Principal Investigator: | 1LT Laveeta S. Springer, BSN |
Co-Principal Investigators/Collaborators: | 2LT Katie R. Coots, 2LT Maria Ewers, Freddie Thomas |
Organization: | Army Nurse Corps Carl R. Darnall Army Medical Center |
Abstract
Problem
Patient comments on this Medical/Surgical/Telemetry floor revealed that patients were not satisfied with the length of time staff took to respond to call lights to assist in areas of toileting, pain, and environmental needs. Additionally, pain reassessments were not consistently documented. To improve these areas a call light program was implemented.
Evidence
Literature revealed consistent rounding on patients improved staff and patient satisfaction, reduced call light usage (38%), patient falls (50%), and skin breakdowns (14%). A baseline log at Darnall demonstrated calls were primarily environment (44.4%), pain/position (13.2%), toileting (11.8%) or undetermined (31.2%).
Strategy
A committee was formed, the floor staff educated and feedback received. From the baseline existing documentation, audit, and satisfaction tools were modified to include a rounding program. The program was implemented with the assistance of the staff.
Practice Change
The practice affected involved the Medical/Surgical/Telemetry floor. Based on the collected data, the PET (pain reassessment/position, environment, and toileting) model was developed. Hourly rounds were conducted from 0600 to 2200 by the day shift staff and every two hours by the night shift (2300 to 0500).
Evaluation
The program was implemented in mid January of 2009 and will end 15 April 2009. Comparison of baseline data to the post implementation data will occur at that time.
Results
Initial results are a reduction in call light usage and increase in satisfaction for both patients and staff.
Recommendations
Longer collections times for baseline data to reflect actual call light use during average census. And more implementation time for pre positioning of necessary support components such as equipment and patient education.
Lessons Learned
Hourly rounding should be the standard practice for nursing. This program can serve as a tool to improve patient safety, reduce skin breakdown, improve satisfaction scores, maximize pain management, improve communication among staff and provide early rescue for patients.
Bibliography
- Culley, T. (2008). Reduce call light frequency with hourly rounds. Retrieved December 17, 2008, from http://nursingmanagement.com
- Leighty, J. (2004, December 4). Hourly rounding dims call lights: Nationwide study sparks protocol. Nursing Spectrum. Retrieved October 2, 2008, from http://include.nurse.com/apps/pbcs.dll/article?AID=200661228023
- Leighty, J. (2006). You called? Hourly rounding cuts call lights. Retrieved December 26, 2008, from www.studergroup.com/dotCMS/knowledgeAssetDetail?indoe=323256
- Meade, C.M., A.L. Bursell, and L. Ketelsen. “Effects of nursing rounds on patients’ call light use, satisfaction, and safety: Scheduling regular nursing rounds to deal with patients’ more mundane and common problems can return the call light to its rightful status as a lifeline.” American Journal of Nursing. Mar. 2006: 58–70.