Create a 3-5-page submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question.

The assessment 3 instruction is to ask pico (t) questions as well as evidence-based.

Practice Issue

I chose to practice the issue of hourly patient rounding as a way to reduce falls on medical-surgical units.

The PICO(T ) Question

Patients in an adult medical-surgical unit P: Rounding every hour I: Traditional nursing care or no rounding at all C: Reduced patient falls O: In a three month period

Evidence sources

1. Olrich, K., Kalman, M., & Nigolian, C. (2015). Hourly rounding : A replication study. Journal of Nursing Care Quality, 30(2): 181-187.
2. Zhu, X., Qiao, Y., Liu, Y., & Liu, Y. (2021). The impact of hourly rounds on patient falls: A systematized review and meta analysis. International journal of nursing, 116: 103861.

Find out what you can

Olrich et al. A study was conducted in 2015 to evaluate the impact of hourly rounds on outcomes for patients, such as patient falls. This study replicated an earlier one that showed hourly rounds reduced falls in patients by half. The replication study involved 132 nurses being trained on how to round patients hourly in a medical/surgical unit. Researchers found hourly rounds significantly reduce patient falls compared with traditional nursing care. The study also found that patients’ perceptions of care quality and satisfaction improved with hourly rounding.

Zhu et al. In 2021, a systematic and meta-analysis was conducted on the impact of hourly rounds of patients. This included 15 randomised controlled trials that involved 37,454 patient. A meta-analysis revealed that the hourly rounds significantly reduce patient falls. This was reflected in a pooled likelihood ratio of 0.71, which is based on a 95% confidence interval between 0.63-0.81. This effect was similar across different studies, rounding protocols and outcomes measures. This study found that rounding patients every hour improved staff and patient job satisfaction.

Relevance

Olrich, et. al. Zhu, Olrich, and others (2015; 2021) have found that hourly rounding is an effective intervention to reduce patient falls in medical-surgical units. Hourly rounds are an effective method to decrease patient falls. In both studies, hourly rounds were associated with a statistically-significant reduction in the number of patient falls. Olrich and al. Patients’ satisfaction levels and their perceptions about the quality of care improved in 2015, according to Olrich et al. Studies provide support for the use of hourly rounding in medical-surgical units as a method to reduce falls. Evidence also indicates that rounding hourly can provide additional benefits, beyond just fall prevention. These include improved patient satisfaction and increased staff morale.

The Implications of Practice

Olrich and al. The evidence from Olrich et al. 2021 suggests that rounding patients hourly can be an efficient intervention in reducing patient falls. In order to reduce the risk of patient falls, healthcare professionals and nurses can adopt hourly rounding in their own practice. Evidence also indicates that rounding hourly can provide additional benefits, beyond just fall prevention. These include improving staff and patient satisfaction. When considering the implementation of hourly rounds, health professionals should consider these additional benefits. The evidence provided by these studies can be utilized to guide healthcare organizations’ policies and practices related to fall-prevention and patient satisfaction.

You can also read our conclusion.

Olrich and al. Zhu, et. al. The 2021 report provides evidence to support the use of hourly rounds as a strategy for fall prevention in medical-surgical units. Hourly rounding was found to reduce patient falls significantly and improve staff and patient satisfaction. This evidence can be used by healthcare professionals to guide their practices and health organizations to improve their policies on fall prevention and improving patient satisfaction.