Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care

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3B: Scheduled Rounding Protocol

Background: Hourly rounds are an opportunity to ensure that universal fall precautions are implemented and that patients' needs are being met. These rounds integrate fall prevention activities with the rest of a patient's care.

Reference: Adapted from Meade CM, Bursell AL, Ketelsen L. Effects of nursing rounds: on patients' call light use, satisfaction, and safety. Am J Nurs 2006;106(9):58-70 with permission. Items that have been modified or added are marked with an asterisk.

How to use this tool: Review the hourly rounding protocol and adapt it to your specific circumstances. For example, components of the fall risk factor assessment can be added, such as a brief mental status screen.

This protocol can be used by staff nurses, nursing assistants, and the unit manager to ensure that universal fall precautions are in place.

The following items should be checked and performed for each patient. Upon entering the room, tell the patient you are there to do your rounds.

#	Item
1	Assess patient pain levels using a pain-assessment scale (if staff other than RNs are doing the rounding and the patient is in pain, contact an RN immediately so the patient does not have to use the call light for pain medication).
2	Put medication as needed on RN's scheduled list of things to do for patients and offer the dose when due.
3	Offer toileting assistance.
4	Check that patient is using correct footwear (e.g., specific shoes/slippers, nonskid socks).*
5	Check that the bed is in locked position.*
6	Place hospital bed in low position when patient is resting; ask if patient needs to be repositioned and is comfortable.*
7	Make sure the call light/call bell button is within the patient's reach and patient can demonstrate use.*
8	Put the telephone within the patient's reach.
9	Put the TV remote control and bed light switch within the patient's reach.
10	Put the bedside table next to the bed or across bed.*
11	Put the tissue box and water within the patient's reach.
12	Put the garbage can next to the bed.
13	Prior to leaving the room, ask, "Is there anything I can do for you before I leave? I have time while I am here in the room."
14	Tell the patient that a member of the nursing staff (use names on white board) will be back in the room in an hour to round again.

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