Hourly Rounding Coupled with the 4 Ps

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One out of every three adults over age 65 falls annually in the United States (U.S.). This number increases two-fold by age 80 (Hornbrook et al., 1994). Fall injuries account for 2.8 million emergency visits, and 800,000 hospital stays in the U. S. annually (Ganz & Latham, 2020). Despite the existing fall prevention protocols at the Veterans Healthcare Administration (VHA) Community Living Center (CLC), the average number of falls exceeds the national standard for falls in similar facilities. The project objective was to bring the fall rate of the VHA CLC to within or below the national benchmark by initiating and implementing the evidence-based hourly rounding process with the 4 P’s (potty, pain, position, and possession). The fall prevention program focuses on veterans’ safety and well-being in short-term and long-term care environments in collaboration with the frontline nursing staff. By implementing this evidence-based process into already existing fall prevention measures, the CLC was able to decrease falls by fifty percent.
Submitted in partial fulfillment of the requirements for the degree Doctor of Nursing Practice