Call light is a vital patient communication link between the nurses’ and the hospitalized patients in health care center. The introduction of call lights in health care centers was initiated in order to prevent patients from falling and have the ability to access their nurses’ when need arises. The call lights also known as call bells are installed in the patient rooms and when he/she needs a nurse presses the button which directs signal to nursing room/ station, the nurse will see flash of lights and will be able to understand in which ward and room in which the patient in need is located. The call lights acts as a linkage between the hospitalized patient and the nurses’ on duty. It facilitates the communication where by the patient requires aid is able to be attended to at any given time without making noise. The help which patient may need may include going to bath room, changing of bed sheets, laying on the bed, when in pain, as the call lights prevents uncertain circumstances which may worsen the patients health.
The statistics collected in most of the health care units indicates that there has been an increase in the number of falls among the inpatients as it has been placed among the common crisis facing most patients in our health care centers. The falls have resulted in the sustenance of physical injuries that may in the long run increase the medical expenses and their stay at the center. The invention has been ranked among key reliefs as the nurses are able to closely monitor the operations of the patients at any given period. However, the effectiveness of the system relays much on the response of the nurses to any call made by a patient. It is believed that mean nurses seems to react much on the fallen patients calls compared to non fallen patients. The falls may occur as a result of either intrinsic or extrinsic depending on a given patient as they occur due to mental deficit, low vision, unsteady gait, the physical environment and the delays in attending to calls by the patients.
The purpose of the study was to analyze the impact of call lights in nursing.
The specific objective of the study is:
- To analyze the usage of call lights in nursing.
- To investigate the impact of call lights on the fall occurrence rate of patients.
- To realize the average response rate on call lights in nursing.
- What are the differences in Nurses’ average call light response times between the fallers and the non-fallers?
- What is the general function of call lights in nursing?
- What is the impact of call lights on the fall occurrence rate of patients?
SIGNIFICANCE OF THE STUDY
The study was carried out to in order to realize the impact of call lights in the nursing setting. The findings are of great benefit to in-patient care services and potential dispensary and hospital investors. The findings of this research will be a basis for advanced studies by other scholars who have got the interest to pursue a career in medicine.
SCOPE OF THE STUDY
The research study focused on Michigan hospital from February 2007 to June 2009. It was undertaken on both patients and nurses present at the time.
This chapter covers the literature relating to the impact of call lights in the nursing setting. The nursing setting taken into consideration is hospitals and any other healthcare service centers set up with an aim of improving human life. It particularly focuses on call lights in the Michigan Hospital and the factors which are affected. The factors include fall occurrence rate, average response rate and self care factors.
This study establishes some of the contributions that have been focused on by other researchers, authors and healthcare professionals. Growth strategy is a practical approach to achieving to-line and bottom-line results.
Chaos approach theory
Chaos theory and its companion model, complexity theory are emerging as legitimate schools of thought to describe how complex systems function.
In this research, the theory argues that call lights essentially functions as a chaotic non- linear, non-deterministic system. As such, existing call lights models fails to explain fully the complex relationships that exists between and among the various elements that constitute a call lights system (Tzeng & Yin, 2009).
System Management theory
It is a system by which an organization generates a global representation of its own processes. In other words, management upon modeling an organization; modeling allows management to perform its distinctive information, processing activities such as monitoring, prediction and control. The purpose to which these activities are directed defines the function of management. The function of management is a product of interaction between system and its environment (Tzeng & Yin, 2009). This is a consequence of way that management systems will tend to adopt to survive and grow in whether specific context in which they are operating.
Growth strategy theory
Call light usage has become significant in many health care centers that offer in patient services. With the aggressive promotion, this tool is expected to increase significantly as the public health sector gradually grows. This concept has gained popularity and one reason for its success has been the perceived need to cut patients off from risk of falls. It is observed that call lights as a tool has led to strong growth in health sector. However, there may arise cases of negligence by nurses hence a basis of critics airing their view on the incompetence of the tool. Therefore it is important for doctors to ensure that nurses uphold ethical standards in thus contributing positively to the functionality of the call lights.
As this concept grows, it is important that to institutionalize call light house education. For example, Harvard released a call lights strategy designed to address its influence in patient care and call lights education to provide undergraduate degree education. The objectives were to develop a strong and competent health care unit, establish a dedicated human and non human resource structure and development strategy, place the health care industry qualifications at par with professional qualifications, encourage robust international exchange of university students and faculty, promote partnership in joint research between international universities to enable shared views, build health care education programs with public health officers to manage education of students undertaking, public health, Bsc. Medicine as a course and courses related to medicine, decrease the reliance on conversion courses and raise the status of the industry as a career profession of choice. A number of physicians have come up with a phenomenon which has culminated into a belief that factors that influence the lives of all human beings are vital, which is true by all means and in all concepts. Hence the coming up with special departments which deal with emergency cases in such a department, skills, procedures and intellectual knowhow are important since it deals with human life (Reiling, 2006).
The traditional way of attending to patients was very unreliable. It was an evident case of complexity in nature, one that has to be squarely and comprehensively addressed those emergent health care destinations anxious to maximize the use of the call light tool. The complexity is about laying emphasis on the operation and benefits of the modern light call device. With the development, growth and expansion of the light call tool, there has been a corresponding proliferation in the range of activities engaged in, participated in, attended and actualized from the health care stand point. The volume of attention that has been directed towards patients has been great hence decreasing rates of patient fall and increased response rate of nurses to patient calls.
The study focused on three independent variables. These are the various factors that call lights have an impact on, in the nursing setting. These included: fall occurrence rate, nurses mean response rate and call light usage.
Fall occurrence Rate
This is considered as a fall which is not intentional and. It was conceptualized as a rest on the lower level. It was also considered as the lowering of the body on the floor. In this research, fall occurred when a patient lost his/ her balance and thus resulting in the lowering of the body by either influence from a helper or alternatively, incidentally found on the ground. Situation s that attracted attention and those that didn’t attract any attention at all were all considered.
The fall record was estimated to be at a constant rate in a number of hospitals as time has gone by. Nearly a third of the patients that fall get physical injuries leading to a longer stay in the hospitals. Such a crisis happening should however be a turning point for a satisfactory alteration of staff for stated estimated period of time basing on the number of patients and the size of the healthcare unit. Factors that influence falls and the management of crisis have however already studied. In calculating the fall occurrence rate, a single binary variable is put into consideration. The fall that was included was the initial first fall experienced during the whole stay of a patient in the health care unit. Various programs have been set up in a number of health care centers for patients to prevent falls although they have had limited success due to the fact that there exists complexity of disorders possessed by a number of patients. There are also cases of deficiency in functional of a number of patients.
Nurses mean response rate
All calls that are initiated from the speakers on the pillow and calls made via cord were generally taken as ordinary calls. The time taken to respond was describes as the time duration the period moment when the call was made active to the moment cancelling of the call was made effective from the room of the patient. The time duration for response by the staff was utilized. The rate of response was determined for all the calls completed in the stated 24 hour duration. This was after and before the work shift in which the cases of patient fall occurred (Miller, Deets, Miller, 1997).
The disparity assumed considering the perception of nurses and in-patients problems relating to safety. This in particular is due to the impatience possessed by some patients in cases when there is no immediate response. The patients then try to sort out themselves hence threatening their safety. In calculating the mean response rate, the operational definition was: the time in seconds that full calls were made via the light call, multiplied by the total sum of calls made via the light call during a period of twenty four hours.
Call light usage
The general count on calls was inclusive of all the calls that were cancelled at the destination or at the original station. The room of the patient was noted at the point after and before the work shift that included a fall by a patient. Great importance has been upheld as call lights is an important link of communication to the patients and the nurses. Usually, there is intention to give notification to the nurses that certain assistance is needed by the patient in a particular room. The patients in the rooms always expect that when they initiate a call at any point of time, a nurse would show up at his or her service. Although the light calls are of great benefit to the patients, critics may argue that it is a source of noise or interruption many a times.
In the calculation of the rate of light call usage, the following consideration was made: a count was made on the calls made normally that are made within a twenty four hour period of time duration and also considering that a fall occurred after each light call was made.
As all the above is taken into consideration, risks should never be underestimated or fully or partially neglected. Risks are unforeseen events whose outcome can never be predicted or pre-quantified. They are categorized into either intrinsic or extrinsic in nature on each and every patient. Risks factors should not be considered individually since they are objective if not subjective. They therefore should be considered in an individualistic manner. Risk factors that are intrinsic are vital in relation to every person that may be affected. The intrinsic risk factors may be in relation to: a deficit in the state of the mind, vision impairment and there being occurrence of falls in the past (Emanuel & Fuchs, 2008).
The factors that are extrinsic are those which are related to the outward state. These factors are usually related to the surrounding atmosphere which can be considered simply as the environment when the call lights are not answered appropriately. It is believed that causes of serious falls were due to the lack of proper care to the patients in the health care units.
Often, there are members of staff who ignore risks hence there being a rise in limitations that are physical. With this, the issue of ethics comes in. Ethics are the generally accepted rules and principles which wholly describe an individual’s nature (Tzeng & Yin, 2008). However, there are cases of errors occurring, which should be acceptable and taken as inevitable and common.
Through the URAC, the center must utilize current health care guidelines when assessing a patient’s condition that are approved by physicians. Through the set policies and regulations by the URAC, proper measures needs to be taken into consideration according the schedule lied that clearly relates with the doctors schedule. There is need for the management in any health care center to ensure that all the nurses’ are called upon to attend to all calls without discriminating on the consistence as it has been realize that most of them seem to attend much on the fallen patients compared to the non-fallen victims. As through proper supervision in the center, the unnecessary cases of emergency in wards can be relatively reduced.
The patient safety is a key agenda that needs to be fully addressed at any given level. For the approval of the patient centered care unit, the entire staff is called upon to set rules and policies that work towards the insuring of the effectiveness in relation to the needs of the patient under any circumstances. The nurses’ response should be a key agenda that should be given priority as its efficiency will create a good rapport among the entire health care center and the society at large.
All the centers are called upon to institute an on-the-job training program in relation to responsiveness of the call lights among the nurses. The program will familiarize all the nurses as they will be able to have proper knowledge on handling all the emergency cases and all those requirements that are normally requested by the patients. They will acquire all the relevant skills that will help them in attending to all the inpatients at any given time.
Through the research, the researchers have been able to identify all the factors that are currently influencing the growth of the health care centers in the society. The information collected will allow the government and other non governmental organizations budgeting and planning for the health care sector in relation to the funding of the project of installing more call lights in its centers so as to improve the process of service delivery in most of all the centers. The government is also called upon to set up more health training institutions that will focus on the usage of the call lights, its effectiveness, efficiency and usefulness in a health care unit. Through the institutions, the nurses will be able to equip themselves with the current changes in technology that will enable to have more knowledge on the functioning of the call lights and health related modern gadgets that use the new technology.
There is need for improvement of the entire communication system in the entire health care center. The executive needs to set up current and modern means of communication that links up the patients and the nurses without any delays. The installation of a Closed Circuit Television (CCTV) that will improve the monitoring of the welfares of all the patients as the management will be able to review all the per-takings by the nurses at any given time through the CCTV as all the call lights made will be recorded and time given in relation to the nurses response. It will also enable all the nurses on duty to observe all the happenings in the patients rooms while in their rooms. The nurses will be able to attend to any case of the patient as they will be able to see and hear the call light within the time schedule hence reducing any delays that normally occur among the nurses.
The health sector should hire a special nurse to monitor and identify the wards where the call lights are originating. The nurse will call and direct other nurses on duty to immediately attend to the needy patients in the respective locations. This will avoid circumstances where all nurses are not in the control room that sometimes led to delays in response to the call bells by the patients.