Documentation of Purposeful Rounding as a Tool to Reduce Patient Falls Cheryl Grohn, RN-BC, MPH
Background: Patient falls are one of the eight patient outcomes included in the nursing care performance measures adopted by the National Quality Forum. Hospitalization increases the risk for falls; reviews of observational studies in acute care hospitals show that fall rates range from 1.3 to 8.9 falls/1,000 patient days. Fall rates were reduced by as much as 50%, in 7 of 9 studies of purposeful rounding where specifically monitored,. Routine, purposeful rounding is when a nurse goes to a patient’s room every one to two hours to assess and meet patient needs; thus, emphasizing communication and nursing presence.
Several publications recommend that purposeful rounding include documentation of the 4 Ps: 1. Pain/Comfort: Staff will be asking - Are you comfortable? Do you need pain medicine? What can we do to make you more comfortable?
2. (Potty) Toileting: Staff will be taking you to the bathroom at least every 2 hours 3. Position: Staff will help you change your position (at least every 2 hours). This helps your circulation and protects your skin. 4. Possessions: Staff will make sure that water, tissue, call bell etc…are within your reach , , .
Situation: The current Providence flowsheet build in Epic does not provide a clear, unambiguous location to chart the four components (4 Ps) of purposeful rounding. There is no report available to track compliance with charting the four components of purposeful rounds. Providence Regional Medical Center Everett ( PRMCE) has continued to experience a high rate of patient falls, in spite of numerous internal actions to correct fall risk.
Prior to the implementation of the Epic electronic health record, Providence Regional Medical Center (PRMCE) had a screen in the electronic health record for charting purposeful rounds containing the four components...