Research Paper Undergraduate 1,154 words

Hourly Rounding: Falls, Pressure Ulcers & Patient Safety

~6 min read 5 sections Health · Patient Safety

Abstract

This paper examines the evidence-based practice of hourly rounding and its impact on patient outcomes in hospital settings, with a focus on fall prevention, reduction of pressure ulcers, and decreased call light use among adult patients aged 60 and older. Using a PICOT framework, the paper reviews relevant quantitative and qualitative studies to assess how systematic, proactive nurse check-ins compare to standard care in improving patient satisfaction and safety. Key findings from the literature indicate that hourly rounding can reduce falls by up to 54%, pressure ulcers by 56%, and call light use by 52%, with associated gains in patient satisfaction scores and institutional revenue outcomes.

Key Takeaways

Introduction: Background on falls and hourly rounding benefits
PICOT Question: Clinical question guiding the study
Literature Review: Review of key studies on hourly rounding
Comparing Research Methodologies: Qualitative versus quantitative research approaches
Summary and Conclusion: Synthesis of findings and remaining gaps

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What makes this paper effective

Uses a structured PICOT question to anchor the literature review in a clear clinical inquiry framework, making the research purpose explicit and measurable.
Critically evaluates individual studies rather than simply summarizing them, noting methodological shortcomings such as missing sample size details, absent theoretical frameworks, and inadequate ethical procedures.
Incorporates direct quantitative data (percentage reductions in falls, pressure ulcers, and call light use) to ground the argument in concrete evidence.

Key academic technique demonstrated

The paper demonstrates critical appraisal of sources — a core evidence-based practice skill. Rather than accepting each cited study at face value, the author identifies specific limitations (e.g., merged introduction/literature review sections, lack of research questions, insufficient sample size reporting), which shows the ability to evaluate research quality alongside research findings.

Structure breakdown

The paper opens with background on falls in older adults and introduces hourly rounding as a solution, then presents a formal PICOT question. The literature review covers four studies individually, comparing their methodological strengths and weaknesses. A brief methodological comparison of qualitative versus quantitative approaches follows. The paper closes with a summary that synthesizes findings and acknowledges remaining gaps in the literature. References follow APA format.

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Essay 1,154 words

Introduction

In the contemporary healthcare environment, falls are a common phenomenon that can cause fatal injuries to older adults aged 60 and above. Nearly 50% of hospitalized older adults face the risk of falls, which can lead to fatal or non-fatal injuries. Consequently, falls produce negative effects including elevated hospital costs and longer hospital stays. To address high fall rates in healthcare settings, various organizations have devised different strategies for hospitalized older adults. While these health practices aim to enhance patient safety, not all of them are effective at preventing falls. For example, call light use may help prevent falls; however, its overuse can increase nursing workloads and reduce nursing satisfaction.

Hourly rounding has been identified as an effective, proactive health practice that can reduce falls and pressure ulcers while improving patient satisfaction. Hourly rounding is defined as a proactive and systematic health intervention that healthcare organizations design to meet the needs of inpatients in order to promote patient safety and satisfaction. It is particularly effective for managing pressure ulcers, which are among the leading causes of untimely death in the United States. Pressure ulcers occur among people who have nerve damage or limited mobility; affected patients suffer from oxygen deprivation in the damaged area. Repositioning is an appropriate strategy to manage pressure ulcers, as patients are moved into different positions to relieve pressure and redistribute body weight, thereby enhancing effective blood circulation. Because patient satisfaction is critical for healthcare organizations, hourly rounding has been identified as an effective strategy for improving patient outcomes.

PICOT Question

This study develops a PICOT question to deepen understanding of the effectiveness of hourly rounding in reducing pressure ulcers, call light use, and falls, all of which ultimately enhance patient satisfaction.

Among adult patients aged 60 years and above (P), what are the effects of hourly rounding (I) as compared to patients not receiving hourly rounding clinical attention (C) on patient satisfaction (O) when the intervention is applied over a period of 3 months (T)?

Literature Review

This section reviews the literature to deepen understanding of the impact of hourly rounding on fall rate reduction, reduction of pressure ulcers, and call light use as they relate to patient satisfaction.

Olrich, Kalman, and Nigolian (2012) conducted a qualitative study on the impact of hourly rounding on fall rates and call light use among inpatients who had undergone medical-surgical operations. Despite being well written, the study does not provide a research question that reflects the phenomenon guiding the research process, nor do the authors offer a comprehensive literature review. While the researchers described their sampling method, they did not provide adequate information on sample size. Although the data collection and analysis process was described, the researchers did not follow appropriate steps when conducting data analysis. Furthermore, the study did not discuss the ethical procedures used to protect research participants.

Meade, Bursell, and Ketelsen (2006) used a quantitative approach to investigate the impact of hourly rounding and call light use on patient satisfaction. While the researchers included a literature review, it was merged with the introductory section. Additionally, the authors did not provide a conceptual or theoretical framework. Despite these shortcomings, the authors developed a hypothesis to guide the research process and identified the target population along with inclusion and exclusion criteria. By using STATS software for statistical data analysis, the authors were able to present their findings in a clear and coherent manner.

Falls among older adults represent a significant clinical problem. Hicks (2015) describes falls as a sudden or unexpected slip from a sitting or standing position that has become one of the top clinical problems among older adults in the United States. In 2000, the U.S. spent over $19 billion managing fall-related injuries. Hicks (2015) identifies hourly rounding as the practice of checking inpatients regularly to meet their health needs and improve satisfaction. Ford (2010) supports this argument, pointing out that hourly rounding is an effective, proactive approach to improving patient satisfaction. To support his argument, Ford drew on the hourly rounding practice at Baltimore Washington Medical Center (BWMC), where:

"Quantitative call light data were collected during this time, along with data from rounding logs and discharge phone calls made to those patients within 48 hours of discharge." (Ford, 2010, p. 189).

The results of Ford's investigation revealed that hourly rounding reduced falls among patients by 54%, pressure ulcers by 56%, and call light use by 52%. A related study investigating the impact of hourly rounding on patient outcomes reported:

"[A] 100% reduction in the fall with injury rate achieved during the study period and contributed to a reduction of 67.8% by the end of the fiscal year 2008. Press Ganey scores reflected increased patient satisfaction during this quarter (as compared to the previous quarter) in teamwork = 3.7%; attention to special/personal needs = 2.1%; overall nursing care = 1.9%; and pain control = 1.2%." (Callahan et al., 2011, p. 1).

Based on the demonstrated impact of hourly rounding on patient outcomes, healthcare organizations that decline to integrate hourly rounding into clinical practice may see a decline in revenue at the end of a fiscal year, as they may be unable to improve patient satisfaction sufficiently to remain competitive.

2 Sections Hidden · 225 words

Comparing Research Methodologies95 words

The outcome of the literature review reveals that qualitative research provides a scientific approach based on the strength of the data collected. Typically, qualitative research offers descriptive insight gathered through interviews, case studies,…

Summary and Conclusion130 words

Patient satisfaction is critical within the healthcare environment. Hourly rounding has been shown to reduce patient falls, with outcomes…

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References

Callahan, L., McDonald, S., Voit, D., McDonnell, A., Delgado-Flores, J., & Stanghellini, E. (2011). Medication review and hourly nursing rounds: An evidence-based approach reduces falls on oncology inpatient units. Nursinglibrary.org.

Ford, M. B. (2010). Hourly rounding: A strategy to improve patient satisfaction scores. MEDSURG Nursing, 19(3), 188–191.

Hicks, D. (2015). Can rounding reduce patient falls in acute care? An integrative literature review. MEDSURG Nursing, 24(1), 51–55.

Meade, C. M., Bursell, A. L., & Ketelsen, L. (2006, September). Effects of nursing rounds on patients' call light use, satisfaction, and safety. American Journal of Nursing, 106(9), 58–70.

Olrich, T., Kalman, M., & Nigolian, C. (2012, January/February). Hourly rounding: A replication study. MEDSURG Nursing, 21(1), 23–36.

Key Concepts in This Paper

Hourly Rounding Fall Prevention Pressure Ulcers Patient Satisfaction Call Light Use PICOT Framework Evidence-Based Practice Nursing Intervention Older Adults Inpatient Safety