Give Your Nurses Back 166 Hours Every Month
On average, nurses spend 10,000 minutes per month (i.e. 166 hours1) responding to patient call lights. Nurses are called into each patient room 12 to 15 times daily for toileting assistance, positioning/transfer, to get or do something for the patient, pain medication, and a variety of other reasons. At one orthopedic unit, these four reasons alone accounted for nearly 71 percent of call lights2. If your organization gained back 166 hours per month, you might feel like you just hired 4 full-time RNs at no extra cost.
Because the last published study of call lights was completed more than seven years ago3, Studer Group sponsored a study by the Alliance for Health Care Research. Goals are to better understand how proactive nursing behaviors can reduce call lights; to assess how well these behaviors correlate to gains in patient safety and quality care (i.e., reduced falls and decubiti incidence); and determine the impact on patient satisfaction.
At press time, 63 units at 22 hospitals in Studer Group's national learning lab (both partner and non-partner hospitals) had enrolled in the study. They are currently tracking the number of call lights, reasons for call lights, and the effect of Studer Group's recommended rounding and behavioral interventions to reduce call lights. (Preliminary study results will be shared at Studer Group's What's Right in Health Care Conference, June 16 to 17 in Chicago, with complete results to be released and published soon thereafter.)
Early Findings:
In the Alliance study, nurses were trained to:
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complete scheduled tasks during regular hourly rounds;
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address the three "Ps" (potty, position, pain);
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conduct an environmental assessment (e.g. Can the patient reach the telephone, tissue, trash can, and TV controls?);
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ensure each patient was covered and comfortable;
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tell the patient they were being 'rounded on' so their comfort levels could be checked;
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ask the patient if there was anything else they could do for them prior to leaving the room; and
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tell the patient that a member of the nursing staff would be back in an hour to round on them again.
Equally important, study participants were asked to use specific key words with each patient to set expectations about when the nurse would return; proactively ask about questions before leaving; and say, "Is there anything else I can do for you? I have the time while I am in the room." Additional measures were also put in place to eliminate call lights for pain management.
Organizations are already anecdotally reporting dramatic reduction in call lights and commenting on how quiet the units are as a result. And of course…nurses are reporting that they really do have more time.
1 Data based on initial results from the Alliance for Health Care Research's call light study, where an average nurse responds to 2500 to 4800 call lights weekly. Response to each call light is conservatively estimated to take 4 minutes of a nurse's or CNA's time.
2 "Prevalence and Nature of Call Light Requests on an Orthopedic Unit," Orthopedic Nursing, Jan/Feb 1994.
3 "Initiating a Patient Service Partner Program," Nursing Management, Vol. 27, No. 10 1997.
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