Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Clark, Paul

Committee Member

Harrington, Candice

Author's Keywords

Proactive Toileting; Purposeful Hourly Rounding; Falls; Urination; Risk Factors; Accidental Falls


The purpose of this DNP quality improvement project was to decrease patient falls on a 21-bed step-down telemetry unit in a Kentucky metropolitan hospital. This project implemented proactive toileting in conjunction with purposeful hourly nursing rounds. A pre-education survey was given one week before the education module, and a post-education survey was provided six weeks after the education module was opened. Pre- and post-survey scores were compared to assess any changes in staff’s understanding of proactive toileting and project goals. Falls were measured, and compliance with proactive toileting was monitored in the electronic health record over an 8-week course. Compared to the previous eight weeks before starting this project, there was an 85.6% decrease in falls during the eight weeks of this project. Proactive toileting charting compliance improved by 4% overall, with an 387.5% increase in “toileting scheduled.” As research into falls prevention continues to grow, this project highlights that well-designed falls prevention programs can decrease patient falls that may lead to more positive patient outcomes.

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Included in

Nursing Commons