Nurses at Mattel Children's Hospital at UCLA Health have just one complaint about the tablets the hospital recently introduced at patients' bedsides: the charger cables-which fit many patient's phones-keep disappearing. Otherwise, nurses have only superlatives to describe the new technology and its impact on patients and nurses. For children, the tablets are loaded with games and videos and are a great distraction during blood draws and other procedures.
"While the tablets are entertaining for kids, they're just as important for parents," says UCLA Health nurse R-J Soliven, MSN, RN, CNS. Physicians can choose to make patient information, such as laboratory test results, available on the tablet, which parents can access with a password. "Parents of children undergoing chemotherapy for cancer treatment, for example, know that the medication can be delayed if a child's white blood cell count is low," says Liz Bolanos, MSN, RN, CPN, another UCLA Health nurse, "so they anxiously check those numbers on the tablet, often getting the information at the same time it's sent to the chart and the nurses' station."
The tablets and other new technological innovations enhance both patient care and comfort and nurses' job satisfaction, says Jessica McKee, BS, RN, clinical communications coordinator at UC San Diego Health. At UC San Diego, patients can use tablets to adjust blinds, control the television, and watch entertainment programs and videos about their condition. "I can see, from visiting patients and working with our nurses, that the tablets are having a positive impact," says McKee. "Patients have control over their environment, and because they get basic information on the condition they're being treated for, the nurses can spend more time on their specific situation, like timing medication once they're home or wound care."
According to Patricia Mook, MSN, RN, a member of the American Organization of Nurse Executives' board and system vice president at Atrium Health, a health care network based in Charlotte, North Carolina, "What makes this and other hospital floor technologies so important is that some needs can be met by staff other than the nurse-and in a growing number of cases, by robots-which frees up nurses for direct care for their patients." Nurses are kept in the loop, though. Mook gives the example of a messaging system that lets patients directly contact a dietitian, with a copy of the communication simultaneously sent to the patient's nurse.
KEY TECHNOLOGIES
In an article on its website, Norwich University in Northfield, Vermont, which offers an online master of science in nursing degree, highlighted several key technologies that have been transforming nursing:
* Electronic health records
* Mobile communications systems
* Patient-generated health-data systems (from devices such as smartphones and smart watches)
* Real-time location systems (for patients, medical staff, and medical equipment)
* Smart alarm technology (to reduce false alarms)
And in a report from technology firm Hewlett Packard Enterprise on technology and nursing, Sandra Bogenrief, MBA, MSN, RN, dean of nursing at Rasmussen College in St. Cloud, Minnesota, says emerging technology is making a nurse's work easier: "We enjoy the efficiency of having medical records at our fingertips, algorithms to guide our nursing critical thinking processes, and pumps that calculate and maintain accurate medication administration."
Some technologies were specifically designed with nurses in mind, such as robotic telehealth systems nurses monitor from their stations to keep an eye on patients who are at risk for a fall or who might pull out an iv line. Digital display signs placed on the door of a patient's room alert staff to crucial patient information (such as allergies) and can be updated instantly with new information.
"It's an amazing time in nursing," says Bonnie Clipper, DNP, MA, MBA, RN, vice president of innovation at the American Nurses Association, who also acknowledges that "it's absolutely a concern that you can lose touch with patients. We're working very hard to keep this about the patient and use technology and innovations to supplement care." Clipper says it's vital that nurses learn everything they can about emerging technology. "We want them to know the strengths and weaknesses, as well as how to communicate about the technologies to patients, so they understand their role."
Clipper highlights opportunities offered by artificial intelligence. Computers, for instance, can be programmed to detect indications and patterns, such as emerging cardiac failure or sepsis. "That allows us to anticipate and predict before bad things happen to patients," says Clipper. She adds that nursing schools are working hard to catch up with technological advances, teaching students about these concepts and the mechanics, "so that the first time they see them isn't on the job." She hopes that nurses will become involved in developing technologies as they identify patient needs and marry these to technological innovation.
Rhonda Collins, DNP, RN, chief nursing officer of the technology firm Vocera Communications, says, "Nurses will use new technologies if it helps make their jobs easier, and if the learning curve is not too steep." Collins observes that leadership sometimes introduces a new technology, such as robot delivery systems on hospital units, but doesn't always offer the necessary training. "To get nurses to make the best use of technology," she says, learning has to be part of implementation.
Clipper observes that younger nurses tend to have an easier time adapting to new technologies "since they grew up with so many." But she notes that nurses of all ages are excited to find tools that improve care and make their jobs easier and more accurate. Introducing a technology many nurses already recognize, of course, speeds uptake. At Cedars-Sinai Medical Center in Los Angeles, for instance, nurses are using Fitbit devices with patients who've had knee and hip replacement. The Fitbits have allowed nursing staff to monitor steps after surgery; they've found that patients who took 1,000 steps a day soon after surgery went home sooner than patients who didn't. There have been more than 20 clinical trials using Fitbits, including one in the January 2018 Annals of Behavioral Medicine, in which the devices were used to determine the likelihood of hospital readmission in patients with peritoneal cancer.
"Nurses are incredibly flexible and very nimble in their embrace of new ideas," Clipper says. "I find them to be excited about new technology, and that's exciting for patients and our profession."-Fran Kritz