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How Can We Improve Response to Call Lights?

Question

I am co-leader of the Inpatient/Outpatient Team. What is the best way to implement call light responses and improve response time?

Answer

Responding well to call lights is an important quality and risk issue. The best process focuses on eliminating call lights from going off in the first place. Most call lights are for toileting and positioning requests, pain medication requests, and personal needs requests. These reasons account for about 95 percent of call lights. The rest are urgent or emergent needs related to a patient’s condition. By addressing the needs of patients in advance of the use of the call light, you improve response to those that do occur, because at that point you know to “drop and run.” At the same time you save the staff work because there are fewer interruptions.

To accomplish this: Do hourly rounds on the patient that focus on eliciting her needs prior to her asking via call light (typically shared by RNs and CNAs). Nurses put PRN pain medication on their list of scheduled things to do so that the patient does not have to use the call light to request them. Respond to IV pump alarms and cardiac/respiratory monitor alarms urgently.

In the process of hourly rounds, first accomplish the task you were scheduled to do for the patient. Then say to her, “Is there anything else I can do for you…I have time.”

Once the patient says she’s fine, do an environmental assessment of the room (call light, telephone, and TV control within reach, bedside table next to the bed, garbage can near bed, etc.). Then tell the patient, “Mrs. Johnson, I will be back to check on you in about an hour.” By telling the patient when you will return, you give her the information to hold her next request until you come back. Patients will do this as long as the need isn’t urgent or emergent.

Certainly any staff member should address a call light and can be trained to triage those requests. It becomes simpler if the above process is in place first. Call lights should be an “all hands on deck” activity.