Reasons for after-hours calls by hospital floor nurses to on-call physicians.

Published

Journal Article

BACKGROUND:Communication failure is a common root cause of preventable medical errors affecting hospitalized patients. A study was conducted to determine the reasons for calls made by nurses working on the general medical wards to on-call physicians from 6:00 P.M. to 7:00 A.M. METHODS:A retrospective review was performed of a random sample of 500 inpatients admitted to general medical wards at an urban public teaching hospital in Houston between January 1, 2000, and February 28, 2003. RESULTS:In 139 (47%) of 293 medical records there were 304 documented calls. The majority of calls (81%) took place between 6:00 P.M. and 2:00 A.M., with peak call volume between midnight and 2:00 P.M. Patients with one or more calls had an average of 2.2 calls during their stay. Ten categories accounted for 65% of all the nurse calls. In 44% of calls, physicians responded by ordering a medication. DISCUSSION:Communication between floor nurses and on-call physicians might be improved by several interventions. Because 10 reasons accounted for 65% of after-hours calls, protocols could allow nurses to resolve some acute problems without physician involvement. For example, appropriate standing orders (e.g., PR.N. medications) may prevent some calls. In addition, sign-out procedures can be tailored to address common problems that are likely to require future telephone communication. With efforts to change error-prone systems, it seems prudent to focus on after-hours coverage.

Full Text

Duke Authors

Cited Authors

  • Bernstam, EV; Pancheri, KK; Johnson, CM; Johnson, TR; Thomas, EJ; Turley, JP

Published Date

  • June 2007

Published In

Volume / Issue

  • 33 / 6

Start / End Page

  • 342 - 349

PubMed ID

  • 17566544

Pubmed Central ID

  • 17566544

Electronic International Standard Serial Number (EISSN)

  • 1938-131X

International Standard Serial Number (ISSN)

  • 1553-7250

Digital Object Identifier (DOI)

  • 10.1016/s1553-7250(07)33039-0

Language

  • eng