NRS 465 Benchmark Literature Review

Sample Answer

Patient falls, especially in the geriatric population, are a safety concern because of their significant impact on the quality of care and patient outcomes. Purposeful hourly rounding as an evidence-based practice (EBP) approach to addressing patient falls is effective and can help geriatric settings reduce and prevent falls.

The purpose of this paper is to review the literature on the proposed intervention, purposeful hourly rounding to reduce and prevent falls in the geriatric population based on the eight peer-reviewed articles evaluated in the literature evaluation table.

PICOT Question

In elderly hospitalized patients (Population/problem), how does purposeful hourly rounding (Intervention) compared to normal rounding by nurses (Comparison) reduce the rate of falls by 40% (Outcome) within three months (Time, optional)?

Summary of the Purpose of the Studies

The purpose of the reviewed studies is to demonstrate the efficacy and effectiveness of purposeful hourly rounding in reducing and preventing patient falls in geriatric settings. The study by Roberts et al. (2020) examines the effects of a 20-minute rounding on patient falls in aged-care facilities while Allari et al. (2023) focus on nurses’ perception of caring using hourly rounding.

Anu et al. (2021) focus on the effects of hourly rounding and patient education while Leamy et al. (2023) demonstrate the positive benefits of intentional hourly rounding on patient falls. The other studies by Di Massimo et al. (2022); Ryan et al. (2022), Sims et al. (2020), and Rasmussen et al. (2022) illustrate the importance of intentional hourly rounding to reduce and prevent falls in the geriatric population. These studies illustrate the benefits healthcare organizations and providers derive from implementing hourly rounding.

Comparison of sample Populations

The studies use different sample populations to illustrate the efficacy of intentional hourly rounding. The study by Di Massimo et al. (2022) uses 485 research subjects while Sims et al. (2020) presents a sample of 112 subjects comprising various demographics.

In their study, Rasmussen et al. (2022) used a population sample of 102 volunteers. Roberts et al. (2020) use a population sample of 41 individuals from aged care facilities. Allari et al. (2023) used 1378 participants in their study while Anu (2020) deployed 61 subjects.

Leamy et al. (2023) used a population sample of 138 participants. As such, these population samples differ based on the aspect of intentional rounding that the investigators are interested in their research. A comparison of the sample population demonstrates that a majority of the studies used small sample sizes due to various reasons and factors.

The study by Allari et al. (2023) had the highest sample of over 1300 participants which validates it as an effective outcome because of having a large sample size. However, such a sample size requires significant resources which many researchers and organizations may not have and deploy.

Synthesis of the Conclusions Themes

The eight reviewed studies demonstrate the effectiveness of intentional hourly rounding as an effective EBP strategy to reduce and prevent falls in geriatric settings or practices. The core themes from the studies include improving quality outcomes, enhancing patient safety, better satisfaction levels for providers, and a rise in reimbursement amounts.

For instance, in their conclusion, Roberts et al. (2020) assert that purposeful hourly rounding improved quality outcomes by reducing falls among the geriatric population. Further, Allari et al. (2023) concluded that positive perception from nurses is critical to improving patient outcomes and enhancing safety as it reduces biased interpretation and assistance to patients who require care.

The article by Anu (2021) demonstrates that a reduction in falls improved patient safety within the facility. Similarly, Leamy et al. (2023) show that managing patient falls is critical to improving safety and quality care outcomes. The study implores nurses to embrace hourly purposeful rounding as an effective way to attain patient safety and better outcomes.

Additionally, articles by Di Massimo et al. (2022), Ryan et al. (2022), Sims et al. (2020) and Rasmussen et al. (2022) all demonstrate that intentional rounding is critical in attaining patient safety, quality care outcomes, and improving satisfaction levels besides bettering interactions and inter-professional collaboration among the different healthcare providers in multidisciplinary teams.

The implication is that these studies illustrate the effectiveness of purposeful hourly rounding as an evidence-based practice strategy to reduce and prevent patient falls in geriatric settings.

Summary of the Limitations of the Studies

The main limitations of the reviewed literature studies include small sample populations, limited time to implement the proposed intervention and resource limitations. These limitations hindered the effective collection of sufficient data to improve findings and evidence. For instance, findings from studies with less than 100 participants cannot be generalized to larger populations because of their scope.

While the findings may be valid, they may not reflect the real or true picture of the efficacy of the intervention. Besides, some studies assert that they had limited time.

Conclusion and Recommendations

Purposeful hourly rounding can help facilities and providers in geriatric settings to reduce and prevent the occurrence of falls among patients. As illustrated through these studies, intentional rounding ensures that providers monitor patients to prevent falls by prompt responses as compared to self-reporting. Nurse practitioners should embrace purposeful rounding as an EBP intervention to reduce falls.

The studies recommend more future research to determine the effects of various aspects and factors within the organization that can hinder the implementation of the proposed intervention.

References

• Allari, R. S., & Hamdan, K. (2023). Caring Behavior and Hourly Rounding Nurses’ Perception.
  The open nursing journal, 17(1). http //dx.doi.org/10.2174/18744346-v17-e230210-2022-118
  
• Anu, J. A. (2021). Hourly Rounding and fall prevention among the elderly in long-term care a
  change process. Journal of geriatric medicine, 3(1) 1-5.
  DOI https //doi.org/10.30564/jgm.v3i1.2614
  
• Di Massimo, D. S., Catania, G., Crespi, A., Fontanella, A., Manfellotto, D., La Regina, M., … &
  INTENTO Study Group. (2022). Intentional Rounding versus Standard of Care for Patients Hospitalised in Internal Medicine Wards Results from a Cluster-Randomised Nation-Based Study. Journal of clinical medicine, 11(14) 3976.
  DOI 10.3390/jcm11143976
  
• Leamy, M., Sims, S., Levenson, R., Davies, N., Brearley, S., Gourlay, S., … & Harris, R. (2023).
  Intentional rounding a realist evaluation using case studies in acute and care of older people hospital wards. BMC health services research, 23(1) 1341. DOI https //doi.org/10.1186/s12913-023-10358-1
  
• Rasmussen, T. R. (2022). An Enhanced Purposeful Hourly Rounding Program Impact of
  Proactive Toileting on Rates of Falls and Injurious Falls. Georgetown University. https //www.proquest.com/openview/32c90604dba320472434dd55cfdd467c/1?pq-origsite=gscholar&cbl=18750&diss=y
  Roberts, B., Holloway-Kew, K., Pretorius, T., Hosking, S., Kennedy, A., & Armstrong, K.
  (2020). Does 20-min rounding reduce falls in an aged-care setting? A pilot intervention study. Geriatric nursing, 41(5) 579-584. DOI 10.1016/j.gerinurse.2020.03.003
  
• Ryan, L., Jackson, D., East, L., Woods, C., & Usher, K. (2022). Mixed Methods Study
  Integration Nursing student experiences and opinions of intentional rounding. Journal of advanced nursing, 78(6) 1787-1797. https //doi.org/10.1111/jan.15197
  
• Sims, S., Leamy, M., Levenson, R., Brearley, S., Ross, F., & Harris, R. (2020). The delivery of
  compassionate nursing care in a tick-box culture qualitative perspectives from a realist evaluation of intentional rounding. International journal of nursing studies, 107, 103580. https //doi.org/10.1016/j.ijnurstu.2020.103580