18/03/2010 by David Slade.

Patient’s calling devices

Patient-to-nurse calling devices should have a tactile feel. The push-button or pull-ring should be easily recognised by its colour (normally amber) and by a nurse symbol indelibly engraved/printed on or alongside the device. Examples of typical nurse symbols are shown in the diagram below.

Typical layout of patient handset with example of symbols

The device should be easy to operate by the patient irrespective of whether he/she is ambulant, disabled or confined to bed.

Patient-to-nurse calling devices are normally of the push-button type; however, different designs and configurations should be available to suit individual patient condition requirements. These should be capable of utilising a common basesocket connector unit to allow flexibility in use at each call point.

For ease of location at night, the hand unit should be permanently back-lit, but not so brightly that it could be confused with the reassurance lamp.

A reassurance lamp in the form of a light-emitting diode (LED) should be positioned adjacent to, or should be integrated within, the call device.

The voltage potential difference between any two points, including earth, likely to be experienced by patients or persons associated with the call unit or its cable should not exceed that which applies to medical equipment described in the MEIGaN regulations either under normal or fault conditions. The nurse-call circuit should be automatically monitored so that a break in the cable or withdrawal of the plug will initiate a call.

Further information:

MEIGaN

Wall- or trunking-mounted push-button

The push-button should be large enough and easily recognisable and suitable for all areas of a healthcare facility frequented by ambulant patients or where it may be intended to be used. Associated with the push-button – either integrally or alongside – a reassurance lamp should be fitted.

Hand-held nurse-call-only unit

A hand-held unit used solely for patient–nurse call purposes should consist of a push-button attached to a fixed unit by means of a suitable cable plug/ socket connector. The push-button should be large and easily recognisable, with a reassurance lamp in the form of an LED fitted either integrally or alongside.

The push-button should be permanently illuminated to a level sufficient to allow easy location in the dark, but should not be so bright as to be confused with the nurse-call reassurance lamp.

The unit should be ergonomically designed, with a flexible lightweight cable of sufficient length to enable patients to activate a call from the bed or whilst sitting in a bedside chair or nursing area etc. The means of attachment at both ends of the cable should be in the form of an effective strain-relief device in order to minimise risk of cable failure. The plug attachment to the base unit should be of a pattern that will disengage from the wall socket when strain is applied to the cable from any angle without damage to plug, socket or cable. Where the same plug and socket is used for a patient handset as an alternative to a call-only unit, the circuitry of the call-only unit should be compatible with that of the handset so that the socket can be used for either.

The control of infection should also be considered in the design and manufacture of the patient handset unit. It should be designed with an appropriate IP rating (see BS EN 60529) so that the unit can withstand submersion in various liquids.

It should also be designed to allow patients with a range of disabilities not only to operate the unit but also to understand the functions of the unit.

Some means of attaching the call-only unit securely to the bedclothes or the patient’s clothes should be available, but it should be so designed that any undue force will allow the clip to disengage without tearing the materials.

A parking clip or bracket should be provided to allow the unit to be stored on the wall or locker when not in use.

Pull-cord unit

In showers, bathrooms and toilets, the patientcalling device is normally a ceiling-mounted pullcord unit with pull rings as described in Part M of the Building Regulations – namely, coloured red, located as close to the wall as possible, and having two red 50 mm diameter bangles (or similar) set at different heights. It is important that the pull-cord is easily recognised as the calling device and cannot be confused with a light switch. The pull-cord unit should provide reassurance that the system has operated. The switch should have a momentary action to activate a call. Use of pull-cords within mental illness units needs careful consideration to avoid potential ligature points, and in any case, the cord should have a low breaking strain.

Other call units

Pneumatically-operated call units can be used for patients who are unable to use their hands. The unit comprises an air bulb and connecting tube, terminating in an air-velocity-operated switch that is integral with the wall unit.

Other forms of call unit that facilitate operation by disabled patients should be considered if these provide enhanced and more efficient use. The design and manufacture of such units should be sufficiently robust to provide a safe and reliable service, and their method of operation should be compatible with the remainder of the patient call system.

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