I recently visited a friend while they were in the hospital and during my visit, I stopped by the coffee shop. As I sipped my coffee, I listened to the calls the nurses were receiving on their unit-specific mobile phones. While I can appreciate that a phone makes for better communication between the nurses and hospital staff, I can also appreciate that the same staff are unaware that the phones are inadvertently putting patients at risk.
During the hours I spent with my friend, I was inadvertently present for phone conversations, all on speaker, regarding what patients required pain medication and their room numbers, whose test results were received and their result, what patient was being combative and needed sedation, and who required pain medication. I heard patient names, room numbers, physician names, and patient conditions. And I learned that the wife of the gallbladder in 100B called. Needless to say, it was an interesting and enlightening time. Let me just say that when HIPAA became de rigueur, nurses would have been fired for less illicitly passed information than I learned that afternoon. You weren’t allowed to utter a patient name or room number anywhere where other patients or family members or the public in general were located. If overheard or reported by fellow staff, you were terminated.
The nurses carrying on these conversations were on a break from their units, attending a Nurses Week event, but I’m sure these conversations occur all day long, no matter where the nurse is… in report, at the bedside, at lunch, even in the bathroom. While I’m sure the latter is at most inconvenient and intrusive, the prior is downright dangerous. I’m sure if they even get a break off the unit, the phone goes with them and so does the stress.
We teach students and new nurses to prepare medications where they are not distracted, to check everything multiple times. We never tell them “OK, let’s see if you can titrate this medication while a disembodied voice is telling you about another patient who urgently needs you.” We also don’t teach them that while they are attempting to complete complex therapy requiring their undivided attention while keeping a field clean or sterile, that they will be called multiple times about multiple patients. Several studies have noted that these distracted nurses are at higher risk of committing a medication error or an error of omission.
Do they change gloves and wash their hands after handling the phone? Do they ignore the calls when they are in the middle of changing a dressing or toileting a patient? A 2009 study in Turkey found that 94.5% of health care workers’ cell phones tested positive for bacteria including the MRSA. Further, it was found that mobile phones were only cleaned per policy 10.5%. That leaves a staggering 89.5% that were NEVER cleaned! You don’t need to be an infection control nurse to figure out that the mobile phones carried by nurses and other staff are contaminated with nosocomial pathogens that place both the staff and their patients at risk. So along with the importance of hospital staff washing their hands after patient care, they must also be mindful of hand hygiene between patient care and handling of their mobile phones.
Although many hospital systems have implemented policies with regards to mobile phone use, hopefully to increase patient safety and confidentiality, they need to be reviewed and reinforced periodically. It is easy to become desensitized to our actions and those of others in the health care field and it is pretty glaring when violated. Policies should include when the phone should be in silent mode, when and how phones should be cleaned, and how calls to nurses should “roll over” to the nurse’s station—especially when staff are involved in patient care activities. The policy should also include enforcement and the consequences of policy violation.
