Need help from everyone re: communication devices.

[Mags4711, RN]

Hello fellow NICU folks. We are building a new hospital and our NICU is going from 9 to 12 bed rooms to all single care rooms. Needless to say it's quite an adjustment for most of us.

I've been charged with the task of coming up with a list of must-haves for our new communication devices. We currently use old Spectralink phones (very old). Vocera *badges* are 97% not an option, but the phones haven't been ruled out. Other units are currently trialing Cisco 7825 phones.

What do you feel you need to do your job safely?

Do you need your device to be able to be completely hands free?

For those who use Vocera badges, how often do you leave them in hands-free mode?

Does anyone use smart-phones?

Do you use phones for more than just phone calls? (Such as to get labs from, receive pages, text other staff or MD/NNP, to page MD/NNP?)

Do different level care providers carry different devices (Techs may carry pager, MD/NNP carries smart phone, Charge RN carries smart phone, RN staff carries regular phone)?

How does alarm escalation work for you (who gets next alarm, do you even have it enabled)?

Are your vent and pump alarms tied to your phone?

Anything I may have missed?

Thank you all!!!

[ittybabyRN, RN]

I'm a fairly new nurse but I work on a 54 bed private room unit so I can give you some info. We use Ascom phones. Everyone uses the same phone (Charge RN/RN/MD/RT/PCA/PSA/Pharmacy... basically everyone in the hospital) but the phones each have an "identity". For instance I can open my address book and get Respiratory 1, 2, or 3 (depending on who mine is), or I can get the Fellow etc so phones are programed to who uses them. The RN's phones on our unit all are "NICU" and a number so for instance my phone number today was 7909 which if I were to call someone shows up as "NICU 09". Get it?

We don't have the hands free devices I've seen some places use...I don't necessarily think its necessary, if im using my hands for something so important I cant answer my phone then I probably don't need to be talking on it either...I can call them back.

We do have "tracer" tags we wear, outside every room is three lights, if an alarm is going off it lights up red, if the RN is in the room with the tracer on there is also a green light so others know there is someone in there. (There is also a yellow light for resp therapists).

The alarms take a minute. Typically on our monitors there is a 15 second lapse between the event and the alarm (ie a kid needs to be satting 75 for 15 seconds before the monitor reacts), its roughly an additional 15 seconds for the alarm to come to the phone so about 30 secs total. If you don't confirm the alarm on your phone within a certain time (a minute maybe?) the alarm goes to your back up rn who is assigned to you in the comp...usually the same person you're assigned to rotate breaks with so typically the person in the room right next to or across from you. IF the backup does not confirm the alarm then it goes to the Charge nurse...that doesnt typically happen though.

We use our phones for EVERYTHING. Updating parents, talking with the UC at the front desk, calling for labs, pharmacy, calling the docs, xray, OR...on and on (one major problem is our batteries constantly dying and us having to go to the front of the unit to replace them up to 2-4 times a day). We can also send texts from the phones for less urgent things.

Our vents and pumps are not associated to the phones.

One flaw we have noticed in the system which has been worked out quite a bit over the past few months of using them is during Code situations. When the Code button is pushed the code is sent to all the phones (with the rm number) but it cant send it to all the phones at the same time, it kind of goes "down the line" I think theyve finaly gotten it worked out that when Code is pushed it goes to the backup RN, the MD/NNP's, and the charge nurse all at once, then it kind of goes down the line of the rest of the phones so whoever had NICU 04 would get it before NICU 27. There were issues initially where charge nurses didnt have specific phones and werent getting the codes until the end of the line...its not a huge delay but still a good 30-60 second delay. I think they got that pretty much worked out though because I havent seen any issues recently. And you know when a code is hit because phones start going off all over the place...typically even before our overhead alarm that we do have just in our unit (we do not get alarms/messages from the rest of the hospital overhead).

We also have a "staff assist" button in our rooms, when hit a msg goes to the back up RN, the Resident/fellow, the charge nurse and the respiratory therapist. This can be used if your kid isnt coding but you could go that way if you don't get help, or if your baby extubated but is doing ok with bagging and doesnt need the entire unit at your door to help.

Also we have white boards in our rooms, every morning they are updated, RN puts their number, RT puts theirs, PCT theirs and if you have a sick kid and think you're going to need the docs number fast you can put theirs up too. We have printed out sheets that are updated every month with the new residents and numbers on it as well as all the main numbers needed - all the docs, social workers, pharmacists, etc that we may need. There is one of those sheets in every patient room and at every computer station. Yes there are still times where numbers are wrong and you go around in circles trying to get someone in pharmacy but for the most part the system works well.

The clerks at the desk can also send out mass messages to everyone's phones too if needed (ie staff mtg starting, coffee in the lounge etc ).

Hope that helped a little, sorry it was long!

[walkingrock, ADN]

Spectralink

That's what we are still using.....

[Bobbkat]

We use.............standard telephones. So many spectralinks have been lost that there aren't enough for every nurse on the shift so a lot of the time at least one room doesn't have any. Instead everyone is reached by calling the phone in that room. How's that for high-tech?

[Mags4711, RN]

THANK YOU to all who have replied. Keep them coming, folks!

Anyone use iPhones?

[SteveNNP, MSN, NP]

Our medical teams use Ascoms. The nursing staff each has a pod desk with a phone extension. No portable phones for us, and boy, am I glad.