Patterns of paging medical interns during night calls at two teaching hospitals

Abstract

Objective: To assess the patterns of paging medical interns during night calls.

Design: Descriptive study; diaries were used to log calls between 7 pm and 7 am for 1 week in February 1991.

Setting: Two teaching hospitals in Halifax.

Participants: All 10 interns assigned to the 15 medical units and nurses from 3 representative medical units.

Main outcome measures: Number and nature of calls.

Results: The overall response rate was 90%. A total of 309 calls were logged by the interns and 107 by the nurses. Each intern had 17 calls on average (range 6 to 33) per 12-hour period. Of the calls 27% occurred after midnight, 25% disrupted sleeping, and 19% interrupted direct patient contact. Overall, the most common reasons for paging interns were related to prescribing of medications (42% of the calls), direct patient assessment (25%) and reporting of laboratory results (18%). According to the nurses, there were no delays in the interns' responding to the pages, and 61% of the calls led to a new physician order.

Conclusions: Paging frequently interrupts interns during work and rest on night calls. Assessment of paging patterns may be useful in identifying specific interventions to reduce the number of calls so that interns will have fewer interruptions during patient encounters and more rest. The collection of data from nurses in a routine nursing audit may be useful for evaluating the communication between interns and nurses and, indirectly, for assessing interns' workload.