Identifying a Problem

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Identifying a Problem

Grand Canyon University

Professional Capstone Project


Identifying A Problem

Hourly Rounding

One of the major causes of hospital injuries for hospitalized patients is falls. Falls are directly associated with the quality of nursing care. The Joint Commission (2014) states falls are responsible for 11,000 deaths annually in America, the Center began working on new measurement systems and solutions to try and combat this problem. Lack of negligence and trouble in hourly rounding could bring forth terrible issues one or the other times. The image and reputation of the health care organization is also greatly impacted.

Nature of the Problem

Lack of management and organization is the key issue behind negligence shown towards patients. There have been several aspects that have contributed reducing the risk of falls to some of these factors are the elderly population, high patient acuity, staff shortages, and work environment for caregivers. This can all contribute negatively and make any process improvement a challenge. Leadership plays an instrumental role in understanding the problem, establishing a safety climate culture, and improving the work environment of caregivers so that much needed direct nursing time for patient care can be increased. Hourly rounding could also be the most appropriate and suitable way in ensuring a reduction in hospital falls


The setting for this problem is mostly on a medical /surgical ward. It has been observed that there is an increase of falls mostly overnight. This happens over a twelve hour shift. Falls in the hospital environment are often as a result of different complications. Patient often get more confused when in an unfamiliar environment. Unfamiliar environments can signify a change, mostly for patients who are elderly or face more difficulties to adjust to changes in their environment

Detailed Description

Ford (2010) states hourly rounding is a proactive nursing intervention designed to anticipate and address the needs of hospitalized patients. Studies indicate when there is hourly rounding; it promotes quality and safe care for patients. Hourly or Purposeful rounding turns up as the most eminent issue and looks forward to better management and reduced hospital falls Purposeful Rounding seeks to improve the patient experience through the use of a structured hourly rounding routine. Rounding every hour helps nurses identify those patients who are at risk of fall due to sundown syndrome.

Impact of the problem

Major impact of the problem is the cost on healthcare. The average hospital cost for a fall injury is $35,000. This cost is subject to increase depending on patient’s age. The states (Medicare) will pick up about 78% of the actually cost. This still puts a major pressure on individual hospital budget. The safety of patients hospitalized in health services is one of the priority concerns in quality control systems. The falls suffered by the patients during their hospitalization are one of the most important occurrences in the breakdown of security. This suggests that the hourly rounding should be given importance and significance in order to realize for better growth and progress in the most likely way (Mitchell & Haroun, 2011).

Gravity of the problem

According to Sherrod et al., (2012), the incorporation of hourly rounding into an existing fall prevention program will decrease fall rates by 40%. Hourly rounding will cut cost as well as promote pate safety. With this, it could be made out strongly understood that the conditions are Its significance to nursing could also be make out in a way that the patient’s care and treatment could take place in the most hopeful and fruitful manner.

Proposed solution to address the problem

Hourly rounding is the proposed solution to address the problem. This will benefit patients by keeping them safe when in hospital, and also benefit hospitals by reducing the cost of inpatient falls. It’s essential to remember that purposeful rounding is ultimately about building relationships and trust as much as it is about meeting the physical needs of the patient.


Jackson, T.L. (2012). Standard Work for Lean Healthcare. CRC Press.

Kenney, C. (2016). Transforming Health Care: Virginia Mason Medical Center’s Pursuit of the Perfect Patient Experience. CRC Press.

Mitchell, D. & Haroun, L. (2011). Introduction to Health Care. (3rd ed.). Cengage Learning.

Ford, Beverly M. “Hourly rounding: a strategy to improve patient satisfaction scores.” MedSurg Nursing May-June 2010: 188+. Academic OneFile.

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