Purpose: A fall is defined as an unexpected descent to the ground. Falls account for the greatest number of adverse events and are the most common cause of injury to patients (Hicks, D., 2015). One strategy to prevent falls is hourly rounding (Morgan, L., Flynn, L, Robertson, E., New, S., Forde-Johnston, C., and McCulloch, P., 2016). Rounding involves checking on patients regularly to address their needs, i.e., the 5 Ps (pain, position, potty, periphery, and pump). Fall prevention is a patient safety priority and ongoing challenge on one 41-bed medical-surgical unit. Rounding by volunteers was seen as an expansion of their traditional roles, as an opportunity to improve patient safety.
Description: The purpose of this pilot project was to decrease the occurrence of patient falls and falls with injury during the time volunteers were present on the unit. The pilot lasted for four weeks, with volunteers scheduled daily. Volunteers received training and scription on rounding, falls prevention, and educating patients. Volunteers reported to the unit and received a list of patients whose Morse falls score was equal to or greater than 45 from the charge nurse. Volunteers performed purposeful rounding, and if any patient needed assistance with toileting, the volunteer would stay with the patient and notify staff to assist. At the end of the shift, the volunteer would check out with charge nurse, and complete a volunteer rounding feedback form.
Evaluation/outcomes: During the study period, two patient falls occurred. One happened during a timeframe when there was no volunteer present on the unit. Both falls were related to patients returning from the bathroom. Three falls were prevented because of volunteer intervention. Patients and staff both reported satisfaction with and support of volunteer rounding. Volunteers noted improved confidence with patient and team member interactions. In additional to toileting, volunteers attended to the nutritional needs of patients, stocked supplies in rooms, and assured that patients at high risk for falls had the proper equipment in place (socks, signage, falls identification bands, etc.). Based on the success of this pilot, the program has been expanded to other units in the hospital.
Evidence-based references
1. Hicks, D. (2015). Can rounding reduce patient falls in acute care? An integrative literature review. Med-Surg Nursing, 24(1), 51-55.
2. Morgan, L., Flynn, L., Robertson, E., New, S., Forde-Johnston, McCulloch, P. (2016). Intentional rounding: A staff-led quality improvement intervention in the prevention of patient falls. Journal of Clinical Nursing, 26(1-2), 115-124.