The Effect of Fall Prevention Programs with Hourly Rounding on Fall rates Among Adults Patients in Neurological Unit
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Purpose The purpose of this QI project was to evaluate the effect of a structured hourly rounding program on patient fall rates in an adult neurological inpatient unit. Background Patient falls remain a major safety concern in acute care, particularly among hospitalized neurological patients with impairments in mobility, cognition, and balance. In an adult neurological unit within a Magnet-designated hospital, fall rates exceeded national benchmarks, underscoring the need for a targeted quality-improvement Methodology A pre–post QI design, guided by the Plan-Do-Study-Act framework, was implemented over 12 weeks in a 28-bed neurological unit. This intervention featured structured hourly rounding using the 5Ps framework: pain, position, potty, possessions, and plan. Nurses and patient care assistants alternate rounding responsibilities, with compliance documented using standardized logs. Outcome measures included fall rates per 1,000 patient-days, while process measures assessed rounding compliance. Data analysis used descriptive statistics, run charts, and paired t-tests. Results The baseline fall rate was 3.68 falls per 1,000 patient-days, which decreased to 3.24 during implementation. After excluding falls due to contextual factors such as sitter removal, the adjusted fall rate was 1.8, successfully meeting the project aim of 2 per 1000 patient. Notably, high early compliance (over 95%) was associated with fewer falls, whereas declining adherence was associated with increased events. Implications Structured hourly rounding offers an effective, low-cost fall-prevention strategy for high-risk neurological patients, if staff sustain adherence. Continued commitment to rounding can help improve safer outcomes and foster a culture of safety in neurological care units.
Author: Ogundeji, Oyinlola A
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7154547359