Introduction
The implementation of evidence-based practices (EBP) remains one of the most effective methods to improve the quality of provided services in healthcare and advance academic thought. The selected clinical question concerns the impact of purposeful hourly rounding by nurses and members of interdisciplinary teams in an acute care setting on fall prevention among patients. Ultimately, the current paper provides a thorough overview of databases relevant to the chosen research question and examines findings from prominent evidence-based practices.
Database Overview
Fall prevention is a highly relevant topic in the healthcare academic community, and there are numerous sources of data. One of the specialized databases related to the theme is the National Falls Prevention Database, which focuses explicitly on “evidence-based fall prevention programs across the country” (“National falls,” n.d.). Other viable data sources that comprise hundreds of articles on evidence-based healthcare practices are the database of the National Institutes of Health (NIH), the Journal of Nursing Administration (JONA), and BioMed Central (BMC). These databases contain relevant information, and a large number of research articles are in free access. Hence, they are practical instruments for learning more details about numerous healthcare topics both for professional clinicians and aspiring nurses.
Evidence Overview
The largest part of the current paper discusses findings from the mentioned databases on the impact of hourly rounding on fall prevention in an acute care setting. The research by Sun et al. (2020) from the JONA explores the present topic by overviewing the literature on fall prevention and conducting a thorough observational experiment to determine whether hourly rounding has a positive effect on fall prevention. The authors monitored eleven healthcare units at four hospitals and made 9,683 observations, establishing that hourly rounding does reduce the number of falls in an acute care setting (Sun et al., 2020). While this research is highly relevant to the topic, there might be several inconstancies with the findings. Namely, the authors examined the impact of hourly rounding and bedside shift reports, and the latter was a compounding variable that could have affected the results. Hence, it is critical to examine more evidence-based research to draw definitive conclusions.
There is extensive research on fall prevention interventions in general; however, there are significantly fewer articles on the impact of hourly rounding. For instance, the study by Zhao et al. (2019) heavily emphasizes the effectiveness of EBP implementation on fall prevention, confirming the positive correlation between environmental, educational, communicational, and nursing process interventions and the reduced number of falls. In this context, hourly rounding is a component of the communicational and nursing process activities because it concerns verbal communications, visual signs, and the improvement of nursing protocols (Zhao et al., 2019). The authors prove the effectiveness of these evidence-based practices; however, they also emphasize the significance of educational and environmental interventions (Zhao et al., 2019). Hence, the article provides valuable information on the topic, confirming the effectiveness of communicational activities, but it does not specifically examine hourly rounding.
Another research area that could potentially advance academic progress in fall prevention is qualitative feedback from patients. The article by Radecki et al. (2018) explores how inpatients perceive the actions of nurses in an acute care setting, establishing whether there is qualitative proof for the effectiveness of hourly rounding. This patient-centered approach revealed that while patients generally approve of hourly rounding, there were multiple challenges concerning privacy and falls, specifically during toileting (Radecki et al., 2018). These findings support the idea that structured hourly rounding can be beneficial in fall prevention, but it is critical to maintain patients’ privacy and a sense of dignity to establish trustful communication and reduce falls.
Lastly, there is extensive research demonstrating that some strategies in hourly rounding might be more effective than others. Ram et al. (2019) discuss the significance of purposeful hourly rounding that focuses on the five primary needs of patients (5-P Framework): Pain, Potty, Personal Needs, Positioning, and Possessions. The authors conducted the research based on the existing evidence-based practices in patient/nurse communication and observation (Ram et al., 2019). Their work demonstrated that patients were more willing to cooperate if nurses and managers listened to the provided suggestions and were open to changes in hourly rounding. This finding further supports the idea that hourly rounding might be highly effective in fall prevention, especially compared to practices without hourly rounding at all; however, nurses require professional communication competencies and should respect patients’ privacy (Ram et al., 2019). These conclusions are valuable in analyzing the impact of purposeful hourly rounding on fall prevention and the general improvement of patients’ quality of life in an acute care setting.
Conclusion
Evidence-based practices are critical to improving existing healthcare traditions, and the analysis of hourly rounding might help reduce the number of falls in hospitals. As the current paper shows, there is extensive research on fall prevention interventions in general, but there are significantly fewer articles about hourly rounding in this context. Hence, the proposed clinical question is highly relevant since it might advance the academic progress on the reduction of falls in hospitals. Consequently, the examined databases and evidence in the current paper are valuable to determining the exact research hypothesis for the consequent study and making a positive change in the healthcare tradition of fall prevention.
References
National falls prevention database for professionals. (n.d.). National Council on Aging. Web.
Radecki, B., Reynolds, S., & Kara, A. (2018). Inpatient fall prevention from the patient’s perspective: a qualitative study. Applied Nursing Research, 43, 114-119. Web.
Ram, M. S., John, J., & John, S. (2019). Purposeful hourly rounding by nurses: A best practice implementation project. International Journal of Nursing Care, 7(2), 16-19. Web.
Sun, C., Fu, C. J., O’Brien, J., Cato, K. D., Stoerger, L., & Levin, A. (2020). Exploring practices of bedside shift report and hourly rounding. Is there an impact on patient falls? JONA: The Journal of Nursing Administration, 50(6), 355-362. Web.
Zhao, Y. L., Bott, M., He, J., Kim, H., Park, S. H., & Dunton, N. (2019). Evidence on fall and injurious fall prevention interventions in acute care hospitals. JONA: The Journal of Nursing Administration, 49(2), 86-92. Web.