Research Brief
Perspectives of staff nurses toward patient- and family-initiated call light
usage and response time to call lights
Huey-Ming Tzeng, PhD, RN
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Department of Nursing, School of Health Professions and Studies, The University of Michigan-Flint, Flint, MI 48502, USA
Received 13 January 2009; revised 7 March 2009; accepted 10 March 2009
Abstract This survey study describes nurses' perspectives about call light usage and response time. Staff
perceived call lights as being patient safety related (52%) and meaningful (81.6%), and answering
calls prevented them from doing the critical aspects of their role (43.8%). Staff's perspectives toward
call lights should be surveyed on a regular basis.
© 2011 Published by Elsevier Inc.
1. Introduction
Hospital inpatient falls consistently comprise the largest
single category of reported accidental falls (Joint Commis-
sion, 2005). Inpatient falls can lead to injury, prolonged stays,
lack of patient independence, and additional resource
expense. It is commonly assumed that if a nurse responds
to a call light more quickly, the patient may have less
opportunity to fall. Conversely, call lights have been
commonly perceived by nursing staff as noise and interrup-
tions to nursing tasks, instead of an important way for patients
to request assistance (Deitrick, Bokovoy, Stern, & Panik,
2006; Meade, Bursell, & Ketelsen, 2006). Deitrick et al.
(2006) used ethnographic methods to examine problems
related to answering patient call lights on one acute, medical–
surgical, inpatient care unit. They found that communica-
tion through the call light consisted of three interrelated
components: (a) answering the call light, (b) communicating
the patient's request, and (c) following through with the
request. Frustration over delays in answering call lights was
one of the most frequent comments patients made.
Tzeng and Yin (2008) investigated the extrinsic risk
factors for inpatient falls in an acute medical unit and
identified several human resource issues related to call light
use, including difficulties in determining patient care
priorities, nursing staff's misconception about the purpose
of call lights, call lights not being answered in time,
difficulty in implementing scheduled observation plans and
toileting plans, and patient assignments not being in
proximity (resulting in delays in responding to call lights
and patient needs). A study (Tzeng & Yin, 2009a) assessed
the opinions and observations of recently discharged older
adult patients about the fall prevention program during their
most recent hospitalization. Delayed response to call lights
was indicated as one of the main safety concerns. Another
recent study (Tzeng & Yin, 2009b) used archived hospital
data to determine the contribution of the call light use rate
and average call light response time to patient outcomes in
inpatient acute care settings. The patient care unit was the
unit of analysis, with data aggregated by month for
analyses. It revealed that, when the average response time
to call lights was longer, the patient satisfaction scores
were lower.
In short, the call light response time is often assumed to
be linked to patient satisfaction with nursing care, although
this linkage has not been verified. A recent study (Roszell,
Jones, & Lynn, 2009) examined the correlation between the
patient satisfaction at discharge in relation to the number of
call light requests from the patient's room and call light
response time in a 32-bed surgical unit (the individual
patient was the unit of analysis); however, no statistically
significant relationships were found. It is arguable that
nursing staff's perspectives and actions toward call lights
may mediate the relationship between call light use
frequency and call light response time and inpatient fall
rates in inpatient acute care settings. No studies have
explored the perspectives of nursing staff toward the reasons
for and nature of call lights.
Available online at www.sciencedirect.com
Applied Nursing Research 24 (2011) 59 – 63
www.elsevier.com/locate/apnr
⁎
Tel.: +1 734 358 0358.
E-mail address: tzenghm@gmail.com.
0897-1897/$ – see front matter © 2011 Published by Elsevier Inc.
doi:10.1016/j.apnr.2009.03.003