When the nursing staff on the 12th-floor orthopedic and spine unit at NYU Langone Medical Center Hospital for Joint Diseases noticed responses to patients’ call lights were not timely, they brainstormed to find a way to remedy the problem.
While researching call light response times, literature spelled out how important a timely response was when patients needed assistance. A 1994 study by K. Van Handel and B. Krug, “Prevalence and nature of call light requests on an orthopaedic unit,” published in the January/February issue of Orthopaedic Nursing, concluded “unanswered call lights of immobile orthopedic patients can create a sense of helplessness and fear.”
Using input and feedback in the form of an opinion survey from the RNs and nursing assistants, Patricia Lavin, RN, MS, and team members Marcy Evans, RN, BSN; Loradelle Abott, RN, BSN; and Carmen Moran, RN, MS, implemented a standard change-of-shift report for the unit’s nursing assistants to ensure patients’ needs were consistently met, thereby reducing the number of calls.
The two-week pilot process looked at assistance with toiletry and movement — areas in which patients reported improvement, said ortho nurse Beverly Ramsey, RN, who discussed the program at a recent roundtable with Nurse.com Nursing Spectrum staff. “Call button help as soon as wanted, increased from 42% at the beginning of the pilot to 51%, and help with toileting as soon as wanted, increased from 48% to 60%,” she said.
The numbers show marked improvement in Hospital Care Quality Information from the Consumer Perspective scores for the first quarter of 2011. If scores continue to improve, staff will recommend checklist implementation on all inpatient units.
This project is one of many that nurses at NYU HJD have implemented to improve patient care.
With a mission of “Teach. Serve. Discover.” the nursing department’s patient and family-centered professional practice model — designed by Anna Sevilla, RN, BSN; Juanita Vergera, RN, BSN; and Rhesa Zarate, RN, BSN — focuses on professionalism, integrity, respect, excellence and diversity, said Althea Mighten, APRN, EdD, BC, director of nursing education and recruitment.
“The nurses here spent several months researching the literature and gathering ideas before submitting several drafts of what that revised model should be,” Mighten said. “Of the 19 different revised models, these five made the final list. Nurses then voted over a two-week period for the model that they believed would help us achieve our desired outcomes.”