Devices & Technology

Nursing Technology, Specialty by Specialty

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By Christina Orlovsky Page, contributor

July 15, 2011 - Talk about technological innovations is often focused on universal tools like the electronic medical record and computerized order entry. But not all health care technology is made equal--in fact, certain tools are more beneficial to some specialties than they are to others.

Here’s a look into the latest technology making its way to a specialty unit near you:

Operating Room

“The operating room has always been an area of practice that has been exposed to new technological advances for medical and nursing practice,” said Denise Downing, MS, BSN, RN, perioperative nursing specialist, informatics, Association of periOperative Registered Nurses (AORN).  “Advanced technologies in the OR drive the way surgical procedures are performed, the structure of the operating room, and the supplies and devices used to provide care.”

As advanced technology has made its way into the OR, the responsibilities of the perioperative nurse have expanded to not only include learning to use new tools, but also learning how to educate patients on their care, both in the hospital and once they’re discharged.

“The advancement of technology in the operating room has lead to new surgical procedures, such as robotic procedures; new surgical suites, such as hybrid ORs; new supplies used for procedures, such as tissue-engineered replacement grafts known as cytografts; and nursing staff that are required to be the perioperative technological superusers,” Downing continued.

“As more surgical procedures are being performed using minimally-invasive techniques, the patient’s length of stay at the facility has decreased, which has lead to an increase in education provided by the perioperative nurse about the medical devices required for the patient to have at home, such as medication administration devices, or pain pumps, and peripheral intelligence, or tele-monitoring, devices,” she added.

Additional technology in use in the OR includes tracking mechanisms for patients, which allow their loved ones to know where the patient is in their surgical process, as well as tracking devices for surgical equipment, often involving radio-frequency identification (RFID) to ensure recovery of surgical sponges or devices.

One specific technology created by AORN is AORN SYNTEGRITY, which automates AORN-recommended practices for perioperative nursing using the Perioperative Nursing Data Set (PNDS).

“AORN SYNTEGRITY uses standardized, evidence-based terminology in nursing documentation to achieve clear and consistent reporting leading to quality process improvement initiatives, development of operational metrics, and fiscal justification for resources,” explained Downing. “The standardized data tables, developed from the uniquely coded PNDS elements, clearly and consistently define the terms and definitions used during perioperative nursing documentation. The evidence-based data elements, mapped to SNOMED-CT®, contributes to an EHR that can be shared between providers, facilities, and different information systems.”

Intensive Care Unit

With critical patients that require the most vigilant care, the level of technology in the intensive care unit (ICU) needs to be top notch—and easily accessible in the most urgent situations.

In the July issue of the American Journal of Critical Care, authors Richard H. Savel, M.D., and Cindy L. Munro, RN, Ph.D., ANP, call out one device that’s commonplace in mainstream culture as one of the ICU’s key technology tools: the iPad.

In their article, “Scalpel, Stethoscope, iPad: The Future is Now in the Intensive Care Unit,” the authors attest the tools in use by teenagers everywhere are also great assets to health care professionals and are “fundamentally changing the quantity of information available to clinicians where they need it the most: at the point of care.”

Savel and Munro explained that text messaging allows ICU providers to communicate easily with other physicians, coordinating interdisciplinary care, while smart phones and tablets like the iPad allow clinicians to research, communicate and review patient records, tests or X-rays, right at their fingertips.

“As practicing ICU clinicians, we are all fans of technology in one way or another, or we wouldn’t have been drawn to critical care in the first place,” Savel and Munro concluded. “We tend to be early adopters and believe that with the strategic use of technology we can help get our patients and their families through their critical illnesses.”

Another aspect of ICU technology is the tele-ICU, also known as an eICU, virtual or remote ICU, which allows a team of clinicians to monitor critical care patients from a remote location via a camera in the patient’s room. Tele-ICU nurses monitor these patients 24 hours a day, seven days a week.

According to Susan F. Goran, RN, MSN, author of “A Second Set of Eyes: An Introduction to Tele-ICU” in the journal Critical Care Nurse, the technology provides improved safety and enhanced outcomes.

“The ICU environment continuously assails clinicians with distractions, alarms, and interruptions that produce alarm fatigue and the potential for increased error rates. While addressing the needs of one patient, a busy nurse or physician may be unaware of a second patient’s change in status that requires immediate attention,” she wrote. “The tele-ICU is that ‘second set of eyes’ that provides additional clinical surveillance and support. By collaborating with the bedside team, the tele-ICU can support care without distraction and deliver timely interventions when minutes may make the difference. The purpose of the system is not to replace bedside clinicians or bedside care, but to provide improved safety through redundancy and enhance outcomes through standardization.”

Embracing Technological Advancements

With these and other new-and-improved technologies making their way into health care facilities every day, it is clear that it’s become a necessity for nurses to embrace technology in order to work as safely and efficiently as possible.

“Most new technology is designed to make nurses’ lives easier or patient care safer. Since technology is always changing, nurses should look at how the technology can be used for a positive change,” concluded Mary Pat Aust, MS, RN, clinical practice specialist, American Association of Critical-Care Nurses (AACN). “Sometimes it disrupts processes you already have in place and you may have to look for ways to change the way you work. Introducing and embracing new technology requires good communication and open collaboration among all stakeholders.”

Downing concurred. “Emerging technologies in the perioperative area can create angst and challenges for the perioperative nurse,” she said. “But to ensure safe, quality care and a positive patient outcome the new technologies must be integrated into the perioperative nurse’s patient care delivery practices.”


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