Date of Graduation

Fall 12-17-2021

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Executive Leader DNP

First Advisor

Dr. D'Alfonso

Second Advisor

Dr. Buccheri


Problem: Patient falls remain a critical and persistent safety problem in healthcare today. The prolonged impact of the COVID-19 pandemic raises leadership concerns regarding the safe care of high-risk COVID patients and mitigating the increased stress and potential risks of infection to clinical staff.

Context: This Doctor of Nursing Practice (DNP) scholarly project details implementation of an evidence-based purposeful nurse hourly rounding (PNHR) pilot project designed to decrease the incidence of patient falls on a designated COVID-19 unit.

Measure: A modified PNHR rounding tool was implemented to guide focused elements for key nurse/patient interactions.

Interventions: PNHR strategies were further augmented by innovative quantum caring healthcare leadership (QCHL) principles intended to support team engagement and enhance a culture of safety. The transformational leadership approach and theoretical foundations of QCHL were viewed as pivotal enculturation tactics and were aligned to sustainability goals. The project aim was to decrease the incidence of adult patient falls by 10% over baseline data during a four-month pilot on a designated COVID-19 nursing unit.

Results: The post-implementation outcomes highlight a 58% reduction in patient falls from 4.29 to 1.79 falls per 1,000 patient days.

Conclusions: Quantitative and qualitative findings support a proactive leadership approach to patient safety and staff engagement that utilizes an evidence-based, structured, timely, and sustainable nurse hourly rounding strategy.

Dissemination: Low costs, improved clinical outcomes, and positive impact on patient safety and employee engagement increase the potential for spread of this scholarly project to non-COVID care units across the organization and to other systems.

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