"Preventing Falls in Long-Term Care Facilities" by Kay Keise

Date of Conferral

2019

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara A. Niedz

Abstract

Falls and related injuries have affected residents in long-term care facilities for many years. It has been well-established that patient fall prevention includes staff education and hourly rounding in addition to adequate risk assessment. These steps, taken together, have the potential to decrease a 52.7% fall rate on the long-term care pilot unit. The purpose of this quality improvement project was to: (a) educate staff on the process of properly performing hourly rounding and (b) and achieve a decreased incidence of falls from the current fall rate. Thus, the practice-focused question for the project addressed whether rounding hourly on patients in a long-term care facility would decrease the numbers of falls and related injuries. The conceptual framework used for this evidence-based project was the Institute for Healthcare Improvement's rapid cycle improvement. A sample size of 40 residents' fall rates were compared for a 6-week period before the intervention of hourly rounding to the fall rates after 6 weeks of full implementation of the rounding process. A Wilcoxon Signed Ranks test (z = -4.169, p < .001) showed that there was a statistically significant improvement in staff knowledge when mean pretest scores (75.9%) were compared to posttest scores (94.5%). Nursing staff were also evaluated on competencies, and 100% of the staff successfully completed the competency checklist on the first attempt. Post project fall rates revealed a decreased fall rate by 22% over a 6-week period post implementation. Nursing leadership should ensure that staff are continually educated on policies being implemented to ensure an effective outcome. Having hourly rounding as a permanent policy can decrease the patient's fall rate and improve patient safety, a positive social change.

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