Bottom line:  Intentional rounding and hourly rounding are associated with reduced fall rates, but higher quality study designs are needed to determine the extent of benefit in various settings.

Summary:
Halm MA.  Hourly rounds: What does the evidence indicate? Am J Crit Care 2009;18:581-584.
Seven of nine studies in which falls were evaluated found a decrease in fall rates upon implementation of hourly rounding. Table 1 (p. 582) of this review summarizes effect on fall rates, as well as patient satisfaction and other indicators, in recent studies on hourly rounding.

Meade C, et al. (2006) is a highly cited study included in the review by Halm. This quasi-experimental, non-randomized study compared fall rates among units assigned to one of three groups:  1) hourly rounding 7am-3pm & every 2 hours 3pm-7am, 2) rounding every 2 hours, or 3) no specific procedure for rounding.  Groups 1 and 2 had specific procedure to follow.
RESULTS: Group 1 (hourly) – 25 falls during baseline period reduced to 12 falls during study period (p=0.01); Group 2 (every 2 hours) – 19 falls reduced to 13 falls; Group 3 (control) – 18 falls reduced to 17 falls.

Of the 11 articles not included in the review by Halm listed here, eight found a reduction in falls upon implementation of intentional rounds; note that some of the ten articles’ institutions implemented other fall prevention strategies in addition to intentional rounds. Only one of the eight articles stated that the reduction in falls was significant (Saleh et al., 2013). For the two remaining articles, the difference in the number of falls was not found to be significant in one article due to the infrequency of falls (Krepper et al., 2014), one did not experience consistently improved outcomes (Dyck et al, 2013), and the total number of falls did not change but the number of falls with injury was reduced (Sherrod, 2012). Dyck et al. (2013) discusses how they sustained participation in the program despite inconsistent outcomes.

Reviewed and updated 4/15/2014 ldt