Topic: Nurse Leadership

Discover a New Standard of Care at the AvaSure Symposium

AvaSure Symposium

As a nurse leader, including 14 years as chief nursing officer of the U.S. Department of Veterans Affairs and its 80,000 nursing staff members, and as someone who cares deeply about improving patient care, I am very much looking forward to this year’s event. Even though I have been an AvaSure board member for several years, I was amazed by last year’s inaugural symposium. The turnout, the enthusiasm of AvaSys users, the intense interest from those who were thinking about adopting this solution, the quality of the keynote speakers, and the depth and breadth of the breakout sessions were extremely impressive. I don’t often say this about conferences, but it was exciting. I take great pride in my VA tenure as the chief nursing officer of the largest integrated healthcare system in America. I am equally proud to be a small part of the AvaSure team.

Equally striking was how much of the talk at last year’s Symposium was NOT about patient falls and sitter costs. Of course, those are usually topics 1 and 1A when people are first looking into remote patient monitoring, but most organizations that have implemented AvaSys quickly see its potential across a wider range of uses. Suicide ideation, neonatal care, emergency department care, elopement, illegal drug use, traumatic brain injury, staff safety – well, the list goes on and on.

This year we’ll hear current innovations on some of the same themes, but I sense the emphasis is expanding. User-driven changes in the software are making this a data-driven enterprise. The ability to record patient safety events in real time is informing changes in protocols. The clinical evidence for monitoring a broader spectrum of patient populations is becoming clearer. And, for the first time in patient care, we will have a record of near-misses – adverse events that didn’t happen because of the constant vigilance of video monitoring. (For more on that see my fellow board member Pat Quigley’s post).

The official theme of this year’s symposium is celebrating the 10-year anniversary of the AvaSys technology. To me, the real theme is that remote monitoring is fast becoming a standard of care, much as telemetry is in cardiac care. Soon, I believe, the question won’t be, “Do you have video monitoring in your hospital?” Instead, it will be: “What is your comparative analysis with other institutions in how you are keeping patients and staff safe through telemonitoring?”

At this year’s symposium you will also be introduced to the new software that is improving “hub and spoke” systems – centralized monitoring stations for observation of patients in many hospitals or even multiple states. Imagine the cost savings of having one operations center for hospitals in multiple states, a center that might also include other forms of patient monitoring.

Just looking at the breakout sessions for this year’s event, I can see how AvaSys is already transforming the ED, often the source of patient self-harm, elopement, and attacks on staff.

And once again, I am so impressed by the nationally known keynote speakers who have agreed to present at the AvaSure Symposium. They will provide insights into national health policy and make the emotional case for making sure patients are safe and secure in hospital care.

So, unless you have something else you simply can’t miss in early October, come to Grand Rapids, MI, and join me and hundreds of your peers in learning more about the newest standard of care.
Cathy Rick, former chief nursing officer of the U.S. Department of  Veterans Affairs (2000-2014), is a healthcare consultant and a faculty member for the Executive Fellowship in Innovation Health Leadership program at Arizona State University.

Opioid Epidemic: Video Monitoring Helps Reduce Substance Abuse in Hospital Setting

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Almost daily we read reports of patients needing to be resuscitated from an overdose while in hospital, or dealers being arrested while visiting a detox patient to make a sale. As many AvaSys® clients know, video monitoring often uncovers drug deals or patients attempting to use their IV to self-administer heroin.

In 2015 the journal Drug and Alcohol Review published a study tracking more than 1,000 patients with substance use disorder. Almost half (43.9%) reported using illicit drugs while they were in the hospital. These patients experience higher levels of HIV/AIDS, Hepatitis C, non-fatal overdose and other injection-related infections requiring hospitalization. Although they need medical care, they are at much higher risk for leaving the hospital against medical advice (43.4% did so at least once).

A 2016 case study published in the journal Case Reports in Infectious Diseases describes a puzzling case of sustained bacteremia that didn’t resolve with multiple antibiotic regimes during the patient’s hospitalization. Eventually, hospital staff discovered the patient was self-injecting heroin with an unsterile needle through his central line. This case highlights the importance of close monitoring inside the hospital for patients with active substance use disorders. Usually, this sort of patient would benefit much more from staying in somewhere like the Enterhealth Ranch, where they can get specialist addiction treatment. However, for one reason or another, they have to be in hospital and so are unable to access that sort of treatment. Nevertheless, they shouldn’t be in a position where they are able to self-administer heroin. Ultimately, the goals of rehabilitation should involve using diagnostic tests such as the 10 panel drug test to provide appropriate treatment and safety for these patients.

“Drug usage precautions,” “possible drug usage through IV” or “watch for drug activity” are seen with surprising frequency as reasons for video monitoring. According to ORNA, AvaSure’s video monitoring database, 60% of hospitals have used video monitoring to prevent drug activity within patients’ rooms. Many hospitals are now adding “substance use disorder” to their video monitoring policy’s inclusion criteria. It is therefore suspected that the Best Treatment Approaches For Drug Addiction might incorporate video monitoring technology in the future.

Addressing this complex and growing epidemic requires a multi-pronged approach that includes compassion and appropriate treatment of the underlying issues. Video monitoring is increasingly used to help hospital staff be aware of and prevent potential adverse events in this challenging patient population.

Lisbeth Votruba, MSN, RN, Vice President of Clinical Quality and Innovation at AvaSure