Call Light Responsiveness and Effect on Inpatient Falls and Patient Satisfaction

描述（由申请人提供）：住院患者跌倒可能导致受伤、住院时间延长、患者缺乏独立性和额外的资源费用。这个研究项目的长期目标是了解导致跌倒的因素，并开发和测试预防跌倒的干预措施。关于护理人员对病人呼叫灯的反应时间的研究很少，因为它有助于预测病人摔倒。该项目扩展了PI关于住院患者跌倒风险因素的初步发现，特别是呼叫灯的使用和对跌倒的响应时间与患者满意度之间的关系。本研究的具体目的是研究呼叫光响应时间在预测以下方面的独特贡献：1)总坠落率，2)伤害性坠落率，以及3)患者对呼叫光响应的感知。我们将使用2002年1月至2008年12月的医院存档数据/报告，分析密歇根州四家医院（三家教学医院和一家社区医院）32个单位的数据。数据将从存档的医院数据/报告中提取，并使用多元回归分析来解决以下假设：H1)呼叫灯响应时间将显著有助于预测跌倒率。H2)呼叫光响应时间将显著有助于预测伤害性坠落率。H3)呼叫光响应时间对患者呼叫光响应感知有显著影响。因变量为总坠落率、伤害性坠落率和患者对呼叫光反应的感知。主要的自变量是呼叫光响应时间。控制变量为医院、单位类型、呼叫灯使用率、每患者日总护理时数（HPPDs）以及注册护士提供的总护理时数的百分比。对于回归分析，患者护理单位-月将是分析单位，定义为每个患者护理单位按月汇总的数据。样本量（N=2688）将提供足够的统计效力。这项多医院研究设计的结果将增加对多个成人急性住院病房中工作人员对呼叫灯和跌倒的反应时间与患者感知之间关系的理解，并将为未来的描述性和干预研究奠定基础。长期目标是促进住院病人更安全的住院，包括减少住院病人跌倒和跌倒伤害。

DESCRIPTION (provided by applicant): Inpatient falls can lead to injury, prolonged stays, lack of patient independence, and additional resource expense. The long-term goal of this program of research is to understand factors that contribute to falls and to develop and test interventions to prevent them. Little research has been done on the nursing staff's response time to patient call lights as it contributes to predicting patient falls. This project extends the PI's preliminary findings on the risk factors for inpatient falls, and specifically on the relationship of the call light usage and response time to falls and patient satisfaction. The specific aims of this proposed study are to examine the unique contribution of call light response time in predicting: 1) total fall rates, 2) injurious fall rates, and 3) patients' perceptions about call light responsiveness. We will analyze data from 32 units from four Michigan hospitals (three teaching hospitals and one community hospital) using archived hospital data/reports from January 2002 to December 2008. Data will be abstracted from the archived hospital data/reports and multiple regression analyses will be used to address the following hypotheses: H1) Call light response time will contribute significantly to predicting fall rates. H2) Call light response time will contribute significantly to predicting injurious fall rates. H3) Call light response time will contribute significantly to predicting patients' perceptions about call light responsiveness. The dependent variables are the total fall rate, injurious fall rate, and patients' perceptions about call light responsiveness. The primary independent variable is call light response time. The control variables are the hospital, unit type, call light use rate, total nursing hours per patient-day (HPPDs), and percent of the total nursing HPPDs supplied by RNs. For the regression analyses, the patient care unit-month will be the unit of analysis defined as data aggregated by month for each patient care unit. The sample size (N=2688) will provide adequate statistical power. Findings from this multi-hospital study design will increase the understanding of the relation between staff response time to call lights and falls and patient perceptions in multiple adult inpatient acute care units and will lay the foundation for future descriptive and intervention studies. The long-term goal is to promote safer hospital stays for inpatients, including fewer inpatient falls and fall injuries.