Document Type

DNP Project

Publication Date


Degree Name

Doctor of Nursing Practice

Faculty Advisor

Rosemary Johnson, DNP, APRN, FNP-BC

Practice Mentor

Nicole Radi



Falls are events with a resultant effect of an individual accidentally or unintentionally coming to rest on the floor, ground, or other lower level; also, injuries sustained from falls may be fatal or non-fatal depending on the severity of the fall (World Health Organization [WHO], 2021). Falls are the second leading cause of unintentional injury deaths globally; each year, an estimated 684 000 individuals die from falls globally, of which over 80% are in low- and middle-income countries; adults older than 60 years of age suffer the greatest number of fatal falls, and 37.3 million falls that are severe enough to require medical attention occur each year (WHO, 2021).

Project Goals

  1. To determine the best practices for preventing or reducing the rate of falls among older adult patients/residents in the LTCFs using the SMART criteria, which stands for Specific, Measurable, Achievable, Relevant, and Time-Bound. Fall rate will be measured and reported in percentage by obtaining fall rate data 30 days before and 30 days after the process change. Also, the goal is to achieve between 5-10% reduction in fall rate.
  2. To educate nurses and other nursing staff on fall prevention and implement a new policy of hourly rounding along with functional assessment utilizing the Fall Risk Assessment Tool (FRAT) and evidence-based practices (EBP).


Pre-implementation and post-implementation fall rates were obtained, calculated, and recorded in percentages. The implementation of hourly rounding lasted for 30 days, from January 1, 2023, to January 31, 2023. The fall rate was determined by subtracting the post-implementation fall rate from the pre-implementation fall rate.


Hourly rounding was implemented on 28 long-term residents for 30 consecutive days, and the fall/percentage fall rate dropped from 22.3% to 16.1%, a 27.8% reduction in the fall rate in 30 days.


The implementation of hourly rounding in reducing the rate of falls among older adults living the long-term care facilities reduced the fall/percentage fall rate by 27.8%. The practice change should be adopted to minimize hospitalization, disability, and potential deaths resulting from falls. Also, it would improve patient safety, quality of life, patient/family satisfaction, and overall health and well-being.


A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

Available for download on Friday, December 27, 2024

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