Call Lights and Nursing Rounds in Hospitals

Nursing Proposal -- Evidence-Based The utilization of call lights particularly in hospital settings has recently been put under study as a function of various aspects of nursing including shortages, rounds and analyses of patient outcomes. The proper scheduling of nursing rounds may be essential to enhance the capability of nurses to tackle common or ordinary patient issues relative to more dire needs that have to be regarded as the primary/main target for the use of call lights by patients.

Besides patients' general well-being and safety while hospitalized, nursing employees are also concerned with how satisfied the patients are. On a rather fundamental level, hospital settings that enable patients to experience peace of mind allow them to heal quicker than those that do not; these patients are highly likely to relay less stressful communications to those around them, and have a higher possibility of clearer perspectives that allow them to distinguish between their many desires and needs while in their hospital beds.

The implementation of frequent and regular nursing rounds may put to rest patient anxiety on two matters: the meeting of their needs and the prioritization of their comfort by the nursing staff. Regular nursing rounds also help hospitals develop a degree of predictability that can function as a coping mechanism during longer or difficult hospital stays. The suggested PICOT structure is an inquiry that is structured in such a way to further explain these issues based on evidence-based studies.

P = Patient Problem/Population I = Intervention C = Comparison O = Outcome T = Time P =Patients (non-ambulatory) in acute care I = Call light use and hourly nurse rounds C = Call light use only O = Improved patient satisfaction, decrease in number of falls, and decrease also in the number of pressure ulcers T = 6-month period The PICOT inquiry states: (P) Will patients in acute care (I) who are able to use call lights and frequent and regular nursing rounds (C) compared to other patients in acute care who only use call lights (O) exhibit more patient satisfaction, a decrease in falls and a decrease in number of ulcers due to pressure (T) in the 6-month time period after the implementation of the interventions? Investigations reveal that literature supports the fact that institutionalization of regular nursing rounds plays a significant role in the reduction of the utilization of call lights, which will greatly increase patients' overall satisfaction.

Problem Description The utilization of call lights has been of late, under increasing scrutiny, due to its relations to the changing conditions in both medicine and provision of healthcare in the hospital setting. The supply of nurses has been fluctuating constantly for many years, similar to the monies available to staff medical institutions adequately. The changed financial structure of private hospitals has meant more operational oversight with the aim of savings costs and also increased focus of stockholders on financial returns.

Further complicating this problem is the lack of evidence-based studies on the impact of different types of arrangements of nursing rounds particularly on patient outcomes and issues related to nursing staff. Several available studies of patient outcomes have revealed that compulsory overtime results in poorer student safety and well-being ("ANA," 2006; AACN, 2001; Bae, 2010, 2013; Meade, 2006; Saleh, 2011; Trinkoff, 2006). The matter of compulsory overtime for nurses is strongly linked to the issue of nurses being chronically fatigued, overworked and unsatisfied with their work.

Job satisfaction, in turn, is linked to the degree to which professionals are feeling that their employers and the work environment in general supports them to do their jobs well. In a hospital setting that overworks nursing staff, the utilization of call lights by patients may be seen as an unwanted burden and as a system best misused, or abused by non-ambulatory patients.

The perceptions of patients and those of the nursing staff may be completely different in terms of the dimension of quality of care that involves the regularity and the speed with which common needs-patients are served (Nguyen, 2002; Gonzalez-Valentin, et al., 2005). Solution Description The scheduling of hourly-nursing rounds may be essential to the ability of nurses to tackle common and ordinary patients' wants and needs relative to more dire needs that may be seen by others as ones that should warrant the use of call lights by patients. Meade, et al.

(2006) carried out a study on the utilization of call lights by patients in twenty two hospitals. The study revealed that patients use call lights for the following reasons: room amenities; non-serious health or personal issues; secondary medical reasons; and no reason or miscellaneous. It is my opinion that most of these reasons for usage are common, and can be better catered for, through proper scheduling of nurses rounds. Besides patients' general well-being and safety while hospitalized, nursing employees are also concerned with how satisfied the patients are.

Changes in the operations of hospitals that enable increased frequency in nursing rounds can have a significant impact on the success of the management of patient care, improve patient safety and increase the satisfaction levels of patients and their loved ones. It is essential that nurses have both personal and clinical skills in their profession. Hence, creating and sustaining disciplined schedule for hourly nurse rounds tends be productive in decreasing falls, and diminishing the use of call light, which leads to an increase in patient satisfaction.

A lot of evidence exists that supports this argument; for instance, Jean Watson's Theory of Human Caring offers solid rationale on which to build this model on in supporting this hypothesis. The comprehensive theory offers personal approach which describes the reason behind the practical effectiveness of nurses' personal care framework. The theory relies on the notion that a loving and kindness approach in clinical setting seems effective in enhancing the quality of patient care.

The ultimate goal of Watson's theory is infusing "heart-centered" practice of care into the habitually stressful environment in clinics and hospitals (2147499). Implementation Plan Implementing an intervention to reduce the number of calls can be somewhat logistically complex, however it is completely feasible. First, one has to identify and hire a properly qualified project manager to run the intervention. The intervention can be effectively managed utilizing a suitable project format. One of the essential requirements for the first step will be the collection of baseline data.

This will allow one to have definite point of reference that will allow him or her to determine the intervention's effectiveness. The intervention in itself will entail the creation of proper metrics and staff training to enable compliance with the best healthcare practices identified in literature pertaining to effective strategies aimed at reducing the number of patient calls. During the implementation of the project, another critical component will run concurrently to monitor compliance with the desired intervention strategies and the prescription of corrective action in cases where necessary.

Any calls after the commencement of the intervention strategies will be investigated in order to understand what caused the call and the results of the investigation/analysis released to enable the enhancement of strategies (2147746). There will also be a need for a dedicated project management team hired to implement the organizational changes. This team will be overseen by the project manager.

A properly qualified project manager can incorporate an operational change improvement initiative that is more likely to succeed than any other person who does not have any project management skills (2147746). The implementation phase will commence with the staff training, to bring the staff up-to-date with the industry's best practices and the desired new processes that will be proposed by the project team.

The training will include various aspects such as the scope of the project, justification for the project, the changes in procedures and processes, and information about the best practices. This information will enable nursing staff to be comprehensively informed of the reasons why the changes are being instituted (2147746). A project of this magnitude will require a couple of organizational resources including a project manager. Due to the crucial nature of this position it will probably be full-time one.

There will be a need to reduce organizational responsibilities of the other project team members to allow them enough time to for project responsibilities. All the employees of the organization are also required to make time for training. The project team also ought to gather data on the level of information possessed by the staff before the commencement of training. This data will serve as a baseline to enable the rating of the effectiveness of training.

A part of the team will need to be delegated to monitor the intervention's effectiveness and recommending improvements as more data is collected (2147746). Evaluation Plan Different evaluations will be utilized to assess the project outcomes. The survey will be utilized to collect patients' and staffs opinion so as to measure their level of satisfaction. The key variable-patient satisfaction will be evaluated from the nursing staff.

Besides, the study will utilize in depth interviews of with some of the nurses to collect their opinions on their overall work satisfaction, which will in turn help to improve the evaluation of the outcomes (2147897_2). Staff turnover will also be utilized to evaluate the project's outcome. The rate of staff turnover prior to and after the project will be determined, and the difference between the two will in turn be used to calculate the project's outcomes.

The percentages of repeat patients will also be used evaluate the outcome of the project; the before and after percentages will help in this particular intervention. If the percentage of repeat patients has increased after the project, then the conclusion will be that the project was successful. Moreover, revenues and sales recorded prior to the start of the project will also be compared to the revenues and sales after implementation of the project, and the difference will be utilized to evaluate the project's outcome.

If the revenues and sales recorded after the project are higher, it can then be concluded that the project has been successful (2147897_2). Dissemination Plan A different strategy will be utilized to disseminate the results of the project to the stakeholders. First, the project researcher will through a memo inform organizations' management and other key stakeholders of the project evidences. The memo will delve into the suitable and recommended benefits that these organizations will gain from the project.

The study will also focus on key results and policy recommendations at scholarly and professional associations (2147897_2). The project team will also use a press release and newsletters to inform the public about the project and its intended benefits. More significantly, policy papers, reports and journal articles will be used to share the project's result with other associated scholarly and professional societies and also members of the public who are interested.

The policy papers will be disseminated in the form of hard copies at events and also published in the electronic format on the project's website (Wyatt, Finn, Wadhwa, et al. 2013 p 15). Closely related to this matter obviously is the need for the creation of a website to disseminate information and data about the project to the public. Presentations at conferences and also at different but related websites are some of the effective ways of promoting the outcomes of the project (Wyatt, Finn, Wadhwa, et al., 2013).

Review of Literature It is obvious that the call light feature can be a lifeline to many patients in hospital settings; however, it can also impose significant demands on the nurses' time. Quite a number of studies have revealed the unfavorable impacts of the frequent utilization of call lights on the effectiveness of the management of patient-care, which, in some cases might already be hindered by shortages in labor, job dissatisfaction and burnout among nurses.

Studies have shown that patients utilize call lights mostly for reasons that do not necessarily require responses from the nursing staff and can be sufficiently handled using nursing aids. Authors Van Handel and Krug (1994) categorized the reasons why patients used call lights in their work, they also identified that call lights were largely used during medication and meal times, when the nursing staff was busiest.

This led to the implementation of two interventions to cut patients' call lights usage: first, the incorporation of a non-nurse personnel position (a nursing assistant) and the implementation of what was referred to as 'reactive-proactive' procedures that included, nurses asking patients and their roommates and other patients in rooms close to theirs if they required any additional assistance when responding to a call light (Saleh, 2013). A nurse's ability to meet the needs of the patient determines the patient's perception of the level of nursing care.

Hospitalized patients often require help with common self-care needs and usually communicate their needs by utilizing call lights. A couple of studies have assessed patients' perception of nursing care based on the kindness, smile, compassion and the ability of the nurse to anticipate their needs. In short, how the patient perceives the quality of nursing care will be determined by the ability of the nurse to meet his or her needs in addition to the nurse's ability to foster a relationship with the patent.

This study is based on the notion that patients will be able to see or feel that proactive nurses provide them with frequent and regular care that meets their emotional and physical needs (Saleh, 2013). According to Tea et al. (2006), the goal of hourly nursing rounds is to enhance patient satisfaction and safety, and also to reduce the stress levels among the nursing staff. Other authors, Deitrick et al. (2012), argue that hourly nursing rounds, though beneficial, can be quite challenging to implement in hospital settings.

Many staffs are of the opinion that hourly nursing rounds force more work and not as a proactive process to improve patients' safety and are of the.