Falls are the leading cause of preventable harm in Canadian hospitals, accounting for approximately 8–10% of all adverse events in acute care. One-third of hospital falls result in injury; 1–2% cause serious injury including hip fracture, subdural haematoma, or death. Falls with injury are associated with increased length of stay (average +6.3 days), functional decline, and litigation. Inpatient falls are a nurse-sensitive outcome — the quality of nursing surveillance, hourly rounding, and individualized fall prevention planning directly determines patient safety outcomes. Purposeful rounding — structured hourly check-ins addressing the 4 P's (Pain, Position, Personal needs/toileting, Possessions) — reduces falls by 50–60% in randomized controlled studies. Top 3 nursing priorities: 1. Identify high-risk patients using a validated fall risk tool (Morse Fall Scale or STRATIFY) on admission and with every status change — implement individualized fall prevention interventions 2. Conduct purposeful hourly rounding with proactive toileting — toileting urgency is the #1 precipitating factor for patient-initiated falls 3. Post-fall: maintain patient safety, assess for injury, and complete a structured root-cause assessment before any repositioning (do not move a patient after a...