Purpose: The purpose of this presentation is to describe how one medical center successfully utilized technology and evidence-based practices to decrease fall rates.

Learning objective: At the end of this presentation, the attendee will be able to describe how technology can be utilized to improve evidence-based practice compliance with rounding and decrease falls.

Background: Falls are a common problem in hospital care, occurring at a rate of 3-5 per 1000 bed days. Falls cause patient harm and can increase direct costs over $35,000. Despite intensive research and quality improvement efforts, falls continue to be a problem. Evidence-based practices for fall prevention programs are available through AHRQ. The program’s success depends on consistent execution of appropriate patient interventions. Consistent execution of patient interventions has been enhanced with regular patient rounding by nursing. Nurse rounding has been shown to be a positive intervention in reducing falls. The aim of this quality improvement project is to use technology in promoting nurse rounding for the reduction of falls.

Description/methods: After months of gradually increasing patient falls and failing adoption of a new nurse call system, leadership of this approximate 100-bed teaching medical center decided to improve both. It was determined that the nurse call system could be programmed to remind RNs and PCTs that patient rounds needed to be completed. The nurse call technology was programmed so that a rounding button in the patient rooms could be used to register in/out each time the RN/PCT conducted rounds. If the RN or PCT did not register in within 60”, a reminder light was triggered and flashed at the patient room in the corridor. The light continued to flash until the “rounds” button was deactivated/reactivated in the patient room. Education on purposeful rounding was conducted with staff. Leadership made themselves available to model behavior and ask questions; they also developed a tool to track adoption of rounds and shared in daily huddles. Rounding adoption success was set at 70% completion per shift.

Results: At four months, adoption rates reached >80% and remained above threshold. The fall rate went from 3.92 to 1.94 with a p value of .013. Additionally, nurses found that they were able to get their work done in a more timely fashion due to fewer interruptions.

Abe Brown MS, RN

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