THE IMPACT OF
TECHNOLOGY ON NURSES AND THEIR
PATIENTS FULL ARTICLE INSIDE
Introduction Welcome to this informative magazine which highlights the Impact of Technology on Nurses and Their Patients. This Publication will showcase how technology is being used by the modern nursing profession to compliment healthcare delivery whilst still ensuring that the principles of nursing are being upheld. NHS England has a £65m Nursing Technology Fund which has mainly been accessed by applicants from acute trusts, with fewer community nurses getting involved. The NHS has a multi-generational workforce who will not be “digital natives”
E-Health E-Health services are helping to meet the increasing demands for health care services while controlling the costs of care provision. New applications of ICT mean that E-Health services are able to complement health care delivery and enable faster, communication between the patient and health care provider. This includes monitoring health status and delivering health care services when they are most needed.
Types of E-Health There are many different forms that E-Health can take. It can involve: • A telephone consultation between patient and a health care practitioner to triage symptoms, provide advice, monitor vital signs and provide guidance on the use of medication • Telephone or text on health promotion, advice and management or appointment reminders • Patient-submitted health information using a mobile device – for example, mobile phone or hand-held computer applications (apps) – resulting in a referral or consultation appointment • A remote consultation between a patient and doctor using video conferencing • Patient-initiated contact with practitioners • Local internet-based support group with a chat room, blog or social network for sharing information with other users. E-Health will help to make nursing more attractive to a generation brought up alongside technology, it will help provide personalised care by giving nurses the tools to empower patients and nurses to work as partners in the care process. E-Health is about quality, safety and innovation, it is not an end In itself, its development and use must always be patient centred and clinically owned by the nursing profession
Robot Nurses and Simulators Believe it or not some hospitals now use robotic nurses in quarantine zones, the Robots in the hospitals are made to look as realistic as possible. There are not many in use in the UK as they are still on a trial basis. The robotic nurse does not have a mind of its own, it is controlled by a nurse in a separate room. The voice and movement of the nurse is mirrored into the robotic form. There are advantages and disadvantages to this. The main advantage is there is no need to put yourself as risk for infectious diseases, this means that there is less danger involved. The main downside to this piece of technology is that at the current time the robot still looks and moves like a robot, the face does not move as a human face does, the expression never really changes, this means that the patient may feel uneasy and not taken seriously. This may lengthen their speed of recovery. There are six C’s of nursing these are, are Care, Compassion, Competence, Communication, Courage and Commitment. The robot nurses cannot portray all these qualities effectively, yes in a way it can be caring and compassionate, competent in what us is communicating. But communication is not just words; communication needs to be facial expression as well.
Simulators have greatly improved nurse education. Salford University School of Nursing, Midwifery, Social Work and Social Sciences use several simulators: •
Emergency Care Patient Simulators: Anatomically correct, feature-rich mannequins, which can be used for the physical demonstration of various clinical signs including bleeding, breathing, blinking eyes and convulsions.
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iStan Patient Simulators: A step up from the ECS, the iStan adds an essential human element to patient simulation. It moves, breathes, can cry out or moan with pain, providing a realistic patient for you to practice on
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Pedia Patient Simulator: A complete reproduction of a six-year-old child enabling you to practice paediatric scenarios
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Baby simulator: This mannequin makes it possible to interact with our most vulnerable patients - in a safe, realistic learning environment
iStan is a highly advanced simulator, it is the most advanced wireless simulator available, it uses internal robotics that mimic the human respiratory, cardiovascular and neurological systems. iStan has the capability to bleed, as he bleeds his blood pressure, heart rate and other clinical signs change. He has a realistic airway, articulated joints and blood in his system. iStan is used in training to give nurses a hands on experience before they go onto the wards, this aims to give them immersive and real situations so they can they can practice their skills in a safe controlled environment.
Merits of Simulation Training •
Enables safe rehearsal of technical and non technical aspects of patient care
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Allows students to learn how to put 6Cs into practice
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Allows teams to learn together
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Encourages competence and competence in acute clinical skills
Apps and Other Smart Technology Apps have started to revolutionise nursing, not only for the professionals but for the patients. Certain apps place care into the patient’s own hands. This takes the pressure off many nurses and their patients.
PillPal PillPal is a medication tracker, users can enter what medication they are currently taking and when it needs to be taken, the app will then remind the users when they need to take their dose. This means the patients are less likely to forget medication or confuse dose instructions. Many patients now live with a number of long term health conditions; they may have diabetes, alongside with heart disease and respiratory illness. They make take a number of medications for each of these. Community Nurses and District Nurses are often the health professionals visiting patients in their own home and assisting them with the complexities of their medication regime.
Ginsberg Ginsberg is an online tool to help people improve their health and mental wellbeing. Users tell Ginsberg how they feel every day and record information about their sleep, exercise, nutrition, alcohol intake and other physical activities, as well as adding context about what has been going on in their lives. Ginsberg combines this emotional, physical and contextual data and provides users with smart, personalised and actionable insights into their mental health. Ginsberg is a joint application/web application by the Scottish Government, NHS 24 and New Media Scotland. Here is an example of the many things you can do with Ginsberg
Health Apple’s new iPhone 6 has introduced a health app. the app is called Health, it is an inbuilt function of Apple’s mobile operating system. On the surface Health enables the phone to track steps walked and flights of stairs climbed. Further exploration reveals the app has many capabilities. For example it can measure: sleep patterns, BMI (Body mass index), peak flow blood pressure and many more. If this app is used correctly and using all the relevant sections it could allow patients to monitor their own readings, this would allow more time for nurses to see other patients that were more of a priority, for example, patients that have been discharged from hospital and are now living at home could use this app to monitor their own vitals and then show the nurse when they arrive.
I could go on for countless page upon page of applications, each with a specific task of helping nurses and their patients, if you wish to find out about more apps, please scan this QR code, this will redirect you to an NHS catalogue of applications.
The new Apple iWatch has set the groundwork for some revolutionary work in nursing. The device comes as standard with a heart rate monitor and accelerometer, which it uses to calculate general fitness, this can link to a variety of apps. This feature could be harnessed in nursing, instead of using a ECG machine, hospitals could save money by having all their patents readings transmitted back to one big source pool. Already nurses are starting to record patients’ blood pressure, pulse, oxygen levels and other important vital signs on tablets and mobile devices. Specialist software, called VitalPAC, automatically told them if the patient was deteriorating. VitalPAC aims to replace human error when conducting paper based observation. Therefore increasing reliably when recording observations and automated EWS calculation at the bedside. It is fast accurate and reliable. VitalPAC reduces the time required to record observations by 40%, allowing more time to do other jobs.
Nursing Practice & Education When undertaking your training did you use technology to assist your clinical learning? When we were in the classroom we used Models that spoke and they could be programmed to simulate emergency situations such as a sudden change in blood pressure or pulse. These simulations were useful, especially for students who had little experience of “real patients”. On one placement with the District Nursing Team we used laptops and uploaded patient notes by a remote connection. What technology do you use in your current role? Routinely nurses now use devices to measure a patient’s observations such as temperature, blood pressure and heart rate. This makes these tasks quicker and they are able to be undertaken by Health Care Assistants too; freeing up Nurses for other tasks. The machinery can “go wrong” so I do need to know how to record observations in the traditional way! I routinely use an iPad on the ward; we use a programme called Patient Track which collates information about the patient’s observations and flags up any changes/ cause for concern. The programme alerts the patient’s doctor and therefore I don’t need to bleep the Doctor as he is alerted and then is responsible for changes to the patient’s medication or care. This system is used by other members of the multidisciplinary team such as Occupational Therapists and Physiotherapists to allow their reports to be available to the medical team allowing the treating doctor to have a full picture of the patient’s needs. When patients are admitted their details are inputted on the PAS - Patient Administration System which allows for effective communication at shift handover and allows the Bed Manager to know where bed vacancies are, which is important on a busy surgical ward. Gone are the days of scrappy pieces of paper with your patients details on;we have a print out which should be up to date.
I think technology can enhance a Nurse’s role, it can free up time allowing me to talk to my patients. My key priorities are to Assess, Plan, Implement and Evaluate Care for my patients and technology can help me do this.
The Use of Technology Name: Chloe Howson Position: Staff Nurse Male Surgical. Ward 11 Location: Manchester Royal Infirmary Time in Post: One year
Nursing Practice & Education When you were training did you use technology to assist your clinical learning? When I trained, which was 29 years ago, there was little technology. We practiced on each other and I remember we even passed an Nasogastric tube into a fellow students stomach! We used the old-fashioned methods to record temperature- a mercury thermometer and a sphygmomanometer (blood Pressure device). My training was ward based so learning was by observation of a qualified nurse and then supervised practice until you were competent.
What technology do you use in your current role? I work in a busy GP’s practice working with a wide variety of patients who visit the surgery. Technology has really changed the way I work as a Practice Nurse. Blood pressure monitoring, which meant the patient visiting the surgery a number of times a week, can now be undertaken in the patient’s own home by loaning the patient a Blood Pressure Monitor which can record blood pressure over a 24 hr period.
The Use of Technology Name: Lorraine Gemmell Position: Lead Practice Nurse & Clinical Services Manager Location: Castleton Health Centre Time in Post: Fifteen years
Telemedicine is another technological advance which has changed my workload and helped improve a patient’s life. My patients wear a device which reports on oxygen saturation levels, weight and blood pressure, which need monitoring in patients with COPD (Chronic Obstructive Pulmonary Disease) and Heart Disease. Monitoring of the vital signs of these patients means they don’t need to visit the surgery or have a home visit from the Doctor or District Nurse. This arms length monitoring is helpful to the patient and it also frees up appointments for others, relieving pressure on the service. As part of a smoking cessation programmes we utilise carbon monoxide monitors- a little like a breathalyser - this tool in our kit which helps the Nurse see whether the patients is complying with the programme. At the practice we use an electronic records programme which helps us share up to date information. I’m not the fastest typist and sometimes feel that as I am entering all the patient’s information, I am focussing on the screen and not the patient. I have had to learn about all the technology we use in General Practice “on the job” but feel that although I am an older member of the workforce I can adapt and move with new devices and practices, where they improve patient care and efficiency.
News
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