1
|
Cho M. Evaluating Therapeutic Healthcare Environmental Criteria: Architectural Designers' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1540. [PMID: 36674294 PMCID: PMC9865628 DOI: 10.3390/ijerph20021540] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/08/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
This study presents architectural designers’ perception of the importance of healthcare environmental criteria in the implementation of user-centered, therapeutic hospital design. Architectural designers with over three years of professional experience (N = 182) in South Korea were surveyed using an empirical questionnaire. The extensive interviews of 15 hospital design experts followed to interpret the survey results and discuss the barriers and suggestions for the successful delivery of therapeutic healthcare design practice. Among the 27 variables selected from the preliminary literature review, factor analyses revealed seven important therapeutic environmental criteria (i.e., management, interior design, spatial quality, service, nature and rest, ambient indoor comfort, and social program and space; χ2 = 1783.088, df = 300, p < 0.001). Analyses of variance revealed the level of importance among these criteria related to respondents’ personal and professional characteristics. Significant differences were found for the variables from the management, interior design, and spatial quality factors in relation to the respondents sex and age. For the successful delivery of therapeutic healthcare design, the design experts highlighted the implementation of evidence-based design practice that integrates local and international knowledge from various hospital users and multi-disciplinary specialists participating in the healthcare design process.
Collapse
Affiliation(s)
- Minjung Cho
- Department of Architecture, Inha University, 100 Inharo, Michuholgu, Incheon 22212, Republic of Korea
| |
Collapse
|
2
|
Pati D, Valipoor S, Cloutier A, Yang J, Freier P, Harvey TE, Lee J. Physical Design Factors Contributing to Patient Falls. J Patient Saf 2021; 17:e135-e142. [PMID: 28157790 DOI: 10.1097/pts.0000000000000339] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to identify physical design elements that contribute to potential falls in patient rooms. METHODS An exploratory, physical simulation-based approach was adopted for the study. Twenty-seven subjects, older than 70 years (11 male and 16 female subjects), conducted scripted tasks in a mockup of a patient bathroom and clinician zone. Activities were captured using motion-capture technology and video recording. After biomechanical data processing, video clips associated with potential fall moments were extracted and then examined and coded by a group of registered nurses and health care designers. Exploratory analyses of the coded data were conducted followed by a series of multivariate analyses using regression models. RESULTS In multivariate models with all personal, environmental, and postural variables, only the postural variables demonstrated statistical significance-turning, grabbing, pushing, and pulling in the bathroom and pushing and pulling in the clinician zone. The physical elements/attributes associated with the offending postures include bathroom configuration, intravenous pole, door, toilet seat height, flush, grab bars, over-bed table, and patient chair. CONCLUSIONS Postural changes, during interactions with the physical environment, constitute the source of most fall events. Physical design must include simultaneous examination of postural changes in day-to-day activities in patient rooms and bathrooms. Among discussed testable recommendations in the article, the followings design strategies should be considered: (a) designing bathrooms to reduce turning as much as possible and (b) designing to avoid motions that involve 2 or more of the offending postures, such as turning and grabbing or grabbing and pulling, and so on.
Collapse
Affiliation(s)
| | | | | | - James Yang
- Mechanical Engineering, Texas Tech University
| | | | | | - Jaehoon Lee
- Institute for Measurement, Methodology, Analysis, and Policy, Texas Tech University, Lubbock, TX
| |
Collapse
|
3
|
Patients' Experience After a Fall and Their Perceptions of Fall Prevention: A Qualitative Study. J Nurs Care Qual 2018; 33:46-52. [PMID: 28448301 DOI: 10.1097/ncq.0000000000000261] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
An exploratory descriptive study was conducted to explore the perspectives of patients who had fallen in the hospital; 100 patients were interviewed. An inductive content analysis approach was adopted. Six themes emerged: Apathetic toward falls, self-blame behavior, reluctance to impose on busy nurses, negative feelings toward nurses, overestimating own ability, and poor retention of information. Patients often downplayed the risks of falls and were reluctant to call for help.
Collapse
|
4
|
Hill AM, McPhail SM, Francis-Coad J, Waldron N, Etherton-Beer C, Flicker L, Ingram K, Haines TP. Educators' perspectives about how older hospital patients can engage in a falls prevention education programme: a qualitative process evaluation. BMJ Open 2015; 5:e009780. [PMID: 26656027 PMCID: PMC4679942 DOI: 10.1136/bmjopen-2015-009780] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 10/18/2015] [Accepted: 11/13/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Falls are the most frequent adverse event reported in hospitals. Patient and staff education delivered by trained educators significantly reduced falls and injurious falls in an older rehabilitation population. The purpose of the study was to explore the educators' perspectives of delivering the education and to conceptualise how the programme worked to prevent falls among older patients who received the education. DESIGN A qualitative exploratory study. METHODS Data were gathered from three sources: conducting a focus group and an interview (n=10 educators), written educator notes and reflective researcher field notes based on interactions with the educators during the primary study. The educators delivered the programme on eight rehabilitation wards for periods of between 10 and 40 weeks. They provided older patients with individualised education to engage in falls prevention and provided staff with education to support patient actions. Data were thematically analysed and presented using a conceptual framework. RESULTS Falls prevention education led to mutual understanding between staff and patients which assisted patients to engage in falls prevention behaviours. Mutual understanding was derived from the following observations: the educators perceived that they could facilitate an effective three-way interaction between staff actions, patient actions and the ward environment which led to behaviour change on the wards. This included engaging with staff and patients, and assisting them to reconcile differing perspectives about falls prevention behaviours. CONCLUSIONS Individualised falls prevention education effectively provides patients who receive it with the capability and motivation to develop and undertake behavioural strategies that reduce their falls, if supported by staff and the ward environment.
Collapse
Affiliation(s)
- Anne-Marie Hill
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Steven M McPhail
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Queensland, Australia Institute of Health and Biomedical Innovation and School of Public Health & Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jacqueline Francis-Coad
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Nicholas Waldron
- Department of Rehabilitation and Aged Care, Armadale Kelmscott Memorial Hospital, Perth, Western Australia, Australia Department of Health Strategy and Networks, Strategic System, Policy & Planning, Department of Health, Government of Western Australia, Perth, Western Australia, Australia
| | - Christopher Etherton-Beer
- WA Centre for Health and Ageing, Royal Perth Hospital Unit, School of Medicine & Pharmacology and Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia
| | - Leon Flicker
- WA Centre for Health and Ageing, Royal Perth Hospital Unit, School of Medicine & Pharmacology and Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia
| | - Katharine Ingram
- Department of Rehabilitation, Aged Care Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Terry P Haines
- Physiotherapy Department, Monash University, Melbourne, Victoria, Australia Allied Health Research Unit, Monash Health, Melbourne, Victoria, Australia
| |
Collapse
|
5
|
Severo IM, Almeida MDA, Kuchenbecker R, Vieira DFVB, Weschenfelder ME, Pinto LRC, Klein C, Siqueira APDO, Panato BP. Risk factors for falls in hospitalized adult patients: an integrative review. Rev Esc Enferm USP 2014; 48:540-54. [DOI: 10.1590/s0080-623420140000300021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 03/29/2014] [Indexed: 11/22/2022] Open
Abstract
Objective: Identifying risk factors for the occurrence of falls in hospitalized adult patients. Method: Integrative review carried out in the databases of LILACS, SciELO, MEDLINE and Web of Science, including articles published between 1989 and 2012. Results: Seventy-one articles were included in the final sample. Risk factors for falls presented in this review were related to patients (intrinsic), the hospital setting and the working process of health professionals, especially in nursing (extrinsic). Conclusion: The systematic screening of risk factors for falls was identified as a contributing factor to the reduction of this injury, helping the non-occurrence of this event that, despite being preventable, can have serious consequences including death.
Collapse
|
6
|
Tzeng HM, Yin CY. i Engaging as an innovative approach to engage patients in their own fall prevention care. Patient Prefer Adherence 2014; 8:693-700. [PMID: 24868148 PMCID: PMC4027936 DOI: 10.2147/ppa.s62746] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Decreasing patient fall injuries during hospitalization continues to be a challenge at the bedside. Empowering patients to become active participants in their own fall prevention care could be a solution. In a previous study, elderly patients recently discharged from a United States hospital expressed a need for nurses to give and repeat directives about fall prevention; when the nurse left a brochure on the topic, but did not provide any (or limited) verbal explanations about the content or the importance of the information, the patient felt that the information was insufficient. To address patients' needs, we developed "i Engaging", a Web-based software application for use at the bedside. i Engaging is an innovative approach that is used to engage patients in their own fall prevention care during hospital stays. The application was designed based on the assumption that patients are the best and most critical sources of information about their health status. i Engaging has not yet been tested in clinical trials.
Collapse
Affiliation(s)
- Huey-Ming Tzeng
- College of Nursing, Washington State University, Spokane, WA, USA
| | - Chang-Yi Yin
- Department of History, Chinese Culture University, Taipei, Taiwan
| |
Collapse
|
7
|
Hill AM, Waldron N, Etherton-Beer C, McPhail SM, Ingram K, Flicker L, Haines TP. A stepped-wedge cluster randomised controlled trial for evaluating rates of falls among inpatients in aged care rehabilitation units receiving tailored multimedia education in addition to usual care: a trial protocol. BMJ Open 2014; 4:e004195. [PMID: 24430881 PMCID: PMC3902351 DOI: 10.1136/bmjopen-2013-004195] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Falls are the most frequent adverse event reported in hospitals. Approximately 30% of in-hospital falls lead to an injury and up to 2% result in a fracture. A large randomised trial found that a trained health professional providing individualised falls prevention education to older inpatients reduced falls in a cognitively intact subgroup. This study aims to investigate whether this efficacious intervention can reduce falls and be clinically useful and cost-effective when delivered in the real-life clinical environment. METHODS A stepped-wedge cluster randomised trial will be used across eight subacute units (clusters) which will be randomised to one of four dates to start the intervention. Usual care on these units includes patient's screening, assessment and implementation of individualised falls prevention strategies, ongoing staff training and environmental strategies. Patients with better levels of cognition (Mini-Mental State Examination >23/30) will receive the individualised education from a trained health professional in addition to usual care while patient's feedback received during education sessions will be provided to unit staff. Unit staff will receive training to assist in intervention delivery and to enhance uptake of strategies by patients. Falls data will be collected by two methods: case note audit by research assistants and the hospital falls reporting system. Cluster-level data including patient's admissions, length of stay and diagnosis will be collected from hospital systems. Data will be analysed allowing for correlation of outcomes (clustering) within units. An economic analysis will be undertaken which includes an incremental cost-effectiveness analysis. ETHICS AND DISSEMINATION The study was approved by The University of Notre Dame Australia Human Research Ethics Committee and local hospital ethics committees. RESULTS The results will be disseminated through local site networks, and future funding and delivery of falls prevention programmes within WA Health will be informed. Results will also be disseminated through peer-reviewed publications and medical conferences. TRIAL REGISTRATION The study is registered with the Australian New Zealand Clinical Trials registry (ACTRN12612000877886).
Collapse
Affiliation(s)
- Anne-Marie Hill
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Nicholas Waldron
- Department of Rehabilitation and Aged Care, Armadale Kelmscott Memorial Hospital, Perth, Western Australia, Australia
- Health Strategy and Networks, Strategic System, Policy and Planning, Department of Health, Government of Western Australia, Perth, Western Australia, Australia
| | - Christopher Etherton-Beer
- School of Medicine and Pharmacology, WA Centre for Health & Ageing CMR, University of Western Australia, Perth, Western Australia, Australia
- Royal Perth Hospital, Perth, Western Australia, Australia
| | - Steven M McPhail
- Institute of Health and Biomedical Innovation and School of Public Health & Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Katharine Ingram
- Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Leon Flicker
- School of Medicine and Pharmacology, WA Centre for Health & Ageing CMR, University of Western Australia, Perth, Western Australia, Australia
- Royal Perth Hospital, Perth, Western Australia, Australia
| | - Terry P Haines
- Physiotherapy Department, Monash University, Frankston, Victoria, Australia
- Allied Health Research Unit, Monash Health, Cheltenham, Victoria, Australia
| |
Collapse
|
8
|
Tzeng HM, Prakash A, Brehob M, Anderson A, Devecsery DA, Yin CY. How feasible was a bed-height alert system? Clin Nurs Res 2012; 22:300-9. [PMID: 22997350 DOI: 10.1177/1054773812460867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This qualitative and descriptive study examined the feasibility of a bed-height alert system as a fall-prevention strategy. The alpha prototype was developed to measure and record bed height, and to remind staff to keep patient beds in the lowest position. This pilot project was conducted in a 52-bed adult acute surgical inpatient care unit of a Michigan community hospital. Qualitative and quantitative information was gathered during semistructured interviews of nursing staff (18 RNs and 13 PCAs; January-April 2011). Descriptive content analysis and descriptive analyses were performed. The overall response rate was 44.9%. The mean values of the feasibility questions are all favorable. Staff's comments also support the view that the alert system would promote patient safety and prevent falls. In short, this system was found to be somewhat useful, feasible, appropriate, and accurate. It has the potential to promote patient safety and prevent bed-associated injurious falls in inpatient care settings.
Collapse
|
9
|
Tzeng HM, Prakash A, Brehob M, Devecsery DA, Anderson A, Yin CY. Keeping patient beds in a low position: an exploratory descriptive study to continuously monitor the height of patient beds in an adult acute surgical inpatient care setting. Contemp Nurse 2012; 41:184-9. [PMID: 22800384 DOI: 10.5172/conu.2012.41.2.184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This descriptive study was intended to measure the percentage of the time that patient beds were kept in high position in an adult acute inpatient surgical unit with medical overflow in a community hospital in Michigan, United States. The percentage of the time was calculated for morning, evening, and night shifts. The results showed that overall, occupied beds were in a high position 5.6% of the time: 5.40% in the day shift, 6.88% in the evening shift, and 4.38% in the night shift. It is recognized that this study was unable to differentiate whether those times patient beds being kept in a high position were appropriate for an elevated bed height (e.g., staff were working with the patient). Further research is warranted. Falls committees may conduct high-bed prevalence surveys in a regular basis as a proxy to monitor staff members' behaviors in keeping beds in a high position.
Collapse
Affiliation(s)
- Huey-Ming Tzeng
- Department of Nursing, School of Health Professions and Studies, The University of Michigan-Flint, Flint, MI, USA
| | | | | | | | | | | |
Collapse
|
10
|
Tzeng HM, Titler MG, Ronis DL, Yin CY. The contribution of staff call light response time to fall and injurious fall rates: an exploratory study in four US hospitals using archived hospital data. BMC Health Serv Res 2012; 12:84. [PMID: 22462485 PMCID: PMC3364911 DOI: 10.1186/1472-6963-12-84] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Accepted: 03/31/2012] [Indexed: 11/20/2022] Open
Abstract
Background Fall prevention programs for hospitalized patients have had limited success, and the effect of programs on decreasing total falls and fall-related injuries is still inconclusive. This exploratory multi-hospital study examined the unique contribution of call light response time to predicting total fall rates and injurious fall rates in inpatient acute care settings. The conceptual model was based on Donabedian's framework of structure, process, and health-care outcomes. The covariates included the hospital, unit type, total nursing hours per patient-day (HPPDs), percentage of the total nursing HPPDs supplied by registered nurses, percentage of patients aged 65 years or older, average case mix index, percentage of patients with altered mental status, percentage of patients with hearing problems, and call light use rate per patient-day. Methods We analyzed data from 28 units from 4 Michigan hospitals, using archived data and chart reviews from January 2004 to May 2009. The patient care unit-month, defined as data aggregated by month for each patient care unit, was the unit of analysis (N = 1063). Hierarchical multiple regression analyses were used. Results Faster call light response time was associated with lower total fall and injurious fall rates. Units with a higher call light use rate had lower total fall and injurious fall rates. A higher percentage of productive nursing hours provided by registered nurses was associated with lower total fall and injurious fall rates. A higher percentage of patients with altered mental status was associated with a higher total fall rate but not a higher injurious fall rate. Units with a higher percentage of patients aged 65 years or older had lower injurious fall rates. Conclusions Faster call light response time appeared to contribute to lower total fall and injurious fall rates, after controlling for the covariates. For practical relevance, hospital and nursing executives should consider strategizing fall and injurious fall prevention efforts by aiming for a decrease in staff response time to call lights. Monitoring call light response time on a regular basis is recommended and could be incorporated into evidence-based practice guidelines for fall prevention.
Collapse
Affiliation(s)
- Huey-Ming Tzeng
- Department of Nursing, The University of Michigan-Flint, School of Health Professions and Studies, 48502, USA.
| | | | | | | |
Collapse
|
11
|
Exploring the relationship between patient call-light use rate and nurse call-light response time in acute care settings. Comput Inform Nurs 2011; 29:TC75-80. [PMID: 21562385 DOI: 10.1097/ncn.0b013e31821ef7fc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Patient call-light usage and nurse responsiveness to call lights are two intertwined concepts that could affect patients' safety during hospital stays. Little is known about the relationship between call-light usage and call-light response time. Consequently, this exploratory study examined the relationship between the patient-initiated call-light use rate and the nursing staff's average call-light response time in a Michigan community hospital. It used hospital archived data retrieved from the call-light tracking system for the period from February 2007 through June 2008. Curve estimation regression and multiple regression analyses were conducted. The results showed that the call-light response time was not affected by the total nursing hours or RN hours. The nurse call-light response time was longer when the patient call-light use rate was higher and the average length of stay was shorter. It is likely that a shorter length of stay contributes to the nursing care activity level on the unit because it is associated with a higher frequency of patient admissions/discharges and treatment per patient-day. This suggests that the nursing care activity level on the unit and number of call-light alarms could affect nurse call-light response time, independently of the number of nurses available to respond.
Collapse
|
12
|
Exploring the relationship between patient call-light use rate and nurse call-light response time in acute care settings. Comput Inform Nurs 2011; 29:138-43. [PMID: 21099676 DOI: 10.1097/ncn.0b013e3181fc41d9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patient call-light usage and nurse responsiveness to call lights are two intertwined concepts that could affect patients' safety during hospital stays. Little is known about the relationship between call-light usage and call-light response time. Consequently, this exploratory study examined the relationship between the patient-initiated call-light use rate and the nursing staff's average call-light response time in a Michigan community hospital. It used hospital archived data retrieved from the call-light tracking system for the period from February 2007 through June 2008. Curve estimation regression and multiple regression analyses were conducted. The results showed that the call-light response time was not affected by the total nursing hours or RN hours. The nurse call-light response time was longer when the patient call-light use rate was higher and the average length of stay was shorter. It is likely that a shorter length of stay contributes to the nursing care activity level on the unit because it is associated with a higher frequency of patient admissions/discharges and treatment per patient-day. This suggests that the nursing care activity level on the unit and number of call-light alarms could affect nurse call-light response time, independently of the number of nurses available to respond.
Collapse
|
13
|
Hill AM, Hoffmann T, Beer C, McPhail S, Hill KD, Oliver D, Brauer SG, Haines TP. Falls After Discharge From Hospital: Is There a Gap Between Older Peoples' Knowledge About Falls Prevention Strategies and the Research Evidence? THE GERONTOLOGIST 2011; 51:653-62. [DOI: 10.1093/geront/gnr052] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
14
|
Link Between Patients’ Perceptions of Their Acute Care Hospital Experience and Institutions’ Injurious Fall Rates. J Nurs Care Qual 2011; 26:151-60. [DOI: 10.1097/ncq.0b013e3181f9604d] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
15
|
Abstract
OBJECTIVE This multihospital study determined the contributors to patient/family satisfaction levels with nurses' call light responsiveness and compared the reasons for call light usage as perceived by patients and nurses. BACKGROUND Delayed responses to answering call lights may result in a patient falling and can affect patient satisfaction. METHODS This cross-sectional survey study was conducted from September 2008 to November 2009 in 4 US hospitals; 1,253 patients/family participants and 988 nurses were surveyed. Descriptive and multiple regression analyses were conducted. RESULTS Women, older patient/family participants, and those who perceived that nurses often answered call lights in person, that their problems were resolved after pushing the call light, and that their call lights less frequently involved safety issues were more satisfied with nurses' responsiveness. The top 5 reasons for using call lights were the same for patients and nurses. CONCLUSION Nursing administrators should emphasize increasing staff's call light responsiveness.
Collapse
|
16
|
Tzeng HM. Perspectives of staff nurses of the reasons for and the nature of patient-initiated call lights: an exploratory survey study in four USA hospitals. BMC Health Serv Res 2010; 10:52. [PMID: 20184775 PMCID: PMC2841165 DOI: 10.1186/1472-6963-10-52] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Accepted: 02/26/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little research has been done on patient call light use and staff response time, which were found to be associated with inpatient falls and satisfaction. Nurses' perspectives may moderate or mediate the aforementioned relationships. This exploratory study intended to understand staff's perspectives about call lights, staff responsiveness, and the reasons for and the nature of call light use. It also explored differences among hospitals and identified significant predictors of the nature of call light use. METHODS This cross-sectional, multihospital survey study was conducted from September 2008 to January 2009 in four hospitals located in the Midwestern region of the United States. A brief survey was used. All 2309 licensed and unlicensed nursing staff members who provide direct patient care in 27 adult care units were invited to participate. A total of 808 completed surveys were retrieved for an overall response rate of 35%. The SPSS 16.0 Window version was used. Descriptive and binary logistic regression analyses were conducted. RESULTS The primary reasons for patient-initiated calls were for toileting assistance, pain medication, and intravenous problems. Toileting assistance was the leading reason. Each staff responded to 6 to 7 calls per hour and a call was answered within 4 minutes (estimated). 49% of staff perceived that patient-initiated calls mattered to patient safety. 77% agreed that that these calls were meaningful. 52% thought that these calls required the attention of nursing staff. 53% thought that answering calls prevented them from doing the critical aspects of their role. Staff's perceptions about the nature of calls varied across hospitals. Junior staff tended to overlook the importance of answering calls. A nurse participant tended to perceive calls as more likely requiring nursing staff's attention than a nurse aide participant. CONCLUSIONS If answering calls was a high priority among nursing tasks, staff would perceive calls as being important, requiring nursing staff's attention, and being meaningful. Therefore, answering calls should not be perceived as preventing staff from doing the critical aspects of their role. Additional efforts are necessary to reach the ideal or even a reasonable level of patient safety-first practice in current hospital environments.
Collapse
Affiliation(s)
- Huey-Ming Tzeng
- The University of Michigan, School of Nursing, Division of Nursing Business and Health Systems, 400 North Ingalls, Room 4156, Ann Arbor, MI 48109, USA.
| |
Collapse
|
17
|
Tzeng HM, Yin CY. Relationship between call light use and response time and inpatient falls in acute care settings. J Clin Nurs 2009; 18:3333-41. [PMID: 19735337 DOI: 10.1111/j.1365-2702.2009.02916.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES This exploratory study used archived hospital data to determine whether the call light use rate and the average call light response time contribute to the fall and the injurious fall rates in acute care settings. BACKGROUND Inpatients often use call lights to seek nurses' attention and assistance. Although implied in patient safety, no studies have examined data related to the call light use or the response time to call lights collected via existing tracking mechanisms to monitor nursing practice. DESIGN The study was conducted in a Michigan community hospital and used archived hospital data for analyses for the period from February 2007-June 2008. The unit of analysis was unit-week. METHOD The call light use rate per patient-day was calculated based on information retrieved from the call light tracking system. The average response time in seconds was used as generated from the tracking system. The fall and injurious fall rates per 1000 patient-days were calculated based on the fall incident reports. SPSS was used for data analyses. One-way ANOVA and correlation analyses were conducted. RESULTS More calls for assistance related to less fall-related patient harm. Surprisingly, longer response time to call lights also related to fewer total falls and less fall-related patient harm. Generally speaking, more call light use related to longer response times. CONCLUSIONS This study's findings challenged the appropriateness of targeting the goals of reducing the frequency of call light use and the fall rates as two outcome indicators of conducting hourly patient rounds. RELEVANCE TO CLINICAL PRACTICE Encouraging call light use is a key to reducing injurious fall rates. Unit managers should routinely monitor the trend of the call light use rate and ensure that the call light use rate is maintained at least above the mean rate.
Collapse
Affiliation(s)
- Huey-Ming Tzeng
- Division of Nursing Business and Health Systems, School of Nursing, University of Michigan, 400 North Ingalls, Room 4156, Ann Arbor, MI 48109, USA.
| | | |
Collapse
|
18
|
Tzeng HM. Perspectives of staff nurses toward patient- and family-initiated call light usage and response time to call lights. Appl Nurs Res 2009; 24:59-63. [PMID: 20974057 DOI: 10.1016/j.apnr.2009.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Revised: 03/07/2009] [Accepted: 03/10/2009] [Indexed: 11/19/2022]
Abstract
This survey study describes nurses' perspectives about call light usage and response time. Staff perceived call lights as being patient safety related (52%) and meaningful (81.6%), and answering calls prevented them from doing the critical aspects of their role (43.8%). Staff's perspectives toward call lights should be surveyed on a regular basis.
Collapse
Affiliation(s)
- Huey-Ming Tzeng
- Department of Nursing, School of Health Professions and Studies, The University of Michigan-Flint, 48502, USA.
| |
Collapse
|
19
|
Are Call Light Use and Response Time Correlated With Inpatient Falls and Inpatient Dissatisfaction? J Nurs Care Qual 2009; 24:232-42. [DOI: 10.1097/ncq.0b013e3181955f30] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|