Does revealing contextual knowledge of the patient's intention help nurses' handling of nurse calls?

Int J Med Inform. 2016 Feb:86:1-9. doi: 10.1016/j.ijmedinf.2015.11.010. Epub 2015 Nov 26.

Abstract

Objectives: An inherent part of nurses' work is to handle nurse calls that often cause challenging interruptions to ongoing activities. In situations when nurses are interrupted by a nurse call, they need to decide whether to continue focusing on the task at hand or to abort and respond to the nurse call. The difficult decision is often influenced by a number of factors and can have implications for patient safety and quality of care. The study investigates how technology could be designed to support nurses' handling of nurse calls by allowing patients to communicate a more contextualised message revealing their intention to the nurse when issuing a nurse call.

Methods: Through a qualitative methodology employing a scenario-based design approach, three different nurse call system concepts are evaluated by nurses from different departments of a Norwegian university hospital.

Results: Nurses find the uncertainty of not knowing the reason behind a nurse call stressful in situations where they are required to prioritise either the calling patient or a patient they are currently nursing. Providing information about a patient's intention behind a nurse call influences the nurse's decision to various degrees depending on the situation in which they find themselves and the information that is communicated. The nurses' reflections suggested that the message communicated should be designed to contain neither too little nor too much information about the patient's needs.

Conclusions: A nurse call system that allows nurses to discern the reason behind a nurse call allows them to make a more accurate decision and relieves stress. In particular, the information communicated would reduce uncertainty and lessen nurses' dependence on other factors in their decision. The design of such a system should, however, carefully consider the needs of the department in which it is deployed.

Keywords: Communication; Interruptions; Nurse call; Qualitative research.

MeSH terms

  • Attitude of Health Personnel*
  • Efficiency, Organizational*
  • Health Facility Environment
  • Hospital Communication Systems / statistics & numerical data*
  • Humans
  • Medical Errors / prevention & control*
  • Nursing Staff, Hospital / organization & administration*
  • Patient Safety
  • Task Performance and Analysis*
  • Wireless Technology / statistics & numerical data*