The Perspectives article posted today (below) discusses how telehealth for virtual nursing is being used at hospitals. Coincidentally, this Editor had in the ‘virtual file’ for posting today two articles on how virtual nursing is being used in two settings–and in two countries.
In-hospital virtual nursing has been introduced at two Avera Health hospitals in South Dakota, Avera McKennan Hospital & University Center in Sioux Falls and Avera St. Mary’s Hospital in Pierre. This is very much along the lines of adjuncts to bedside nursing in supporting additional care and time-consuming administrative tasks, such as admission assessment, medication reconciliation, pain reassessments, and second RN availability for independent double checks. For Avera, this answers some of their workforce and workflow problems, such as relieving workload and providing second checks.
An example is intake assessment which in some cases can take up to 30 minutes. The virtual nurses at their stations (left above) work with bedside nurses not only to ask patient questions but also to relieve their anxiety and answer questions. The bedside nurse introduces the virtual nurse, explains the camera/microphone, and then the virtual nurse picks up the assessment from the bedside nurse, who can move on. The camera can also zoom in on equipment such as IVs or vital signs monitors. Virtual nurses can also call bedside nurses when they are needed. No information is recorded.
Avera is a rural health system of 37 hospitals in South Dakota. They introduced virtual nursing in May in the same two hospitals on one metric–reducing in-hospital falls that happen when a patient at increased risk of falling gets out of bed. The virtual nurse uses the camera and speaker to direct the patient to wait for care team assistance or alert staff to help. This 24/7 monitoring program decreased falls with more than 6,800 redirects between May and October. Avera plans to roll out the virtual nursing program eventually to all of their hospitals. Becker’s, Sioux Falls Business (photo credit)
In the UK, Doccla is partnering with Up Care Derbyshire to set up ‘virtual wards’ for at-home care in Derby and Derbyshire. The NHS has a well-known problem with available hospital beds. Much like the US, a nascent hospital-at-home program is attempting to relieve the situation by moving the patient back home faster without skimping on care in five care areas: palliative, respiratory, frailty, cardiology and hematology (haematology). The patient in the program receives a Doccla box with the tools needed for monitoring and coordinating care: a pre-configured smartphone with an easy-to-read large font for the app, plus wearable medical devices to monitor vital signs such as heart rate, respiration rate, body temperature, blood oxygen levels, and blood pressure that are connected to the smartphone. Clinicians monitor the patients at dedicated hubs and call in home health nurses when needed. The program will be at five locations initially within Up Care Derbyshire’s integrated health system (ICS) to enable local NHS hospitals to discharge eligible patients and has a peak capacity at present of 200. One objective is faster patient discharge, but the second is to reduce the need for hospitalization for patients with long-term or chronic health conditions. One area that isn’t apparent is if the camera is used as part of evaluations or contact.
Doccla is now in one-third of integrated care boards (ICBs) and more than 25 NHS Trusts, with a patient compliance rate of over 95% and an independently verified saving for the NHS of £3 for every £1 spent on Doccla. DigitalHealth.net