Introduction.

This treatise is an analysis that uses PICOT question-answer systematic mnemonic pertaining to the health care continuum and provides research that will help in developing medical conclusions on the falls. According to the World Health Organization, falls are the second leading cause of deaths as a result of unintentional and accidental injury across the world (WHO, 2018). The lucky ones who escape without injuries end up developing the fear of falling which reduces mobility and physical activity. In the United States, cases of falls have plagued transitional care units and proved to be a considerable challenge to the teams. Hospitals handling acute care inpatients record falls at a rate of 1.3-8.9 falls in 1,000 patient days with 30% developing in serious injuries (Goldsack et al., 2015).

Despite many strategies put in place to curb this challenge, falls continue occurring with many patients often hiding the occurrences. A comprehensive root cause discussions and strategies to reverse the situation are inevitable. With the experience of a team leader in a transitional care facility, I venture to investigate how hourly rounds by nurses can be applied to reduce the number of falls experienced by patients.

PICOT question?

In patients under transitional care, does hourly rounding help decrease falls if done persistently?

Definition:

P– (Patient, population, or problem): Fall risk patients undergoing transitional care.

I– (Intervention): Patient-centered consistent hourly rounds by nurses and caregivers.

C– (Comparison with other treatment/current practice): Not doing rounds hourly.

O– (Desired outcome): When nurses and caregivers conduct hourly rounds, there is a reduction in the rate of falls.

Patients under transitional care have a high risk of falling while going through their daily recovery process especially when going to the bathroom. When these patients are admitted into the program, they are educated about these risks are consequently provided with mechanisms of avoiding them. One such prevention technic is asking for help when they need assistance like going to the bathroom.

Most of the patients that experience falls have prior diagnosis and history of falls or have suffered from gait debility. With most falls taking place on Wednesdays between 2 am and 6 am, they forget to call for help when getting out of bed or wheelchair.

What is the practice area?

Falls are prevalent in most long term care units. Nursing homes have recorded such cases with many risk factors related to the cases. Patients with diabetes, stroke victims, Alzheimer’s disease have high chances of falling under nursing home settings (Hicks,2015).

Non-medical conditions such as slippery floors or foot wares aging and environmental factors have been found to be consequential  (Rubenstein, 2006).

Working as the team leader of the transitional team, I noticed that we had an average of 19 falls within a period of three months. These meant every week we had a fall incident with various injuries as a consequence.

The use of electronic systems or computer-based application in risk assessment has found that patient assessment is the first step. A patient’s history of falls ranging from cases of vision impairment on the individual level will help predict falls in the future. Every patient should have a unique profile with their risk assessment results will help to schedule the rounds in line with the needs (Hitcho et al., 2004). Patients prefaces are also important.

Patients under long term care. Nursing homes,