Effects of Nursing Rounds on Patients’ Call Light Use, Satisfaction, and Safety Introduction to Nursing Research

Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.

Safety is an essential factor in the creation of the healing environment and this is dependent on the role of the caregiver and the patient when it is possible. “Safety is a basic component of professional nursing and Caritas Processes. Safety concerns affect all of the nurse’s activities related to supporting, protecting, and correcting the environment for healing at all levels, To feel safe and protected is a basic need” (Watson, 2008, p. 13). Many factors impede the safety of patients in a healing environment such as Risk of falls, Pressure ulcers, and close calls. Ford’s literature (as cited in Woolley et al, 2012) found that “hourly rounding resulted in a 52% reduction in call light use, giving nurses more time to provide patient care and prevent patient calls” and in Bourgault et al.’s study conducted in 2006 (as cited in Woolley et al, 2012) “expected outcomes of hourly rounding included increase

With patients today using the threat of reporting low satisfaction rates in the hopes of receiving faster or higher quality care, they seem to have taken the upper hand in some of the decision making of what will take place in the healthcare world (Sullivan). But is it really the survey results that will make the drastic changes that are needed?

Answering the call light (also called call bell a handheld like that is attached to the patient room wall, above the headboard of the bed) in a timely manner by the nursing staff in hospital setting is necessary to prevent falls that can harm, prolonged stays, and unnecessarily increase the cost of healthcare. However, researches concerning call light uses as it relates to patient safety, patient-care management and patient satisfaction are limited (Meade et al. 2006). Patients and their families emphasize that nurses should monitor patients constantly and provide assistance and answer a call light in a timely manner (Yoder, 2011). Note that the falls may be caused by several factors such as

Patients depend on healthcare professionals through the use of call lights. Many different factors can affect a patient’s ability to function independently such as “cognitive impairments, visual loss, and decreased mobility” patients turn to call lights for assistance (Huey-Ming, 2010). Unfortunately, if a nurse or certified nursing assistant is occupied risks occur and can ultimately lead to injuries of patients due to help not received at that given moment. In the journal titled Perspectives of Patients and Families About the Nature of and Reasons for Call Light Use and Staff Call Light Response Time written by Huey- Ming Tzeng, patients felt “staff responsiveness to call lights often affect nurse-patient communication, patient

Patient satisfaction: This issue can affect funding, revenue and reimbursement from insurance providers. Patient satisfaction can be affected by nearly any aspect of the hospital experience, surveys are done randomly to gain insight on the patients overall treatment at the facility. Negative feedback can cause assumptions about treatment and quality by the HCO as well as decrease in incoming patients.

Hourly rounding is a strategy involving nurses and other health care staff to regularly “check in” on patients every hour. Because nursing staff is not reacting to call lights, patients are more content and happy; therefore nurses feel they are doing a better job helping their patients (Studer, 2007). Research has shown that rounding every hour lowers patient’s use of call lights and resultantly decreases the workload of the nurse (Leighty, 2007; Meade, Bursell, & Ketelsen, 2006; & Tipton, 2008). Performing hourly rounds has contributed to 20% less walking per shift

Hourly rounding also known as intentional rounding or comfort rounding is an initiative that hospitals nationwide are beginning to implement. Hourly rounding should be purposeful. “Hourly rounding is a systematic proactive nurse-driven evidence based intervention to anticipate and address needs in hospitalized patients” (Deitrick, Baker, Paxton, Flores, & Swavely, 2012, p.13). “Purposeful nurse rounds encompass a practice where nurses attend to and document scheduled patient reviews at pre-determined and regular intervals (hourly or second hourly)” (Lyons, Biunero, & Lamont, 2015, p.31).

Despite many efforts to improve staffing numbers, there is often still a staff shortage among staff in hospitals and acute care settings. While the most obvious solution to short staffing is to hire more nurses, there are also other ways to make staffing more effective. A patient acuity tool is a staffing instrument that can be used to decide how much time and attention each individual patient requires. By knowing the acuity level of each patient, charge nurses can decide how many patients each nurse can be assigned to at a time. This essay describes the way a patient acuity instrument improves healthcare outcomes by promoting patient-centered care and improving on key nurse competencies including teamwork and collaboration, quality improvement, and safety measures.

Tzeng and Yin (2009) identified the main reasons for call light use and the impact that hourly rounds have in decreasing the call light use rate and patient falls. This study was done in a community hospital located in Michigan and used archived hospital data for analyses. The archives involved were from four adult acute care units during February 2007- June 2008: one surgical unit with 53 beds, two medical units with both totaling 87 beds and one medical-surgical combined unit with 58 beds (Tzeng, & Yin, 2009).

The purpose of this study was to identify and describe the structures, processes, and perceptions of the outcomes of bedside handovers in nursing practice.

Patients in a hospital and/or healthcare facilities have to be cared for all day and all night, everyday of the week by nurses. The usual way to fulfill this need is to divide up the day into three 8-hour shifts. Different shifts have been put into place to help improve nurse satisfaction, decrease the nursing shortage and save the hospital money. The 24-hour day is made up of two 12-hour shifts; 12 hours in the day and 12 hours at night. There has been quite an ongoing debate over the years regarding this issue of nurses working over 8 hours in a single day. Many people, such as hospital nursing administrators, have reason to believe that working long hour shifts causes more errors in

Hollan, J. (2010). Communication key to patient satisfaction scores. Hospital Case Management, 18(11), 164-166. Retrieved from http://www.library.ohiou.edu.proxy.library.ohiou.edu/cgi-bin/redir_allcampuses.pl?http://search.ebscohost.com

Hourly rounding contributes in several key areas to achievement of high levels of patient satisfaction, including quality of care and patient safety. This puts patients at the center of care by building on the fundamental aspects of care, which are so important. Thus by checking in on patients in wards regularly to see whether they are comfortable and have everything they need can produce a number of positive results. Nurses

The data are collected from observation of over 100 patients’ visits, 50 of which were observed and audio taped. The research questions that are asked by Davidson are: