In this blog I want to talk about ways that technology can reduce the physical workload for nurses. In case you didn't know just how physically taxing a nursing career can be, let me break it down for you. An article by Spencer Jones (2017) states that on average, a nurse will walk 4-5 miles and burn 1400 calories in a 12-hour shift. The American Nurses Association states that nurses lift 1.8 tons per shift and 38% of nurses (some sources say up to 80%) will be affected by back injuries (n.d).
I am a Medical Intensive Care nurse where my 1:2 nurse to patient ratio is better than most clinical areas. We rarely have nursing assistants and are usually responsible for the total care of our patients. A "normal" normal patient assignment for me could be a vented and sedated patient that is most likely incontinent of stool and has a bowel movement every two hours; the other patient could be a 450lb patient with symptoms of obesity hypo-ventilation that wants to get up out of bed but needs assistance. Depending on the critical state of the patients around mine, I may or may not be able to get assistance with turning and cleaning up patient number one or getting patient number two out of bed. I am daily at risk of being just another statistic
Some hospitals, like my own, are currently trying to put a patch on this problem by installing lifts and teaching classes on ergonomics, placing medication rooms and supply rooms in a centralized location and implementing a 35lbs weight restriction. These are important moves towards decreasing the amount of work related injuries for nurses, however, I propose a more efficient solution to this problem. I propose using robotics in patient care to reduce nurse workload.
Robots can be used to build cars, lift heavy objects and perform complex surgeries. I believe that they can be adapted for use in hospital and clinic settings.
Research is currently underway to develop robots that can be used as nursing assistants in clinical settings.
Meet RoNa (Robotic Nursing Assistant) System:
RoNa was developed by HStar Technologies to assist with safe patient handling. RoNa is capable of assisting healthcare providers to lift and turn up to 500lbs and also has telepresence capbilities, allowing nurses and providers to communicate with patients that RoNa is assisting (Robotic nursing assistant", 2016).
This is TRINA:
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| Photo credit: http://www.dukechronicle.com/article/2016/11/duke-engineers-nurses-develop-robotic-nursing-assistant |
ROBEAR:
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| Photo Credit: http://www.theverge.com/2015/4/28/8507049/robear-robot-bear-japan-elderly |
Robear was designed by Toshiharu Mukai, a Japanese researcher with the aging population in mind (Byford, 2015). Mukai intended to create a robot with a nonthreatening appearance that can assist elderly patients in an out of wheelchairs, help them to stand and perform other important tasks in place of caregivers (Byford, 2015).
Why are we not funding this?
It is not difficult to understand the benefits of using robotic nursing assistants in clinical settings. The Occupational Safety and Health Administration (OSHA) estimates that work-related injuries cost healthcare institutions an estimated $2 billion annually in workers' compensation and $27,000 to $103,000 to replace injured nurses (n.d.). Implementing safety measures such as permanent overhead patient lifts could cost hospitals $16,000 per lift and $6,000 for mobile lifts (Rubenfire, 2015). In a 24-bed unit like my own, installing ceiling lifts in every room would cost $384,0000 to install, one or two mobile lifts might also be needed to assist with ambulating patients leading to a total cost of $396,000 for my unit alone.As most robotic nursing assistants are still in the prototype phase, this is the largest barrier to their use in clinical settings. Other barriers to using robotic nursing assistants are high cost, complexity of use, lack of patient trust in the robot's capabilities, and potential depersonalization of care (Byford, 2015). Change is difficult, but I believe that robotic nursing assistants are a change for the better.
Are they really better?
Robotic nursing assistants are more cost effective than current best practice standards and they are also more versatile. The most recent Robear prototype has an estimated cost of $168,000 to $252,000 in comparison to the estimated $384,000 cost of installing lift equipment (Byford, 2015). As shown earlier, robotic nurse assistants are capable of lifting, turning, and ambulating patients. The robotic nurse assistants would be useful where lifts are not. For instance, Robotic nurses can lift and hold patient limbs during difficult dressing changes, can turn patients so that they can be cleaned, and can assist in getting patients in and out of beds or chairs. Robotic nursing assistants could greatly reduce staff injuries from lifting and turning patients, saving healthcare systems billions in workers’ compensation and offering a safe alternative to ambulating patients ("Worker safety in your hospital", n.d.). Robotic nursing assistants would allow nurses to focus more on their direct patient care by saving time in trying to track down help for a turn or boost.
Toshiharu Mukai's Robear's non-threatening appearance might be more easily accepted by patients than the RoNa or TRINA models (Byford, 2015). This feature may be important when considering specific patient populations such as pediatric and geriatric patients. Robotic nursing assistants like TRINA could be used to care for highly infectious or contagious patient populations, thereby protecting hospital staff from the risk of infection (Liu, 2016). The TRINA and RoNa robotic nursing assistant models have telepresence capabilities making them more than just a "lift team" and this function might be more useful in intensive care settings or clinical environments that utilize telemedicine.
Currently, there are more robotic nursing aid prototypes than TRINA, RoNa, and Robear, however this blog was designed as an introduction to the topic as opposed to an extensive review of robotic nursing assistant models. Robotic nursing assistants show promise in reducing the physical workload of nurses and nursing assistants in clinical settings. My hope is that robotic nursing assistants will eventually replace ceiling and mobile lifts, making the hospital environment a safer place for patients and healthcare workers.
References:
Byford,
S. (April, 2015). This cuddly Japanese robot bear could be the future of
elderly care. The Verge. Retrieved from:
http://www.theverge.com/2015/4/28/8507049/robear-robot-bear-japan-elderly
Jones,
S. (February, 2017). Are nurses caring for themselves? Impact and outcomes of
the 12-hour shift. Linus Medical. Retrieved from: http://lineusmed.com/new-blog/are-nurses-caring-for-themselves
Liu,
E. (November, 2016). Duke engineers, nurses develop robotic nursing assistant.
The Chronicle. Retrieved from:
http://www.dukechronicle.com/article/2016/11/duke-engineers-nurses-develop-robotic-nursing-assistant
Rubenfire,
A. (June, 2015). Taking a load off nurses: Hospitals eye installing patient
lifts but face technical, cost challenges. Modern Healthcare. Retrieved from:
http://www.modernhealthcare.com/article/20150627/MAGAZINE/306279979
Robotic
nursing assistant (RoNa) system. (April, 2016). HStar Technologies. Retrieved
from: http://www.hstartech.com/index.php/rona.html
Safe
patient handling movement (n.d.). American Nurses Association. Retrieved
from: http://nursingworld.org/DocumentVault/GOVA/Federal/Federal-Issues/SPHM.html
Worker
safety in your hospital (n.d.). Occupational Safety and Health Administration.
Retrieved from:
https://www.osha.gov/dsg/hospitals/documents/1.1_Data_highlights_508.pdf
Blog Responses:
Annie Berlin--March 3, 2017 at 4:54pm
William Hale--March 4, 2017 at 8:40 pm
Blog Responses:
Annie Berlin--March 3, 2017 at 4:54pm
William Hale--March 4, 2017 at 8:40 pm
