Date of Completion

Summer 2026

Document Type

DNP Scholarly Project

Academic Department

School of Nursing

Degree Type

Doctoral

Degree Name

Doctor of Nursing Practice

First Advisor

Dr. Lydia Forsythe

Second Advisor

Dr. Adriane Stasurak

Third Advisor

Dr. Sabrina Oliver

Abstract

Problem: Falls are the most frequently reported preventable events in hospitalized patients.  Falls in the project unit were increasing, and a gap analysis revealed variation in how nurses assessed fall risk and implemented interventions. Evidence indicated that inconsistent rounding undermined situational awareness and delayed identification of patient needs. This gap highlighted the need for a structured, evidence‑based rounding process to improve consistency and reliability.

Aim of the project: The Purposeful Rounds (PR) project aimed to implement a structured process to improve rounding consistency and staff responsiveness, while reducing fall rates over a 12‑week period.

Review of the Evidence: Evidence-based literature supports PR, paired with validated fall-prevention tools, as a method to improve rounding consistency and reliability. Evidence shows that structured rounds provide a measurable intervention to prevent fall-related harm.

Project Design: The PR project used a quality‑improvement framework integrating the Plan-Do-Study-Act (PDSA) cycles and the OhioHealth Change Management Model to guide planning, implementation, and evaluation. These frameworks supported iterative testing, frontline engagement, and structured change management to promote adoption and sustainability.

Intervention: The intervention included implementing structured rounds supported by three validated tools: the Morse Fall Risk Assessment, the Tailoring Interventions for Patient Safety TIPS Fall Prevention Tool, and an internal rounding audit checklist. Staff received hands-on simulation education, visual aids, and real‑time coaching to reinforce consistent use of the tools during each round.

Significant Findings/Outcomes: Fall rates decreased following implementation, with no falls resulting in injury during the 12-week period; rounding compliance was 92%; and call‑light usage decreased by 38%. Audit data showed increased reliability in fall-risk assessment, intervention, and staff responsiveness.

Implications for Nursing: PR strengthens communication, enhances situational awareness, and supports consistent delivery of evidence‑based fall‑prevention practices. From a nursing perspective, PR helps nurses anticipate needs and strengthen therapeutic relationships. The project demonstrates that structured workflows, supported by validated tools and change‑management strategies, can reduce falls.

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