Meade, C.M., Bursell, A.L., Ketelsen,

¶ … Meade, C.M., Bursell, a.L., Ketelsen, L. (2006). Effects of nursing rounds on patients' call light use, satisfaction, and safety. American Journal of Nursing. 106(9) 58- 70.

How will this research benefit patients and nurses? Interestingly, according to the American Journal of Nursing, although some interactions between nurses and patients, such as smiling, the nurse's use of humor and reassurance, touching, and anticipating patient needs increases patient satisfaction, a nurse's frequent responses to call lights, not only interrupts the continuity of patient care on the wards as a whole but may actually may decrease all patients' sense of satisfaction.

The nurse's physical presence is the key variable that makes some interactions helpful and others less helpful and satisfying for patients. Rather than using call lights, researchers found that the use of periodic rounds reduced call light use for frivolous purposes, increased patient contentment, and improved patient safety. Also, the nurses commented that they were more satisfied with making more frequent rounds because the reduced patient use of call lights allowed them additional time to spend with the patients in need in an uninterrupted fashion.

How could the finding be implemented at your setting? Even in medical practices that do not make extensive use of call lights, such as ordinary doctors offices can benefit from this evidence-based research. It is not the medical knowledge that a nurse provides that is always the critical factor in increasing patient satisfaction, rather the simple presence of another knowledgeable human being in a physical fashion that can make a sick patient feel more secure.

The reason for accidental or frivolous use of call lights may have little to do with the patient's health, and everything to do with the patient's psychological needs. Increasing the frequency of patient visitation in hospitals, and also, even when people are waiting in the ER or an office, to make a 'round' which allows the nurse to acknowledge the patient in a human fashion can potentially increase satisfaction and reduce patient anxiety in a way that is beneficial for all, both providers and patients.

What barrier to implementing evidence-based practice do you face at your workplace? One barrier, of course, is partially logistic -- it is necessary to have greater numbers of nurses to make more frequent rounds in any setting, and the larger the setting the more difficult it is to use human beings, rather than technology in the workplace. Also, as technology is supposed to reduce workloads, there may be some managerial resistance to implementing this evidence-based finding, as it seems counterintuitive.

There may be legal concerns, as the availability of a call light might be a legal 'cover' for accusations of ignoring patients, even if ward rounds are increased. But the findings suggest that call lights and decreased nursing visitations to all patients, regardless of their use of a call light, supports the unavoidable need for human connection on the part of patients and actually improve medical care, and specifically reduces the risk of falls.

Most nurses' intuitive awareness of patient psychology is supported by the findings of the article, and if quality of care improves, so will the respect given to the medical facility in question. Also, legal risks to the hospital will be reduced.