Quality Improvement Project
Answering the call light (also called call bell a handheld like that is attached to the patient room wall, above the headboard of the bed) in a timely manner by the nursing staff in hospital setting is necessary to prevent falls that can harm, prolonged stays, and unnecessarily increase the cost of healthcare. However, researches concerning call light uses as it relates to patient safety, patient-care management and patient satisfaction are limited (Meade et al. 2006). Patients and their families emphasize that nurses should monitor patients constantly and provide assistance and answer a call light in a timely manner (Yoder, 2011). Note that the falls may be caused by several factors such as physiological, psychological and/or environmental-related to each individual patient (Joint Commission, 2005). The nurse initiating this project will focus on the rate of falls related to a delay in response to the call light.
The hospital, where the Quality Improvement Project (QIP) is done, uses the Hill-Rom system to operate and record the time it takes to respond to a call light prior to the incident as base for the (QIP). The nurse will identify opportunities to improve the quality of care delivered as well as the response time to a patient's needs. The nurse working on the project used the study done by (Tzeng & Yi Yin, 2009) as a model to follow. In fact, Tzeng & Yi Yin suggested that the goal of the quality care is to reduce the response time to the call bell to a number that is unlikely to lead to a fall. During their project, the authors explored the contribution of the call bell use rate and the average response time to the fall rate, the injurious fall rate and patient satisfaction scores that occurred in four adult inpatient acute care units (Tzeng & Yi Yin, 2009). Improving the responsiveness to the call light and reducing the fall rate is important for both the safety of the patient and the reputation and success of the organization. Yoder proposed that the patients are becoming more sophisticated and view themselves as “consumers” who can take their business elsewhere (Yoder, 2011).
Since the hospital is a Magnet and applies the shared governance model, there is an organizational structure for nursing quality that can facilitate the project. In fact, each unit has a designated staff member for the Unit’s Council Quality Champion (UCQC). This unit representative functions as a quality improvement resource for the unit council, and performs unit-based monitoring and analysis as well as collaborating with unit staff members on improvement plans. This allows for an opportunity to network and share best practice (MLHS, 2010). The nurse handling the project can set up a meeting with the UCQC, and ask for input from other members such as patient care manager (leadership in implementing changes), physicians (after assessing the patient, leaving the bed in high position), housekeeping (placing caution signs on a wet floor), pharmacy (flagging medications that can contribute to falls such as sedatives, hypnotics, beta blockers), and dietary service (placing trays within the reach of the patient). The multidisciplinary team allows for a better planning approach to the subject and prevents malpractice (Yoder, 2011)
The information recorded from the patient room call light system was used in this study. The rate of inpatient falls, which have long been perceived as a nursing-sensitive quality indicator, is defined as the rate at which patients fall during their hospital stay per 1000 patient-days (American Nurses Association, in Tzeng & Yi Yin, 2009). As the nurse working on the QIP a notification to the institutional review board will be sent if further approvable are necessary. The only statistical data the nurse could obtain from the manager are related to the numbers of falls per 1000 patient days with injury. The data gives us information about the rate of falls in...
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