Improving Nurse Responsiveness
Allison Brown, Bethany Zimmerman, Kayla Myers, Madelyn McLain, & Morgan Tolbert
Description of the Issue
Macro:
● Nursing responsiveness is primarly based
on the pereception of how quickly the nurse
responds to call bell requests (Michell,
Lavenberg, Trotta, & Umscheid, 2015).
● Hourly rounding has been shown to
increase patient and nurse satisfaction by
reducing call light use. Hourly rounding
prorams also improve perception of nurse
responsiveness (Michell et al., 2015).
● Patient Surveys look at patient perception of
nurse responsiveness and hourly rounding.
Responses to HCAHPS surveys affect
hospital reimbursement.
Micro:
● HCAHPS scores are low on patient
satisfaction to nurse responsiveness.
○ Range over past year 49-83%
● Lack of understanding from the patients and
the staff on effective hourly rounding.
● Ineffective communication between team
members slows responsiveness.
● Ineffective teamwork and shared
responsibility in answering the call bells and
patients are waiting longer.
Bon Secours Memorial College of Nursing
Analysis of the Issue Solution
In our two step solution, if call bells rang to a desk
Our goal is to understand patient perception of where a secretary relayed the message to staff via a
Vocera hands free device, then this will prevent delay in
responsiveness of staff, how it relates to
nurse responsiveness and improve patient satisfaction,
patients’ needs being met, and HCAHPS thus increasing HCAHPS scores by 10% from
scores. Three themes emerged when data was implementation of the Vocera devices (Richardson &
collected from nursing staff and patients on the Ash, 2010).
unit: ● Vocera hands free device is a more direct route of
● Ineffective communication communication and easier route of locating staff
(Pemmasani et al., 2014)
● Ineffective teamwork ● Using Vocera hands free device helped to reduce
● Non intentional hourly rounding. nursing staff steps by over 2,000 per shift
(Pemmasani et al., 2014)
Root Cause ● Online Vocera education of all staff
● Purchasing Voceras
● Purchasing Vocera badges
Logistics ● Educating all secretaries on proper delegation
The root cause is ineffective communication ● Electrical configuration of call bell system to
secretary desk.
between team members in response to
patient needs and/or requests. We came to ● Hospital
● Unit Secretaries
this conclusion after interviewing patients ● Nurses
Stakeholders ● Patient Care Technicians
and staff on nurse responsiveness.This ● Nurse Leaders
communication breakdown causes a delay ● Online Vocera education of all staff
in meeting patient expectations and is ● Educating all secretaries on proper delegation to nurse
or patient care technician
reflected in this unit’s low HCAHPS scores Cost ● Purchasing Voceras
● Purchasing Vocera badges
(Williams, 2014). ● Electrical configuration of call bell system to secretary
desk
References ● eless controllers, servers, charging port, etc)
● Step 1: Rewiring the call bells to the
Mitchell, M. D., Lavenberg J. G., Trotta, R. L., & Umscheid, C. A. (2014). Hourly
rounding to improve nursing responsiveness: a systematic review. The Journal of secretary desk (within 3 months)
Nursing Administration, 44(9), 462-72. Timeline ● Step 2a: Purchasing Voceras and providing
staff education (6 months)
● Step 2b: Implement Voceras on the floor (8
Pemmasani, V., Paget, T., Minamareddy, P., Pemmasani, S., & Van Woerden,
months)
H.(2014). Hands-free communication free up nursing time.Nursing Times. 110. 12-14.
● Management will survey nursing staff about
Richardson, J. E., & Ash, J. S. (2008). The effects of hands free communication communication improvements on the unit
devices on clinical communication: balancing communication access needs with user Collection ● Management will survey nursing staff for
overall satisfaction on vocera use
control. AMIA ... Annual Symposium proceedings. AMIA Symposium, 2008, 621–625.
Data ● Management will survey patients on nurse
response time
Williams, D. B. (2014, December 12). Improving Staff Responsiveness to Patient-
Initiated Call Lights. Master's Projects and Capstones. 57.