AHC Research Call Light Study

Published Date: 09/01/2006

Hourly Rounding Improving Nursing and Patient Care Excellence VHS/DVD

New York, NY (August 30, 2006) -- A nationwide study, published in the September issue of the American Journal of Nursing (AJN), revealed that regular nursing rounds every one to two hours were associated with a significant reduction in call light use, fewer patient falls, and greater patient satisfaction.

“Because there is little empirical evidence of patient call light use pertaining to patient care management, safety, and satisfaction, this study sought to determine the frequency of, and reasons for, patients’ use of call lights and the effect of one-and two-hour nursing rounds to better assist hospitals and nurses in improving daily operations and patient safety,” said Christine Meade, PhD, lead author of the study and executive director of the Alliance for Health Care Research, a subsidiary of the Studer Group, a health care leadership and service excellence consulting firm that funded the study.       

Studies have shown that most call light use occurs at meal and medication time, when staff is busiest.  Studies have also found that hospitalized patients often require assistance with basic self-care tasks, such as using the toilet, ambulating and eating and that patients usually communicate their needs by using the call light.  Therefore, a patient’s level of satisfaction with nursing care frequently depends upon the patient’s perception of how well the nursing staff was able to meet these needs.   

This led to the use of a protocol for all nursing staff to intervene proactively to reduce patient call light use and improve patient satisfaction including:

• Assessing patient pain levels using a pain assessment scale;
• Putting medication as needed on the RN’s scheduled list of things to do for patients and offer the dose when due;
• Offering toileting assistance;
• Assessing the patient’s position and comfort;
• Making sure the call light, telephone, TV remote control, bed light, bedside table and Kleenex are within the patient’s reach;
• Asking the patient if they have any additional needs before leaving the room;
• Telling the patient that a member of the nursing staff will be back in the room in one to two hours.

The six-week nationwide cross-sectional study, conducted in 27 nursing units in 14 hospitals, included two weeks of baseline data collection on call light use, then continuous monitoring of call light use with the implementation of one- or two-hour rounding for four weeks.  One year later follow up was conducted among the 14 hospitals and the analyzed data found:

• Of the units that participated in the rounding, 12 (85.7%) continued the practice;
• Of the hospitals that participated in the study, 13 (92.8%) decided to expand the rounding to other units or all units in the hospital;
• Patient satisfaction scores increased an average of 8.9 points on a 100-point scale, (from 79.9 to 88.8%);
• Comparing the four weeks prior to rounding with four weeks one year after the study, falls have been reduced by an overall 60%;

• Hospitals have made enhancements to help nursing staff continually practice the rounding protocol.

 “We know that a patient can deteriorate when no one is available to respond to call lights or to assess changes in the patient’s condition proactively,” said Diana Mason, RN, PhD, editor-in-chief of AJN.  “The results of this study suggest strategies for operational changes in hospitals that emphasize taking a more proactive approach to ensuring effective patient care management, better patient satisfaction, and safer care.”

Associated Links:
AHC Research Call Light Study