"Running head: EVIDENCE-BASED PRACTICE PROPOSAL1 Evidence-Based Practice Proposal-Section B: Problem DescriptionEVIDENCE-BASED PRACTICE PROPOSAL-SECTION B:PROBLEM DESCRIPTION 2 Evidence-Based Practice Proposal-Section B: Problem Description Considering patient safety in the hospital, preventing patient falls is among the topchallenging issues that come to mind. Fall reduction is one of the performance improvementprograms on this writer’s nursing unit. Compared with medical surgical patients, adultpsychiatric patient fall rates are statistically. Research on hourly rounding has demonstrated thatthis is an evidenced based intervention that results in a significant reduction in patient falls. Mostof the research on hourly rounding has been conducted in the medical surgical in patient settings.Background of the Problem: Patient falls in hospitals are a major concern. It is estimated thatfalls in psychiatric hospitals may be three to four time higher than the rate of falls in medicalsurgical hospitals (Edmonson et al., 2011). Other researchers have found similar results (Allen etal., 2012).This writer is working in a 26 bed psychiatric unit in a general hospital. According tothe literature the causes of psychiatric patient falls differs from the causes of patient falls in themedical surgical setting. The issue of patient falls deserves attention because patient safety is thetop priority. In the psychiatric patient population treatment and patient care mainly focuses onthe psychiatric symptoms with less attention focused on non-behavioral co morbidities.Stakeholders/Change Agents: This project proposal focus is to determine if the benefits ofhourly rounding that are seen in the medical surgical settings will also be realized in the adultinpatient psychiatric patient population. The stakeholders and change agents are the adultpsychiatric in patients, staff and other caretakers. Psychiatric hospitals and patients may benefit EVIDENCE-BASED PRACTICE PROPOSAL-SECTION B:PROBLEM DESCRIPTION 3 from this proposal of hourly rounding in psychiatric hospitals. The PICOT question is can weexpect to see a similar decrease in falls when hourly rounding is implemented in the adultbehavioral health inpatient unit that is seen when implemented in the medical surgical adult inpatient population during hospitalization?Purpose and Project Objectives: The project objective is to implement purposeful hourlyrounding in adult psychiatric hospitals similar to medical surgical hospital units to increasesafety, reduce fall rate, and improve customer and staff satisfaction. According to Meade et al.(2006) patient safety and satisfaction increases when hourly rounding is in place and falls,hospital acquired pressure ulcers and call light usage decrease. Hourly rounding on patients helpsto achieve more effective patient-care management and improved patient satisfaction and safety(Meade etal., (2006).While nursing has focused on purposeful hourly rounding in the general hospital setting(Dewing &O’Meara, 2013) there is limited research on intentional hourly rounding in thebehavioral health- in patient setting (Moran, 2011).Purposeful hourly rounding improves nursepatient interaction and therapeutic communication. Being in the hospital, patients feel lonelinessand frustration and the nurse’s presence reassures and supports them. The nurse-patientrelationship encourages patients to ventilate their feelings provides them with some relief.Purposeful hourly rounding generally targets “four Ps”: pain, potty, position and personalequipment (Halm, 2009).Fall assessment tools originally designed for assessing the medicalsurgical patient fail to capture the unique characteristics of the psychiatric patient that increasestheir fall risk. "