Perspectives of staff nurses of the reasons for and the nature of patient-initiated call lights: an exploratory survey study in four USA hospitals

Abstract

BackgroundLittle research has been done on patient call light use and staff response time, which were found to be associated with inpatient falls and satisfaction. Nurses' perspectives may moderate or mediate the aforementioned relationships. This exploratory study intended to understand staff's perspectives about call lights, staff responsiveness, and the reasons for and the nature of call light use. It also explored differences among hospitals and identified significant predictors of the nature of call light use.MethodsThis cross-sectional, multihospital survey study was conducted from September 2008 to January 2009 in four hospitals located in the Midwestern region of the United States. A brief survey was used. All 2309 licensed and unlicensed nursing staff members who provide direct patient care in 27 adult care units were invited to participate. A total of 808 completed surveys were retrieved for an overall response rate of 35%. The SPSS 16.0 Window version was used. Descriptive and binary logistic regression analyses were conducted.ResultsThe primary reasons for patient-initiated calls were for toileting assistance, pain medication, and intravenous problems. Toileting assistance was the leading reason. Each staff responded to 6 to 7 calls per hour and a call was answered within 4 minutes (estimated). 49% of staff perceived that patient-initiated calls mattered to patient safety. 77% agreed that that these calls were meaningful. 52% thought that these calls required the attention of nursing staff. 53% thought that answering calls prevented them from doing the critical aspects of their role. Staff's perceptions about the nature of calls varied across hospitals. Junior staff tended to overlook the importance of answering calls. A nurse participant tended to perceive calls as more likely requiring nursing staff's attention than a nurse aide participant.ConclusionsIf answering calls was a high priority among nursing tasks, staff would perceive calls as being important, requiring nursing staff's attention, and being meaningful. Therefore, answering calls should not be perceived as preventing staff from doing the critical aspects of their role. Additional efforts are necessary to reach the ideal or even a reasonable level of patient safety-first practice in current hospital environments.

Patients’ experiences of in-hospital care when nursing staff were engaged in a practice development programme to promote person-centredness: A narrative analysis study

“…Rationalising substandard care in these ways may serve to protect the reputation of the vast majority of ward nursing staff. Tzeng (2010) has explored nurses' perspectives on calls for assistance by patients and reported that the majority of nurses do perceive that answering a patient's call is taking them away from important clinical work. In future practice development programmes, it is important that nursing staff are made aware of the impact that delayed nurses' response times have on patients.…”

Does revealing contextual knowledge of the patient’s intention help nurses’ handling of nurse calls?

“…For example, in a study of nurse calls in an orthopaedic unit, Tzeng [5,17] proposed that new technology should support nurses' prioritisation of patient care duties. Such a nurse call system should allow the patient to indicate whether the call is (1) an urgent call, (2) a normal call, or (3) an orderly assistance.…”

“…Such a nurse call system should allow the patient to indicate whether the call is (1) an urgent call, (2) a normal call, or (3) an orderly assistance. However, few such nurse call systems are implemented in hospitals today [17] and only a few have been reported on in scientific litterature [18,19]. Within healthcare, and other contexts, call screening has been advocated as a way to allow people to manage interruptions mediated through mobile phones [20][21][22].…”

Social Media as a Tool to Reduce Sexual Misconduct in Medical Facilities

“…The primary method of collecting real-time complaints from patients is via bed-mounted call buttons or speakerphones. 4 Call requests are answered by a representative at the nearest nurse station who is trained to ask questions, identify patient needs, and then route a nurse or technician to the patient's room. 5 Call buttons have inherent limitations for patients who do not speak English as their native language, do not have the strength to reach or press the physical button, or are uncomfortable or incapable 4 of disclosing concerns into a speakerphone.…”

“…4 Call requests are answered by a representative at the nearest nurse station who is trained to ask questions, identify patient needs, and then route a nurse or technician to the patient's room. 5 Call buttons have inherent limitations for patients who do not speak English as their native language, do not have the strength to reach or press the physical button, or are uncomfortable or incapable 4 of disclosing concerns into a speakerphone. The stigmatization around sexual abuse is another factor that prevents individuals from disclosing sexual assault, especially if reporting must be done face-to-face.…”