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
Just love RoBear! :)
ReplyDeleteHi, Raenan.
ReplyDeleteBeautiful job on your blog! I love all the white space and soothing colors, and the topic is timely and important.
Before reading your blog and some of the articles you sited, I did know that nurses suffer a lot of work related injuries, but I was not aware that healthcare workers have one of the highest rates of musculoskeletal injuries in the nation (Rubenfire, 2015)! I was also tickled to read in that same article about my hospital and the installation of all our ceiling lifts. I am very fortunate to work at a facility that has ceiling lifts in every patient room and even in the hallways to facilitate walking with unstable patients. The lifts can be used to place the patient effortlessly from bed to a chair or vice versa, and can even be used to roll the patient on one side. Reading in your blog that each lift is estimated to cost $16,000 is staggering! We have two wings on each of 8 floors and 28 beds on each wing. Maybe that's why we don't get holiday pay!
I was shocked to read in the article by the American Nurses Association (n.d.)that healthcare has become one of the most dangerous industries in the U.S.! The information in your blog is so important. Maybe you could share it with your facility?
Great work on the blog! It was nice working with you this semester!
Reference:
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
Safe patient handling movement (n.d.). American Nurses Association. Retrieved from: http://nursingworld.org/DocumentVault/GOVA/Federal/Federal-Issues/SPHM.html
3/3/17 at 1:18pm
#YOHOB is great! I think it should be used on educational posters in healthcare facilities! Great information on interactive robots as nurse's assistants. Utilizing technology that allows for safe, efficient patient transfers, as well as saving nurse's backs is a subject that nurse leaders and healthcare facility executives should look to invest in. It makes a lot of economic sense. As a pediatric nurse, I love the idea of Robear! It's face is very friendly and I believe it would be a great hit on most general pediatric units.
ReplyDelete
ReplyDeleteMarilyne Faustin
#YOHOB this is an amazing blog and all the pertinent information provided with Robotic nursing. Wow! One thing that surprises me is with this cope is how there are some elements that may not be completed with the task of robotic nursing. For example. Robots cannot assess a patient's status and intervene to save her life. Robots cannot tell physicians when they are doing the wrong operation on the wrong patient. Robots cannot call security to remove a drunken surgeon from the operating room. However, I’m please with the advancement of technology, we have come a long way and as we progress robots will be much more capable like Rosie from the Jetson cartoon, we have to stay connected with all new technology and improvement.
Love the blog.
Francis, P., & Winfield, H. N. (2006). Medical robotics: The impact on perioperative nursing practice. Urologic Nursing, 26(2), 99-104, 107-8. Retrieved from http://ezproxy.ju.edu:2048/login?url=http://search.proquest.com.ju.idm.oclc.org/docview/220153988?accountid=28468
Stanton, C. (2011). Keeping up with technology. Association of Operating Room Nurses.AORN Journal, 93(1), C1, C8-9. doi:http://dx.doi.org.ju.idm.oclc.org/10.1016/S0001-2092(10)01271-8
Raenan,
ReplyDeleteSuper blog! What a creative idea. I must live under a rock as I had no idea this was even in the making. As an old CVICU nurse I feel your pain when it comes to ICU workflow. We as nurses also provided all patient care. Being a type A ICU nurse I enjoyed providing full care to my patient. I wanted to be the one to bath them and change their linens etc. Maybe it’s because I didn’t trust anyone else to do the job as well as myself? I feel that if I have a hard time trusting a real nursing assistant I might have an even harder time trusting a robotic nursing assistant.
The Nursing Times (2013) asked healthcare providers for their views on machines that are currently being developed with the potential to carry out basic tasks such as housework, feeding and walking the results concluded that more than half of those surveyed said they would prefer a robotic assistant to a human. With that being said they were against robots that had direct patient contact such as bathing, feeding patients, and getting patients dressed (Nursing Times, 2013). The Nursing Times (2013) also concluded that rather than thinking robotics will eventually take over our positions, those polled felt that they would help reduce physical demands and workloads.
Overall, I think it would take a lot of education before I would feel comfortable giving up the reigns to a Robot even if they were helping with my workload.
Great blog!
Reference:
Nursing Times (2013). Healthcare assistants ‘would welcome robot assistants’. Retrieved from https://www.nursingtimes.net/roles/nurse-managers/healthcare-assistants-would-welcome-robot-assistants/5058248.article
Great blog post!!! I can see you were very creative and put great effort into making this blog flow so well and look great.
ReplyDeleteYour topic was very stimulating. I think that the robots would be a great help especially as far as mobility is concerned. It would be great to have a robot to help move patients or turn them when you need to do a skin assessment or something to that nature. Every day as nurse we put our backs in danger when having to do some of the manual labor that these robots could possibly take over. As amazing as this sounds, you have to think that if these robots become more and more specialized and can do more they could possibly take the place of nursing assistants and could put people out of a job. This is very unlikely for the immediate future because as you mentioned it is very expensive to get one of these let alone program it to have the full capability of a human. Although functional in nature, these robotics would lack the ability to sympathize and have human moments with patients. I think they are an amazing tool to save our backs but should only be there to help and make our jobs easier, not take jobs away.
Interesting reading.
ReplyDeleteAfter going through the blog, one of the interesting aspects to note is you provide readers with an in-depth understanding of how technology is impacting health care sector. I would agree with the you that although technology has played a central role in moving doctors farther and farther from the patients' beds, there is significant hesitation in the adoption of technologies to help reduce the workload associated with nurses. The adoption of robotics would act as one of the main solutions in ensuring that health care facilities focus on protecting their nurses from work related injuries. Specifically, the adoption of the robotic technology would help reduce the $2 billion annually in workers' compensation, as well as, reduce the costs and time taken to replace nurses within health facilities (Safe patient handling movement, n.d.). In most cases, this affects the ability for health facilities to offer the expected quality of health services to match patient expectations.
On the discussion on whether the adoption of such technologies is better, it is important to note that the adoption of robots reduces the workload that nurses experience within their respective workplace environments. In addition, the adoption of this technology is important, as it would help minimize the current crisis within the nursing profession attributed to a significant shortage of nurses. Therefore, this leads to the conclusion that stakeholders in the health care sector must be willing to engage with governments, as well as, private partners in a bid to increasing production of robots such as TRINA, RoNa, and Robear. In the long-term, these technologies will be of value towards increasing capacity for health care facilities with regard to their staffing levels, as well as, abilities to handle patients with diverse health care needs. In addition, this would help minimize the occurrence of medical errors associated with the inability for nurses to function effectively.
Reference
Safe Patient Handling Movement (n.d.). American Nurses Association. Retrieved from: http://nursingworld.org/DocumentVault/GOVA/Federal/Federal-Issues/SPHM.html
Hi Raenam, what a creative idea you have introduced to us! I loved reading you blog. It would be a great investment for hospital to have Robotic nursing assistant for safe patient transfer and help nurses to save their back. I can understand how difficult it would be in ICU to take care of total patient when they are under sedation and over 400 lbs. I think nursing leaders and management should look into this great invention and invest into this for their RNs and CNAs which can prevent workplace injuries that will lower the cost for worker compensation.
ReplyDeleteThis invention’s most beneficial tasks are for patients with highly communicable disease and weakened immune systems, handling hazardous spills and protecting nurses and nursing assistant from injury when lifting and moving immobile and heavy patients. It reduces the risk of staff exposure for a serious communicable disease and also help to prevent workplace injuries. It will be interesting to see what future holds for healthcare industry using this technology that can help to improve patient care and at the same time make the job of health care team easier.
Reference
Robotic Nursing Assistant Technology Developments. (2017, February 27). Retrieved from http://blog.soliant.com/nursing/robotic-nursing-assistant-technology-developments/