and synthesizing 4 research studies that answer the following questions:
How does hourly rounding compared to no hourly rounding impact patient safety (fall) in an acute care setting?
Of the 4 four articles identified, 3 were quasi-experimental designs (Krepper et al., 2012, Olrich et al., 2012 and Saleh et al., 2011). Findings from the studies were drawn by comparing data from one group that was used as the control group (pre-trial) and as the experimental group. The fourth article (Patterson, 2011) was a pilot study that examine the effectiveness of “hourly rounding” on a high dependency unit (HDU). The researcher collected data pre, intra, and post intervention and
