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

Publication ,  Journal Article
Bernstam, EV; Pancheri, KK; Johnson, CM; Johnson, TR; Thomas, EJ; Turley, JP
Published in: Joint Commission journal on quality and patient safety / Joint Commission Resources
June 2007

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.

Duke Scholars

Published In

Joint Commission journal on quality and patient safety / Joint Commission Resources

ISSN

1553-7250

Publication Date

June 2007

Volume

33

Issue

6

Start / End Page

342 / 349

Related Subject Headings

  • Telephone
  • Retrospective Studies
  • Nursing Staff, Hospital
  • Medical Staff, Hospital
  • Humans
  • Hospitals, Urban
  • Hospitals, Teaching
  • Hospital Administration
  • General & Internal Medicine
  • Communication
 

Citation

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Bernstam, E. V., Pancheri, K. K., Johnson, C. M., Johnson, T. R., Thomas, E. J., & Turley, J. P. (2007). Reasons for after-hours calls by hospital floor nurses to on-call physicians. Joint Commission Journal on Quality and Patient Safety / Joint Commission Resources, 33(6), 342–349.
Bernstam, E. V., K. K. Pancheri, C. M. Johnson, T. R. Johnson, E. J. Thomas, and J. P. Turley. “Reasons for after-hours calls by hospital floor nurses to on-call physicians.Joint Commission Journal on Quality and Patient Safety / Joint Commission Resources 33, no. 6 (June 2007): 342–49.
Bernstam EV, Pancheri KK, Johnson CM, Johnson TR, Thomas EJ, Turley JP. Reasons for after-hours calls by hospital floor nurses to on-call physicians. Joint Commission journal on quality and patient safety / Joint Commission Resources. 2007 Jun;33(6):342–9.
Bernstam, E. V., et al. “Reasons for after-hours calls by hospital floor nurses to on-call physicians.Joint Commission Journal on Quality and Patient Safety / Joint Commission Resources, vol. 33, no. 6, June 2007, pp. 342–49.
Bernstam EV, Pancheri KK, Johnson CM, Johnson TR, Thomas EJ, Turley JP. Reasons for after-hours calls by hospital floor nurses to on-call physicians. Joint Commission journal on quality and patient safety / Joint Commission Resources. 2007 Jun;33(6):342–349.
Journal cover image

Published In

Joint Commission journal on quality and patient safety / Joint Commission Resources

ISSN

1553-7250

Publication Date

June 2007

Volume

33

Issue

6

Start / End Page

342 / 349

Related Subject Headings

  • Telephone
  • Retrospective Studies
  • Nursing Staff, Hospital
  • Medical Staff, Hospital
  • Humans
  • Hospitals, Urban
  • Hospitals, Teaching
  • Hospital Administration
  • General & Internal Medicine
  • Communication