Using the Fifth P in Purposeful Hourly Rounding to Decrease Falls and Improve Patient Experience

Falls are on the rise at a facility in the Southern part of Virginia. Reducing falls and falls with injury is a goal for this facility. The falls metric is an important nurse-sensitive quality indicator that impacts mortality, the patient experience, and hospital length-of-stay. A pilot study conducted over two months included an interdisciplinary approach to purposeful hourly rounding and the incorporation of a purposeful pause to consider fall-prevention measures before leaving a patient\u27s room. The intervention demonstrated an improvement in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) overall patient experience of care score as well as an improvement in questions in the responsiveness domain. Falls on the unit slightly increased during the timeframe of the pilot, likely due to other contributing factors, as the hospital was struggling with a high registered nurse vacancy rate of 23% compared to the national average of 9.9% (NSI.com). The Coronavirus-19 (COVID-19) pandemic surge negatively impacted purposeful hourly rounding on inpatient units