Topic: Patient and Nurse Satisfaction

AvaSure Break Out Session: Tales from the Front: Early Wins Beget Long-term Success

AvaSure: Break Out Session: Tales from the Front: Early Wins Beget Long-term Success

When staff sees the advantages of new technology, they are more likely to champion widespread use and new applications. Two hospitals describe how they achieved and communicated success right from the beginning of their program.

Presented by:

  • Baptist Medical Center
  • Valley Presbyterian

RN Panel: How Monitor Staff Help Improve Nurse Productivity

RN Panel: How Monitor Staff Help Improve Nurse Productivity

Nurse leader, Lisa Crochet at Marianjoy Rehabilitation Hospital discusses the impact of remote video monitoring for overworked staff seeking to focus on their core roles as direct caregivers.

Presented by Marianjoy Rehabilitation Hospital

Development and Psychometric Testing of the Remote Visual Monitoring Acceptance Tool

Development and Psychometric Testing of the Remote Visual Monitoring Acceptance Tool
Barnett SD, Desai D, Davis T, et al. J Nurs Meas. 2020;28:339-454.

Summary

Challenge

Studies have shown a strong correlation between nurses’ acceptance and use of new technologies to improve patient care—yet, there are currently no studies that have addressed nurses’ acceptance of remote visual monitoring

Assessing nurses’ acceptance of remote visual monitoring (RVM) will provide hospital administrators with a better understanding of how best to mitigate the underutilization of this safe and cost-effective intervention.

Solution

RVM Assessment Tool (RVMAT)
The RVMAT was designed to assess the perceived:

  • Usefulness of the technology, defined as the degree to which a person believes that using a particular system will enhance his or her job performance
  • Ease of use of the technology, defined as the degree to which a person believes that using a particular system will be free from effort

The 25-item RVMAT uses a 5-point Likert scale: Strongly disagree = 1; Disagree = 2; Neither agree nor disagree = 3; Agree = 4; and Strongly agree = 5. A higher rating indicates a greater acceptance of RVM technology.

Putting the RVMAT to the test
The RVMAT was tested among nurses recruited from a large health system.

Participants were eligible to enroll in the study if they met the following inclusion criteria:

  • Registered nurses
  • Worked on an adult inpatient unit that utilizes RVM technology consistent with a health system–wide protocol
  • Able to speak and read English
  • Willing to provide informed consent

Findings

Completed surveys were available from 412 nurses. The overall total scale mean score was 3.73, indicating a high level of endorsement for RVM among this group of nurses.

  • The item with the lowest mean score was: “I believe that a sitter is safer than RVM.”
  • The item with the highest mean score was: “Having RVM available for patient monitoring is valuable.”

The results from this study show that the RMVAT is a valid and reliable instrument to measure nurses’ acceptance and use of RVM technology.

Despite the fact that the majority of nurses who took part in this study had more than 5 years of experience and that the study findings may not be generalizable to nurses with fewer than 5 years of nursing experience, the strengths of the study outweigh the limitations.

Key takeaway

Because nurses are one of the largest users of healthcare technology, using a valid and reliable tool like the RVMAT to measure their acceptance and the perceived usefulness of RVM technology is needed to gain an in-depth understanding of the factors that influence their adoption of healthcare technology. Such information can guide nurse leaders to implement strategies that create a supportive practice environment where direct care nurses are empowered to incorporate innovative technologies into nursing care to improve overall patient health outcomes.

Continuous Video Monitoring: Implementation Strategies for Safe Patient Care and Identified Best Practices

Continuous Video Monitoring: Implementation Strategies for Safe Patient Care and Identified Best Practices
Abbe JR, O’Keeffe C. J Nurs Care Qual. 2021;36(2):137-142.

Summary

Challenge

Multiple compounding factors result in the increased demand for additional safety monitoring in the inpatient setting

At a large, academic, Magnet-designated medical center in the Pacific Northwest, nursing leadership saw that the need for sitters was rising. Much of this increasing need was being driven by an increase in admissions for inpatient mental health care, requiring additional inpatient monitoring for suicide risk, substance withdrawal, fall risk, eating disorders, elopement, and general safety concerns for both adult and pediatric populations.

Providing 1:1 care for all is costly, ineffective, and resource-intensive—and has a negative effect on staff satisfaction, patient safety, and productivity.

Solution

Continuous video monitoring with AvaSure

Continuous video monitoring (CVM) was identified as a bridge for the nursing staff to enhance safety for patients and as an additional safety intervention when sitter use was not reasonable or feasible. The trick was implementing this program in a way that would enable it to become an accepted part of the healthcare environment.

Adoption of the AvaSure technology was influenced by nurse enculturation and education, leader standard work (standard parameters used by nurse leaders for process improvement), data tracking management, and patient/family feedback.

A multidisciplinary team

Implementation of this program was organized with representatives from across the hospital, including nursing leadership, clinical nursing staff, Clinical Technology Services, Psychiatric Professional Practice Leader, Marketing, Department of Quality Management, Nursing Resource Management, and Nursing Administration.

Ongoing training and education

The monitoring staff received specialized training related to anticipation of at-risk behaviors, system functionality, determination of adverse events, and chain of resolution. Education focused on the clinical nursing staff and consisted of unit in-services, leadership classes, champion classes, case management classes, and transitional care classes for community partners. Clinical nurse champions were integral to the adoption of technology in all settings.

Development of policy, procedures, and patient criteria

Clearly defined inclusion and exclusion criteria for CVM with the input from clinical nurses allowed for clear expectations for clinical staff members. A decisional algorithm was designed to help nurses with clinical  decision-making regarding whether to use a sitter or CVM as an intervention.

Leader standard work

Lean management principles are critical to continuous improvement and empower the frontline staff to solve problems, eliminate waste, standardize work, and improve the value of care delivered to patients. Because Lean management focuses on the frontline staff, it provides an opportunity to enculturate new systems and to identify barriers.

With proper implementation, the benefits became clear.

  • Enhanced nurse safety: With the video monitoring technicians (VMTs) out of harm’s way, they can act quickly to respond to patients who may be escalating and the nursing staff cannot safely advocate for themselves. This keeps both staff and patients safe during high-risk behavioral events
    • Often, the verbal alerts from VMTs can deter the patient long enough so that clinical staff can safely enter rooms that may have additional precautions, such the need to don personal protective equipment
  • Cost savings: Conservative estimates showed that CVM saved this hospital $109,511 in the first 3 quarters of use
  • Reductions in falls: With CVM, the hospital reported an average of 2768 potential “fall events” prevented each month
  • Patient and family satisfaction:
    • 93% of family members indicated that they received more respite opportunities because of the presence of the camera
    • 93% of patients and families felt that they had an added level of security
    • 80% said that they had more privacy compared with 1:1 sitters

Conclusions

The CVM program at this hospital has provided a bridge for the nursing staff to use technology to enhance patient safety and to provide an additional opportunity for  intervention when sitter use is not reasonable or effective. Implementation of CVM reduced costs, improved resource allocation, and enhanced staff and patient family satisfaction.

Wheeling to Efficiency with Hub & Spoke

Wheeling to Efficiency with Hub & Spoke

Hear how health systems use centralized monitoring stations and enterprise software to save money, simplify hiring and training, and save lives.

Presented by Loyola University Medical Center, Trinity Health of New England

Improve Patient Engagement Scores

Improve Patient Engagement Scores

Sarah Brown MSN, RN, CMPE, NEA-BC at UnityPoint Health, discusses the challenges her nursing staff faced during the pandemic and how this caused massive burnout throughout their system. Quality of care was being compromised, so leadership agreed to make innovative changes and identified the use of AvaSure TeleNurse™ solutions as a potential solve. Sarah noted, “Virtual Nursing in the med-surg area immediately helped our nurses at bedside and has grown astronomically quickly.”

Early results of TeleNurse™ Programs:

  • Increases in HCAHPS: 7.6% increase in patient understanding of purpose of taking medication, 2.04% increase in top box score for transition of care
  • Discharges completed by the virtual nurse currently have lower rates of readmission – this is an early trend; they’re waiting to see more results over time to consider it correlated