Medication review and hourly nursing rounds: An evidence-based approach reduces falls on oncology inpatient units

2.50
Hdl Handle:
http://hdl.handle.net/10755/164025
Category:
Abstract
Type:
Presentation
Title:
Medication review and hourly nursing rounds: An evidence-based approach reduces falls on oncology inpatient units
Author(s):
Callahan, Lana; McDonald, Susan; Voit, Daniel; McDonnell, Anne; Delgado-Flores, Jorge; Stanghellini, Escel
Author Details:
Lana Callahan, RN, OCN, Brigham and Women's Hospital, Boston, Massachusetts, email: Lcallahan1@partners.org; Susan McDonald, RN, BSN, OCN; Daniel Voit, PharmD; Anne McDonnell, PharmD; Jorge Delgado-Flores, PharmD; Escel Stanghellini, RN, MSN
Abstract:
Clinical/Evidence Based Practice: The Joint Commission National Patient Safety Goal states that hospitals must reduce the risk of patient harm resulting from falls and recommends a fall reduction program including evaluation of its effectiveness. There is evidence that hourly nursing rounds and prospective review of medications are associated with reduction in falls. The purpose of this project was to evaluate the impact of hourly nursing rounds and prospective review of high risk medications on reduced falls and injury rates and increased patient and staff satisfaction. Within the Hematology-Oncology/Bone Marrow Transplant (HOB) service, the unit with the highest injury rate was selected to implement rounds for 3 months. All patients were assessed daily for fall risk using the Morse Fall Scale. Rounds involved checking pain, positioning/comfort, toileting, personal needs, and safety checks. Pharmacists completed a medication review for patients at high risk for falls and injuries. Daily weekday huddles with the team occurred on the unit to evaluate the process and address barriers in real time. There were 3 falls with injury during the 3 months prior to the PCR and there were no falls recorded during the study period. This reflects a 100% reduction in the fall with injury rate achieved during the study period and contributed to a reduction of 67.8% by the end of fiscal year 2008. Press Ganey scores reflected increased patient satisfaction during this quarter (as compared to the previous quarter) in teamwork=3.7%; attention to special/personal needs=2.1%; overall nursing care=1.9%; and pain control=1.2%. These results were mirrored by overwhelming positive feedback from patients. Staff also reported increased satisfaction related to teamwork and relationship. Registered nurses and pharmacists can use this process to implement hourly rounds and medication reviews in their units to improve patient safety. In addition, program managers can incorporate this quality improvement project into their falls prevention program. Rounds are now fully implemented throughout the HOB service. The next step is to implement a monitoring system to ensure compliance with key rounding elements.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2009
Conference Name:
34th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Antonio, Texas, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleMedication review and hourly nursing rounds: An evidence-based approach reduces falls on oncology inpatient unitsen_GB
dc.contributor.authorCallahan, Lanaen_US
dc.contributor.authorMcDonald, Susanen_US
dc.contributor.authorVoit, Danielen_US
dc.contributor.authorMcDonnell, Anneen_US
dc.contributor.authorDelgado-Flores, Jorgeen_US
dc.contributor.authorStanghellini, Escelen_US
dc.author.detailsLana Callahan, RN, OCN, Brigham and Women's Hospital, Boston, Massachusetts, email: Lcallahan1@partners.org; Susan McDonald, RN, BSN, OCN; Daniel Voit, PharmD; Anne McDonnell, PharmD; Jorge Delgado-Flores, PharmD; Escel Stanghellini, RN, MSNen_US
dc.identifier.urihttp://hdl.handle.net/10755/164025-
dc.description.abstractClinical/Evidence Based Practice: The Joint Commission National Patient Safety Goal states that hospitals must reduce the risk of patient harm resulting from falls and recommends a fall reduction program including evaluation of its effectiveness. There is evidence that hourly nursing rounds and prospective review of medications are associated with reduction in falls. The purpose of this project was to evaluate the impact of hourly nursing rounds and prospective review of high risk medications on reduced falls and injury rates and increased patient and staff satisfaction. Within the Hematology-Oncology/Bone Marrow Transplant (HOB) service, the unit with the highest injury rate was selected to implement rounds for 3 months. All patients were assessed daily for fall risk using the Morse Fall Scale. Rounds involved checking pain, positioning/comfort, toileting, personal needs, and safety checks. Pharmacists completed a medication review for patients at high risk for falls and injuries. Daily weekday huddles with the team occurred on the unit to evaluate the process and address barriers in real time. There were 3 falls with injury during the 3 months prior to the PCR and there were no falls recorded during the study period. This reflects a 100% reduction in the fall with injury rate achieved during the study period and contributed to a reduction of 67.8% by the end of fiscal year 2008. Press Ganey scores reflected increased patient satisfaction during this quarter (as compared to the previous quarter) in teamwork=3.7%; attention to special/personal needs=2.1%; overall nursing care=1.9%; and pain control=1.2%. These results were mirrored by overwhelming positive feedback from patients. Staff also reported increased satisfaction related to teamwork and relationship. Registered nurses and pharmacists can use this process to implement hourly rounds and medication reviews in their units to improve patient safety. In addition, program managers can incorporate this quality improvement project into their falls prevention program. Rounds are now fully implemented throughout the HOB service. The next step is to implement a monitoring system to ensure compliance with key rounding elements.en_GB
dc.date.available2011-10-27T12:03:19Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:03:19Z-
dc.conference.date2009en_US
dc.conference.name34th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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