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How nurses are tapping into smart bedside solutions

Epworth's Point of Care bedside system
Photo: Epworth's Point of Care bedside system
At Epworth Eastern, nurses are using an innovative Point Of Care (POC) bedside system to access patients’ pathology results, streamline discharge processes, and provide patient education.

This Oneview Healthcare technological solution, introduced several years ago at Epworth Eastern, is optimising patient engagement, clinical outcomes and workflow efficiencies.

It’s been such a success, the system has been rolled out to thousands of bedsides spanning all Epworth campuses of Victoria’s largest not-for-profit private health care group.

The technology not only provides a range of entertainment, health care education and information services for patients, it also provides clinical staff with access to a range of applications, from electronic prescribing and administration to electronic nurse rounding, managing room cleaning services and electronic meal ordering.
The system uses 22 inch Cybernet terminals at the patient bedside which are linked to nurse station locations. Clinical staff log on to the bedside terminals using thumb print recognition technology.

Epworth Eastern Acute Surgical Ward Nurse Unit Manager Ian Kite says the digital technology is revolutionising the way nurses manage patient care at the bedside - all at the touch of a button.

“You can log in to a nursing access screen which gives you an overview of where your patient is currently sitting from a medical acute surgical prospective in terms of their condition,” he says.

“It gives you access to the recent pathology results, access to their recent tests and investigations, that can be in the form of an X-Ray or a CT or an ultrasound, so you can physically see what tests patients have had and what their results may well be.

“It gives you the ability to update patient requirements in terms of dietary intake, and certainly from my nursing perspective, my patients have had acute abdominal surgery.

“They need to start off on a particular type of diet and they need to progress upwards, so from fluids to a different type of fluid, and then through to a meal.

“It gives the nursing staff that ability to make that live, which then informs the catering department, as an example, that the menu access has changed and they need to then update what the patient can have for their meals.”

Mr Kite says the system’s online electronic drug chart works to reduce the risk of medication errors and improve patient safety.

“Obviously drug charts previously were written by doctors and anaesthetists with handwritten skills that could be interpreted as not very good,” he says.

“Now they electronically type in what medication they want, the frequency, the dose, any variations or variables to the medication.

“In terms of dosing, it’s a more accurate way of establishing when a patient’s had a medication and when they are next due to have a medication, and it gives you an alert to say that something’s due.”

POC also assists nurses to complete their hourly rounding, where nurses log on to the system to ask a series of questions and record the answers, which is designed to eliminate risk and improve patient safety.

Nurses question patients about whether their possessions or the call bell are in reach, ask about pain levels, whether the patient has moved recently as part of their pressure area care, or whether patients have been to the toilet.

“This has a big impact with my particular patient cohort, who are waiting a lot of the time to pass urine or to have their bowels opened, so it gives you a tracking device as to where they are with their acute care,” Mr Kite says.

“If we are not asking these questions on a regular basis, patients may well just choose to get up and go to the toilet themselves, and that way if they’re of a particular age or if they’ve got particular conditions or comorbidities there’s a falls risk.

“If you’ve had an operation, you’ve got an anaesthetic on board and that can limit your balance and your ability to move, so we need to make sure we’re keeping patients safe by reducing risk, and obviously we do that by assisting patients to and from the bathroom.

“The impact it has on the statistics of falls…certainly in our organisation it has reduced the amount of falls in hospital, which obviously is improving patient outcomes.”

POC features leader rounding, where the nurse in charge will visit each patient daily to discuss with them their stay and record any patient feedback, which can escalate any patient concerns or potential problems, and report positive feedback to staff.

The system boasts discharge planning, where clinicians can plan ahead for patient discharge and refer to rehabilitation, confirm appointments and print out information for patients.

It also assists with patient flow, enabling nurses to discharge the patient directly from POC.

Mr Kite says the digital process reduces the amount of phone calls to other departments and accelerates and streamlines discharge process efficiencies.

“That alerts the kitchen department so that they then don’t put together the next meal for the patient…and that limits waste,” he says.

“You can log on and request that the cleaning department comes through and perform a discharge clean on the room - that seamlessly improves the progression of your next patient coming in from theatre or from home, because the room is ready and in an appropriate time and fashion.”

The system caters to nursing documentation but Mr Kite says nurses and doctors are currently using handwritten documentation for their clinical and risk assessments.

Mr Kite says the digital POC system has unlimited potential.

“It gives nursing staff more time, I would say, to perform the clinical aspect of the job,” he says.

“Previously you might not have had the option to look for your pathology results. From the POC terminal, nursing staff can review the pathology results and they can see what potassium levels are doing, and what haemoglobin levels are doing.

“They can put together what is happening from a pathological perspective, and relate it to their patient, who is lying in their bed in front of the screen,” he says.

“That can have an impact on the patient care and the patient condition because if you can see that the blood count is dropping, and the patient is physically looking as if they are deteriorating, that escalation process can follow.”

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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords