The Effect of Fall Prevention Programs with Hourly Rounding on Fall rates Among Adults Patients in Neurological Unit

Authors

• Oyinlola A. Ogundeji, University of Texas Health at HoustonFollow

Author Biographical Info

Oyinlola Ogundeji, BSN, RN, is a registered nurse with a strong interest in quality improvement and patient safety. Her work focuses on reducing hospital-acquired conditions, particularly patient falls, through evidence-based interventions such as structured hourly rounding. She is committed to improving clinical outcomes in neurological care settings and advancing nursing practice through data-driven initiatives and continuous quality improvement.

Date of Doctor of Nursing Practice Project Completion

Spring 5-1-2026

Faculty Advisor

Dr Sydnee Lucas

Abstract

Purpose

The purpose of this QI project was to evaluate the effect of a structured hourly rounding program on patient fall rates in an adult neurological inpatient unit.

Background

Patient falls remain a major safety concern in acute care, particularly among hospitalized neurological patients with impairments in mobility, cognition, and balance. In an adult neurological unit within a Magnet-designated hospital, fall rates exceeded national benchmarks, underscoring the need for a targeted quality-improvement

Methodology

A pre–post QI design, guided by the Plan-Do-Study-Act framework, was implemented over 12 weeks in a 28-bed neurological unit. This intervention featured structured hourly rounding using the 5Ps framework: pain, position, potty, possessions, and plan. Nurses and patient care assistants alternate rounding responsibilities, with compliance documented using standardized logs. Outcome measures included fall rates per 1,000 patient-days, while process measures assessed rounding compliance. Data analysis used descriptive statistics, run charts, and paired t-tests.

Results

The baseline fall rate was 3.68 falls per 1,000 patient-days, which decreased to 3.24 during implementation. After excluding falls due to contextual factors such as sitter removal, the adjusted fall rate was 1.8, successfully meeting the project aim of 2 per 1000 patient. Notably, high early compliance (over 95%) was associated with fewer falls, whereas declining adherence was associated with increased events.

Implications

Structured hourly rounding offers an effective, low-cost fall-prevention strategy for high-risk neurological patients, if staff sustain adherence. Continued commitment to rounding can help improve safer outcomes and foster a culture of safety in neurological care units.

Keywords

hourly rounding, purposeful rounding, rounding compliance, fall prevention, fall rates, Neurological unit, patient outcomes, patient safety

Recommended Citation

Oyinlola A. Ogundeji, "The Effect of Fall Prevention Programs with Hourly Rounding on Fall rates Among Adults Patients in Neurological Unit" (2026). Doctor of Nursing Practice Final Project Abstract. 158.
https://digitalcommons.library.tmc.edu/dnp_abstract/158