Living with Call Lights

What makes a patient happy?

Seeing someone who cares every hour!

What happens if your patient doesn’t see you every hour?

They push the call light!

I’ll answer your call light …

… when you answer my chocolate light.

What’s the last thing you want when you’re scanning a pile of

meds?

The phone ringing for a call light.

The Answer is

Purposeful Rounding

In 2006, Christine Meade studied the effects of hourly rounding on call light use, falls, and patient satisfaction.

Meade, C. M., Bursell, A. L., & Ketelsen, L. (2006). Effects of nursing rounds on patients

call light use, satisfaction, and safety. American Journal of Nursing,106, 58-70.

About 5,000 fewer calls after rounding

OK – What else did she find?

The number of falls (in 27 nursing units) was cut in half.

Meade, C. M., Bursell, A. L., & Ketelsen, L. (2006). Effects of nursing rounds on patients

call light use, satisfaction, and safety. American Journal of Nursing,106, 58-70.

Is that it?

After one year, the percentage of patients who rated their care as ‘excellent’ was doubled.

!

Meade, C. M., Bursell, A. L., & Ketelsen, L. (2006). Effects of nursing rounds on patients

call light use, satisfaction, and safety. American Journal of Nursing,106, 58-70.

Anyone else looking at this?.

Jennifer Woodard confirmed these good results on a 40 bed unit when the charge nurse rounded every hour. Results confirmed decreased call light use, decreased number of falls, and increased patient satisfaction. And here’s a bonus: After rounding, almost all patients were “certain”, or “somewhat certain”, that help would be there when they needed it.

Before rounding was started, more than half “were not sure if a caregiver would come to help if needed”.

Woodard, Jennifer (2009). Effects of Rounding on Patient Satisfaction and Patient

Safety on a Medical-Surgical Unit. Clinical Nurse Specialist, vol 23 Number 4.

Do half of your patients think that you won’t be there when they need you?

they probably don’t know.

Deritrick, Bokovoy (2006). Dance of the Call Bells. J Nurs Care QualVol. 21, No. 4, pp. 316–324.

Show them which button to push,

When you want your CNA

Show them your phone. Explain that the button calls us directly. Would intercom work for this patient?

When you want your nurse

When you need help now.

I can’t answer it now!

Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: The National Academies; 2001:337.

Roszell, Jone (2009). J Call Bell Requests, Call Bell Response Time, and Patient Satisfaction. Nurs Care Qual .Vol. 24, No. 1, pp. 69–75

Patient satisfaction is not related to response time. 5 seconds and 5 minutes are the same.

Patient satisfaction is dependent on how you respond to their request.

Help out your team

Answer a light for your neighborTell the patient that you’ll get the nurse.

Make the pump stop beepingPatients hate that beeping pump.

Nurses can answer routine lightsCNAs can answer pain lights

You can answer the call light from your phone.

Press the start button twice

• It may or may not ring – you will be connected to the room speaker, or “open air”.

• Choose which patients can benefit from this• Be careful to disconnect before starting another

private conversation.

• Stick your head in the door• Answer by intercom• Send a message that you’ll be there• Build a good track record through

the day• Apologize for delays

Patients want to know that you will be there for them.

It’s not about answering the light quickly,

Look in on them,

That’s called purposeful rounding.

it’s about being there when your patient needs you.

if they can reach their things.if they hurt,

if they’re comfortable,

ask if they need to use the toilet,

“Rather than adding to the nurse's workload, rounding takes less time than answering call lights and dealing with repeated requests.”

Ring for the Nurse! Improving Call Light Management Medscape Education (2008). Downloaded from http://www.medscape.org/viewarticle/570242_2 on 12/16/2012.

Purposeful rounding works

Not because it’s required -

But because it’s the right thing to do.

Question:

How many of our patients get help to the bathroom as quickly as they want?

About half of them – 52%

RiverBend, 8 Medical HCAHPS (Hospital Consumer Assessment of Healthcare Providers & Systems) report 12/31/12.

Are you willing to look in on your patients at least

once an hour?

Are you willing to answer a call light for

someone else’s patient?

Papers cited here are available at the 8 Medical education web page http://crossroads/SC_8Medical_PHOR/