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
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:
When is a virtual nurse needed? What are the skills required? What outcomes are hospitals seeing? Lisbeth Votruba, RN, chief clinical officer at AvaSure, explains
On July 30th, 2020, as hospitalizations from COVID-19 were hitting new peaks across the country, Memorial Hermann Health System initiated a pilot virtual nursing program at 3 of its hospitals in Texas during its COVID-19 hospitalization surge.
ICUs at Memorial Hermann have large windows that allow nurses to monitor and check-in on patients without physically entering the room. As patients filled hospital beds outside these ICU locations, nurses had to physically enter rooms in full personal protective equipment (PPE) to periodically check in on the critically ill.
The program utilized mobile monitoring devices in rooms so nurses could monitor patients virtually, and soon the virtual program covered 14 ICUs during the summer surge through September. The program was designed to maximize shift efficiency, protect staff and patients from COVID exposure, and centralize protocols based on nursing qualifications.
As the COVID-19 delta variant spread, experienced critical care nurses were sent to a central video monitoring station that managed the health system’s 100 mobile monitoring devices, which allowed communication between less experienced staff to effectively monitor and care for COVID patients in the 2 subsequent surges that followed.
The system also allowed nurses at Memorial Hermann to safely and effectively monitor up to 8 patients from remote (at-home) locations if needed.
Memorial Hermann’s protocols included revamping its staff and nurse practices to accommodate for the high demand created by COVID-19 hospitalization surges and ongoing workforce shortages.
“We also in the future could use [the virtual program] for nurses who may not be physically able to work more than 3 shifts,” said Director of Hospital Information Systems at Memorial Hermann Scott Shaver, MSN and registered nurse. “I have full disclosure, I guarantee you if I was a nurse on the floor right now, I would do 3 shifts and that would be it. I am too old to do more than that.
My body doesn’t work that way [anymore]. But I can guarantee you that I can do 3 shifts in the ER and then do a shift at home using this. I could definitely do that. And so we actually have that availability as well not just for COVID but for really anything in the future. This can be applied to really anything that we can think of in the future where we can use virtual nursing to take care of patients.”
The company AvaSure provided the virtual nursing platform used by Memorial Hermann. The company sells evidence-based virtual care solutions, an innovative set of software and hardware aimed at inpatient telehealth care and utilized in nearly 1,000 hospitals across North America.
Juliet Aninye, a VA North Texas Health Care System nurse and LVN Lead for AvaSure’s TeleSitter® Program, was the winner of the Department of Veterans Affairs (VA) 2022 Secretary’s Award for Excellence in Nursing and Advancement of Nursing Programs.
The AvaSure TeleSitter® solution allows one trained hospital employee to monitor up to 16 patients simultaneously, preventing not only falls but elopement, violence against caregivers, and other adverse events.
“The bedside nurse will select which patients are most at risk for some kind of adverse events,” said Lisbeth Votruba, Chief Clinical Innovation Officer at AvaSure and herself a registered nurse. “[Falling] is a very common one. A frail elderly person who’s disoriented in a hospital setting—if they fall it can be really catastrophic. Those types of patients or a traumatic brain injury patient who’s impulsive and aggressive … or a patient who is in isolation with COVID, is delirious, their oxygen level is dropping, they’ve got to keep a mask on and they keep pulling it off. [It is important] to have the ability to monitor those higher risk patients, which is about 10% of the [in-patient] setting.”
Votruba said the virtual nursing models that have emerged improve efficiencies in patient admission and discharge, virtual preceptor mentoring, and critical care support that leverages nursing expertise across a health system in a centralized manner.
AvaSure’s video platforms that enable physicians and other clinicians to have instant telehealth check-ins with patients and their families are part of a $12 billion global telehealth market that exploded in growth during the pandemic.
Texas plans to invest $600 million over the next several years to expand broadband statewide and improve telehealth access for the 2nd largest rural population in the US. Nearly 2.8 million Texas households, or 7 million people, lack broadband access, according to the US Census Bureau.
According to the Texas Rural Health Association and Rural Health Hub, there are 64 counties in the state without a hospital, 25 counties without a physician, and 75% of counties are designated as Health Professional Shortage Areas (HPSA).
Virtual nursing advocates say the shortage of trained health care professionals in rural areas was an existing problem that was exacerbated by the pandemic and highlighted the state’s current health care system’s inability to reach these vulnerable communities.
The University of Texas Medical Branch (UTMB) School of Nursing will be launching a nursing certificate program in January of 2023 that aims to improve care for patients in rural areas where there are not enough professionals to care for these communities.
“For telehealth to be a widely adopted solution across Texas, providers need resources, education, and support to eliminate barriers and successfully implement telehealth tools into modern health care practice,” said Dr. Kristen Starnes-Ott, Vice Dean for Academic Affairs and Professor at UTMB School of Nursing.
She pointed out that many health care institutions shifted to a telehealth model as an emergency measure when the pandemic began, but much of it was done without adequate training.
With proper preparation, training, and implementation, she said that telehealth has great potential to help Texans receive needed care in areas with a shortage of providers.
Source: Boram, K (August 1, 2022). “Virtual nurse emerged as solution workforce shortage in Texas during pandemic surges”. State of Reform Texas
Dear Colleagues:
Providers are under stress. Kaufman Hall reports that through February, the average hospital operating margin had fallen 42.4% in the first two years of the pandemic, to a negative 3.5%. Widespread staff shortages – mainly but not exclusively nurses – and pandemic-related supply chain challenges drove expenses up 32% in the same two years. There are 3% fewer staff on hand, but those who remain cost far more.
More alarmingly, a survey by the American Nurses Foundation revealed that more than half of all RNs were considering leaving their organizations this year.
Last September, the CDC reported that because of these stresses, adverse events were on the rise. Infections, central-line and catheter-associated, as well as MRSA, increased exponentially. COVID made close observation of patients harder and delayed responses as RNs and techs needed to don PPE before entering the room. This is why more than 400 hospitals took us up on our offer of free software licenses for using AvaSure’s TeleSitter® solution to monitor COVID patients.
Social isolation and other stressors from the pandemic have also led to an explosion of behavioral health problems, including drug overdoses, suicidality, eating disorders and violence against caregivers.
Peer-reviewed research, ORNA® data, and anecdotal evidence have pushed protecting nurses and other staff to the top of the list of new uses for virtual care.
Presenters
Lisbeth Votruba MSN, RN, Chief Clinical Innovation Officer, AvaSure
Christina Case, MSN, RN-BC, Clinical Nurse Manager, Providence St. Peter Hospital
Enhancing patient safety while optimizing resources is a continued area of focus for the global health care environment. Sitters, or one-to-one observers, are commonly used in the inpatient setting to meet monitoring needs of high-risk patients.
Read the full article to learn more.
Thanks to technology, nurses and other caregivers at Community Memorial Hospital (CMH) in Ventura have a new way to monitor and communicate with COVID-19 and other high-risk patients. Now, with help from remote “TeleSitters,” physicians and staff at CMH can observe and care for such patients effectively while also minimizing close staff-patient interactions.
Read the full news release to learn more.
