Becker's Clinical Quality & Infection Control

May/June 2020 IC_CQ

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37 QUALITY IMPROVEMENT & MEASUREMENT The technology that has helped improve nursing care: 4 nurses weigh in By Anuja Vaidya B ecker's asked four nurses to discuss the technologies that have helped them give the best care to patients, particularly during the COVID-19 pandemic. Note: e following responses were edited for length and clarity. Sue Murphy, RN. Chief Experience Officer at Universi- ty of Chicago Medicine: Healing often starts with a simple, yet meaningful conversation between a care team member and a patient, and at UChicago, these conversations are supported by human-centered technology. Our nurses and other staff members use a care rounds application to capture questions, comments and requests our patients and their families may have during a hospi- tal stay. And even though the coronavirus has changed many of our workflows, we are still using this technology to conduct vir- tual rounds in order to maintain human connections for isolated patients, remote families and busy care team members. During the first three weeks of virtual rounding, nine members of our patient experience and engagement program completed more than 1,000 virtual rounds. Comments from patients were captured in the mobile application and shared with staff mem- bers to recognize them for their hard work and remind them how important they are to our patients, especially during these challenging times. Winter Chambers, RN-BC. Nurse Educator at Cove- nant Medical Center (Lubbock, Texas): The one piece of technology that has helped me to provide better care as a nurse is the EMR. I am able to reference the patient's medical history and keep track of his or her progress as I am providing care. Lana Adzhigirey, RN. Care Transformation Manager for CHI Franciscan (Tacoma, Wash.): As CHI Franciscan started to manage COVID-19, a small group of CHI Franciscan's 'virtual hospital' nurses paired up with physicians and administrators to [implement a] virtual care response for patients. Within one week, we trained over 1,000 providers and caregivers to become 'virtu- alists' and 'telepresenters.' A simple and secure video connection combined with virtual exam tools and best practices brought providers, registered nurses, medical assistants, therapists and their patients together while keeping the most vulnerable in the safety of their homes. e 50 virtual visits in February jumped to over 1,000 each day in March, and the same rates have maintained in April. Furthermore, the toolkit was quickly adopted by the clinics in other states. In our hospitals, nurses quickly adopted the secure video technol- ogy to conduct medical screening exams, virtual admissions by hospitalists, specialty consults, visits with chaplains, and in some cases, to connect patients with their families. Nurses and care technicians in the 'virtual hospital' could minimize their physical contact with confirmed or suspected COVID-19 patients by using the technology to monitor them 24/7. A physical door was replaced with a virtual door, and the caregivers as well as the patients rose to the challenge and poured all their skills, empathy and knowledge into what they do best — caring for others. Shannon Bates RN. Pediatric Intensive Care Unit Nurse Manger at Covenant Children's Hospital (Lubbock, Texas): We recently made the switch to use a pupilometer. e device objectively measures the pupil size and reactivity to light. e device can identify trends and capture subtle differences that are hard for the naked eye to capture. n How Northwell improved resuscitation outcomes in the ED By Mackenzie Bean V ideotaping staff members performing CPR in the emergency department may help improve resus- citation rates, according to a study published in the Journal of the American Heart Association. The Feinstein Institutes for Medical Research — the research arm of New Hyde Park, N.Y.-based Northwell Health — and Manhasset, N.Y.-based North Shore University Hospital developed the intervention to monitor and improve team members' CPR performance. North Shore implemented the technique — called Mechanical, Team-Focused, Video-Reviewed Cardiopul- monary Resuscitation — in its emergency department in 2018. The approach entails clinicians using a mechanical chest compression device on cardiac arrest patients, which is captured by video technology in resuscitation rooms. A multidisciplinary team then meets biweekly to review the footage and offer personalized feedback. The study examined the outcomes of 97 cardiac ar- rest patients treated before the intervention and 151 treated after. Rates of survival to hospital admission and discharge did not improve. However, the number of cardiac arrest pa- tients successfully resuscitated increased from 26 percent to 41 percent after the intervention. n

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