Introduction
The number of falls and injuries related to falling among senior patients in long-term care institutions is growing, and the expense of treatment and hospitalization is rising as a result (Savage, 2020). The PICOT question seeks to establish if when senior customers (P) are kept track of by registered nurses (I) on an hourly basis compared to when they have been checked on 6 hours basis (C) lowers the risk of their falling (O) throughout their keep (T) in nursing homes. This paper will be a critical appraisal that will examine quantitative articles to determine if the PICOT question is justifiable.
Background of Studies
As a result of hourly rounding, patients can obtain assistance before the situation becomes urgent and they cannot wait for help to arrive. Frequent, deliberate rounds are especially helpful for patients who are disoriented or suffering from dementia (Savage, 2020). The research question is to determine if nurses that check on their senior patients on an hourly basis reduce the risk of falling compared to those that check on the patients on a six-hour basis. As the basis of the study, two articles were selected in which quantitative research is conducted on the topic of patient falls and the work of nursing staff. The article by Lloyd determines the effectiveness of the project aimed at hourly rounding, which reduces the likelihood of patients falling. Anu’s article is aimed at demonstrating the effectiveness of the intervention of nursing staff to prevent the fall of shares.
How Two Articles Support the Nursing Practice Problem
These two articles will be used to answer the PICOT question as they describe in detail the advantages of nurses working on an hourly basis rather than on a 6-hour basis. Lloyd (2021) supports the nursing problem of hourly rounding as this issue determined that the safety of patients is essential to delivering high-quality healthcare. Expenses for the patient and the facility will rise because of a longer hospital stay and treatment time. Lloyd’s (2021) article used research in the academic literature to develop a PICOT question about how effective an hourly basis will be than a 6-hour one for patients prone to falling. In supporting this paper’s aim, Lloyd (2021) confirmed that most acute care units currently use the technique of hourly rounds.
Anu (2021) on the other hand, posits that hourly rounding is a clinically proven practice that helps nurses anticipate and respond to patient’s changing needs and by using this, nurses help to reduce the risk of patients falling. For 10 weeks, Anu’s (2021) study focused on process improvement initiatives, teaching, and the implementation of an evidence-based hourly rounding approach that helped reduce the number of falls in the pilot unit of the facility. In both articles, interventions, and groups are compared with those indicated in the PICOT question according to age, as well as specifically on the intervention of professional nurses.
Method of Studies
Unlike Anu’s (2021) article, by using the Plan, Do, Study, and Act method (PDSA) technique, Lloyd (2021) introduced a new hourly rounding procedure to reduce the number of falls. Like Anu’s (2021) research Lloyd’s (2021) study had an educational component. Lloyd (2021) discovered proof that the new rounding methodology has been applied and that it can improve patient safety via comparisons of fall rates, video surveillance, record audits, and patient questionnaires. However, the limitation is that it is possible that patient-centered hourly rounding is a long-term solution, but further research is required to see how it affects patients over time. The benefit is that hourly rounding is effective in dealing with patients with falls and reduces the risk of injury and death of the elderly.
Anu’s (2021) research used Studer Group’s hourly rounding log and competence assessment that was utilized with permission for the project. The advantage of this method is that the employees were trained to undertake this study and hence they recorded their progress on the hourly rounding log, as well as retrieved data from the facility’s fall rate database to determine the pre-and post-implementation fall rates. The brief pilot phase of 10 weeks in the Anu (2021) article was the study’s shortcoming. The limitation was that several changes had to be made to the documentation, and nursing journals and nurses had to be trained in new forms of working with papers. In both articles, the authors do not consider the entire stay of the patients as suggested by the PICOT question.
Results of Studies
Lloyd’s (2021) research found that patients at a hospital are more at risk of falling if they have hourly rounding compared to no hourly rounding. Anu’s (2021) study revealed that the participants carried out hourly rounds as part of their everyday routines and recorded their rounds on a log sheet, and after the study period, it was found to be statistically significant. The implications of both studies on nursing relate to the findings that fall may be prevented and hospitalizations avoided by including hourly rounding in a fall prevention plan already in place.
Ethical Considerations
The two main ethical considerations of the conducted studies are the consent of medical institutions and the consent of patients. The institutions have to give the researchers a go-ahead to extend the use of patient-centered hourly rounding based on the positive results of the pilot programs. Furthermore, the patients must accept to participate in the study through written agreements. The researchers showed that they received the required permits to conduct the studies.
Conclusion
From the two studies and the PICOT question, when senior patients are checked in hourly rounding programs, there is a significantly reduced inpatient fall rate. It can be concluded that senior customers have fewer risks of falling when registered nurses check on them on an hourly basis than on a six-hourly basis for the duration of their stay in the health facility.
References
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.
Lloyd, S. L. (2021). Hourly rounding to reduce patient falls – A quality improvement project.MSN Capstone Projects. Paper 156.
Savage, A. (2020). Reducing patient falls through purposeful hourly rounding. [Doctoral project, University of St Augustine for Health Sciences].