Registed Nurses' Association of Ontario

Evidence Booster: Identifying and addressing a barrier through implementation of rounding

Faith Manor is a 120-bed long-term care (LTC) home in the Central West region. As part of Holland Christian Homes, the home serves mainly the Christian community, and those primarily of Dutch heritage.

In April 2018, Kaitlan Laviolette, nurse practitioner and Best Practice Spotlight Organization® liaison assembled a team to start planning the implementation of the RNAO best practice guideline Preventing Falls and Reducing Injury from Falls, fourth ed. (2017). After completing the falls gap analysis, Sellinor Ogwu, the falls team lead, and her team decided to focus on several recommendations. This evidence booster will highlight the efforts with implementing recommendation 5.3 - Implement rounding as a strategy to proactively meet the person's needs and prevent falls.

Impact

There was a relative 41.6 per cent decrease in the average number of resident falls from pre- to post-implementation of resident rounding.

Practice change – Education

To address the lower than anticipated adherence to rounding (76 per cent in the first month), the falls team used the "see one, do one, teach one" model (Cameron, 1997) to educate all staff. Table 1 describes the use of the model.

The same trainer provided all the education to ensure consistency. Staff on all three shifts were trained, and each was assigned a 15-minute time slot.

Following the training session, staff were polled regarding their level of comfort with rounding (self-reflection), and the trainer assigned an overall level of skill competence. Upon successful completion of training, all staff received a certificate.