As featured in Health Estates Journal, Medicare Systems, discusses some of the features and capabilities of modern nurse call systems – the functionality of which now extends well beyond their original purpose, explains what to look for when considering purchasing one, and looks ahead to what new features we can expect to be incorporated in the future.
Nurse call systems have been a vital part of hospitals since the Victorian era. Today’s systems are an essential part of nursing, and bear little resemblance to their predecessors. Nurse call systems today need to be functional to withstand the demands of a fast-paced hospital environment. It would be fair to say that many systems are no longer simply a nurse call system; their enhanced technology allows hospitals and other healthcare facilities to access a wider range of features, transforming the way that such institutions operate, and including many advantages for nurses, both directly and indirectly.
Medicare Systems’ MD, Derek Timoney, explains how ‘the information required these days for a nurse call system is far more than just an acknowledgment that the patient in bed 3 has pushed her call button’. He says: “The growth in technology, plus the needs of nursing staff and patients, have led to massive changes in the way the call system operates. We have seen systems with just audible or visual identification become systems with numerous functions, including emergency call, cardiac alert, and real-time data recording, along with the advent of wireless systems which can be installed in hours rather than days, all operating within the busy environment of today’s hospitals. Technology is all-pervasive in our modern-day lives, nowhere more so than the healthcare industry. Indeed, as Pamela Cipriano said in a 2009 article, ‘The technology enabled nurse’, ‘Technology is the greatest tool available to transform and innovate the delivery of nursing care’.”1
What is a nurse call system?
Firstly we should define what a nurse call system is? A nurse call system is, first and foremost, a highly cost-effective solution for monitoring the wellbeing of patients. It ensures that when they have a particular need – whether it is simply for a drink or something to eat, or a medical emergency, medical and nursing staff are alerted and can respond quickly However, modern nurse call systems need to offer considerably more if they are to compete in today’s market.
The key to a contemporary nurse call system is being multifunctional, yet still retaining the simplicity of some of the earlier systems. Nurse call systems now have so much to offer in terms both of improving the patient experience and assisting the nurses caring for them.
There are three points that are fundamental to any room unit:
Performance – The buttons need to be clearly displayed and colour coded. Ask yourself, are the buttons too close together? You don’t want a nurse to press the wrong button by mistake. Each button/call should trigger a different tone for clarity between calls.
Smart – While the functionality of your room unit is key, it also needs to look smart within the bay. The unit needs to be crisp and clear. Hygiene is paramount in hospitals, and ensuring that the nurse call units and system components are easy to clean is vital.
Robust – A nurse call unit or components that will break at the slightest knock are no use to a hospital or other healthcare facility. Hospital environments can be extremely busy, and there is thus a strong chance that your unit could be dropped, so you need to ensure that the unit you choose will stand the test of time. Bedroom units include two sockets, one for the pear push lead and a second for auxiliary items. Your call point should be mounted on a bracket so that it can be moved if required, for safe, easy operation, or secured using a locking clip.
Display panel requirements
Display panels should include the very latest in technology, offering multiple options to suit all environments. There must also be a variety of sizes available, and the option of a wall or desk-mounted display panel to provide the ability to view multiple calls on the same screen. Your display panel will be easily programmed to show just a room number or more detailed individual information specific to your needs. The panel will offer a variety of tones, depending on the call type, which will make it easier for nursing staff to establish the urgency of a call. Display panels will also typically show call logging – the primary aim of which is to monitor, record, and print reports on all calls and responses, providing evidential data for reports.
Medicare Systems’ Call Logging facility makes reporting easy. The key with call logging data is that it needs to be simple, yet at the same time to provide all the necessary information, enabling the recipient to monitor and record all responses. This in return helps to ensure that hospitals and other healthcare facilities get all the information that they require to provide high levels of accountability and efficient delivery of patient care.
Another key feature to consider within a nurse call system is the aesthetics. With technology and manufacturing moving forward there is no excuse for bulky and unsightly systems. The design of the nurse call system should be such that it is immediately clear how to access the key functions, particularly given that in an emergency situation there may be no time to think about which button needs to be pressed. Once staff have been trained, using the system should become second nature.
When choosing a nurse call system, it is important to ensure that the panels are colour-coded to meet HTM guidelines, as follows:
- Standard calls (orange).
- Assistance calls (yellow).
- Emergency calls (red).
- Staff presence (green).
- Call acceptance (grey).
Call points should also employ HTM colouring as standard, with raised buttons to assist patients with poor eyesight.
Wired vs. wireless?
There is still an ongoing argument as to the respective merits of wired vs wireless within the nurse call. Each option has both its positives and negatives to consider (see Table 1), and indeed many manufacturers today offer both wired and wireless systems, to suit the particular application.
‘Landscape’ wireless room units
One flexible solution is with newly designed landscape wireless room units. These are able to fit into bedhead trunking within hospital wards, creating the illusion of a traditional wired system fitting in with the hospital environment, yet simultaneously offering the cost effectiveness and time-saving benefits of a wireless system. Many now argue that wireless call systems offer maximum flexibility, in turn allowing for better care process management. The appropriate use of the system should free up time for staff and enable them to ‘work smarter’, while the greater the ‘future-proofing’ embedded, the better the system will be able to ‘flex’ and be expanded/added to in the future, to address changing demands.
There may be an area of the hospital which presents frequent high dependency situations, and here the ability to offer an emergency response is critical. Nurse call companies will offer a specific button for this, often a unit with a single HTM compliant blue button. A cardiac/crash unit would be ideal for an emergency department within the hospital.
Door contact units
Again, there may be specific areas of the hospital where you may need extra security for patients. A door contact unit is designed to provide an easy-to-operate monitoring system for internal and external doors. The unit will be easily armed and disarmed, often using a magnetic swipe fob or infra-red trigger, and will usually offer an emergency call button for added safety and security.
With the development of ever more sophisticated and capable call systems, various additional features have been added over recent years. Nurse call manufacturers today offer a variety of accessories. These will typically interface with the installed system and aid even the most severely disabled patient in operating it, while a number of accessories and additional components are designed to provide vital alerts to nursing and clinical teams. For example, pressure mats are now available which will activate an alarm should a patient leave their bed or chair, while installing movement sensors will let staff know if a patient is on the move.
Thanks to advanced understanding of illnesses today, there are many specifically designed accessories to address the needs of patients living with illnesses such as epilepsy and dementia – for example, specialised Epilepsy monitors, seizure alarms, and tremor alarms. There may be situations when a patient struggles with the ‘pear push’ button, for example if they have only limited use of their hands and require something a little more touch-sensitive. There is now a diverse range of switches and buttons available to aid every need – from extra-large, extra-sensitive buttons, to finger switches and even breath switches – to ensure that every patient need is met.
An important element when considering selecting a nurse call system is the potential disruption that can be caused during its installation. Thankfully, due to considerable advances in technology, wireless nurse call systems offer a simpler installation than their hard-wired counterparts. MD, Derek Timoney, explains: “A radio system with access to all points on the day could be installed in around five hours – there may typically be a couple of display panels in the ward, one at the nurses’ station, and one in the body of a ward. With ‘wireless’ systems we see all the required components installed in hours rather than days. With no wires to worry about, no fundamental changes are needed to the building, while very little manual labour is required. There is thus minimal disruption for either residents or staff, and generally no need to redecorate after the system has been installed.”
As mentioned previously, a modern nurse call system should be straightforward to use. To ensure that all staff are confident and can use the system efficiently, free comprehensive training should be given. This is often provided on the day of installation, but a separate appointment should be made if staff members are not available on that specific day, or training could be provided online. Good aftersales support is also key – with an already overstretched service, hospitals and healthcare facilities need to know that there is someone on the end of the phone should they need it.
Infection control is clearly a paramount factor within the hospital environment, and equipment should be designed and manufactured with infection control strongly in mind. For example, call points need to be able to be easily wiped clean. Medicare designs its call points with the addition of Microban to the labels, while an anti-microbial additive is also added to the plastic during manufacture to enhance infection control. Pear-push leads should also be manufactured with both these additives, and need to be designed so they can be dipped into the cleaning solutions normally used within the hospital environment to clean surfaces. This will help to eliminate the spread of any infection.
When a wired system in a hospital fails it often affects the whole ward, and getting the fault repaired can be a time consuming process, with it often taking days to find the cause of the problem. During this time a ward is often without a fully functioning nurse alert system, and this is where hospitals need to be prepared for a crisis. Introducing a wireless nurse call ‘breakout’ system is a quick and easy solution to what could otherwise be a significant problem. The breakout system should take around 20 minutes to install, and then be fully functional immediately. A ‘breakout’ system that is pre-programmed for the hospital environment offers an open and practical solution in times of a nurse call crisis. It should be HTM-compliant and quick and easy to programme.
Research on the market
Having looked at what should be considered when selecting a nurse call system, perhaps we should take a little time to consider the future of the nurse call market? Will ongoing development of nurse call systems further enhance the quality of care patients can receive?
A report recently published by Markets and Markets2 about the global nurse call system market explains how an ageing population, the rising prevalence of chronic diseases, new product launches, technological advancements, and increasing healthcare expenditure, are among the major factors driving the growth of the nurse call market. The nurse call systems market is, it says, segmented into ‘buttons, integrated communication systems, mobile systems, and intercom systems’. It is predicted that the integrated communication systems segment will account for the largest share of the market, growing at an annual rate of 13.6% from 2018 to 2021.
The technology ‘division’ of the nurse call system market is spilt into wired systems and wireless systems. In 2018, the report maintains, wireless systems are expected to account for the highest growth rate in the market – driven by low-cost and fast installation, plus the speed of transmission of radio communication.
The development of technology in today’s society means consumers are expecting more and more. Whether it’s mobile phones, computers, or televisions, we are constantly adapting and improving products to make designs smaller and functions more advanced. This is certainly very evident within the healthcare sector. When wireless nurse call systems were introduced, and as they developed, they naturally became more ‘intelligent’, and there is constant pressure to continue improving such equipment and to offer hospitals multifunctional systems.
Del Gray, Medicare Systems’ technical director, explained: “These days call systems are no longer just alerts and alarms; they are an important part of the information technology employed in hospitals. Call systems have come a long way from the simple hand bell, and while their primary function remains the same, they offer so much more than just communication between staff and patients. People want more information, more data analysis, and more functionality.
Accountability and traceability
“Accountability and traceability are two increasingly key requirements, which is why we added features such as our call logging system. This feature allows hospitals to record all events and produce tailored evidential activity reports so that key performance indicators – such as staff response – can be monitored, or data provided if incidents need to be investigated. Routine or regularly required reports can be saved and automatically delivered to the required recipients by email, and maintenance is made easy by automated status reports. We have seen an increase in demand for location and tracking features, particularly within MHU, AMU, CCU, Maternity, and areas where the vulnerable staff or patients require monitoring. In these instances it is important to know who the individual that requires assistance or intervention is, and their location. Knowing the latter also ensures an efficient and timely response to events.”
Both society and the healthcare sector have changed enormously, the latter particularly within recent years with the increasing pressures facing both NHS and private hospitals. Through all these changes nurse call systems have continued to develop and adapt. Increasing demand for information at the point of care has prompted the introduction of a host of new products and technologies designed to simplify the job of those at the frontline, but it’s important not to encumber the user, so integration of these services is key to both the efficient running of a care facility, and the effectiveness of staff under increasing pressure to deliver care within tight budgets. Looking at the progressive nature of the nurse call system, and the new technology developed year after year, the future for such systems, and for companies such as Medicare developing and pioneering new technologies, looks an exciting one.
The original article can be found here.
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