5Ps of Hourly Rounding: Fall Prevention in Hospitals, Study notes of Nursing

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A S S E S S I N G T H E 5 P ’ S O F H O U R L Y R O U N D I N G

FALL PREVENTION

Katie Souviney, RN BSN and Jennifer Posnick RN

ARE FALLS REALLY A PROBLEM?

Here are the facts…

• Each year between 700,000 and 1,000,000 people in the United States will fall in a hospital setting (Agency for Healthcare Research and Quality, 2013).
• A fall can result in injury including fractures, brain bleeds, lacerations, internal bleeds, and loss of self esteem.
• Research shows that close to 1/3 of falls can be prevented in the hospital (Agency for Healthcare Research and Quality, 2013).

THE BIG CHALLENGES TO FALL PREVENTION...

• Each patient is unique and may require a higher level of attention to prevent falls.
• There are many hazards in the hospital that can increase risks for falls: equipment (SCDS, IV poles, items in room), new medications (cardiac medications and narcotics), surgery, increase in pain leading to weakness, illness/diagnosis. Fall prevention must be multifactorial in order to combat all of these hazards.
• “Fall prevention requires an interdisciplinary approach to care” (Agency for Healthcare Research and Quality, 2013).

LET’S TAKE A LOOK AT VA MAINE’S

APPROACH ON FALL PREVENTION

• Includes the patient

and the whole care

team in the fall

prevention

management.

• Team includes: THE

PATIENT , nurses,

nursing assistant,

housekeeping,

physical therapy,

occupational

therapy, doctors,

dietary staff

• Educate the patient

and ensure the

patient interacts in

the plan to prevent

falls.

• Ensure that the

patient understands

the plan by using the

teach-back method

to assess the patients

understanding

WHAT ARE THE 5 P’S

• The 5 P’s of hourly rounding that we assess/ask the patient at the Maine VA are the following: - Are you having pain?
• Do you need to potty /use the bathroom?
• Do you have all your personal belongings within reach?
• Do you need to be re positioned?
• Are all your pumps and items in your room plugged in?

BENEFITS OF THE 5P’S

• Ensure our patients are being checked on/assessed every hour.
• Promotes safe environment
• Increases time of nursing care spent at the bedside
• Decreases pressure ulcers and improves clinical outcomes
• “Builds the patient’s trust” (Death, 2016).
• Decreases use of call lights
• “Increases patient satisfaction” (Death, 2016).

According to the Readiness Rounds Blog, Donald Death (2016) presents us with the following data:

1. Fall Reduction: Over 50%
2. Pressure ulcer Reeducation: 10%
3. Call light Reduction: 40%
4. Patient satisfaction typically improves over 10%

HOW ELSE CAN WE ENGAGE THE PATIENT?

• As a collaborative team, we created a fall prevention/5 P hourly rounding video for patients to view on admission to further engage patients in our fall prevention strategies.
• Our goal was to interact with our patients and ensure they are engaged in their education during their stay.
• The video incorporates multidisciplines to show that it takes more than just one nurse to prevent falls.

5 P HOURLY ROUNDING FALL PREVENTION VIDEO

• https://youtu.be/JsTQwNTLJR

REFERENCES

Agency for Healthcare Research and Quality. (2013,

January 31). Preventing Falls in Hospitals. Retrieved August 1, 2017, from https://www.ahrq.gov/professionals/systems/hospital/ fallpxtoolkit/fallpxtkover.html

Death, C. D. (2016, July 20). Readiness Rounds Blog. Retrieved August 5, 2017, from https://www.readinessrounds.com/blog/the-5-ps-of- rounding-the-foundation-of-patient-satisfaction