Editor's Note

Dear Professionals,

Greeting from RGUHS Journal of Nursing Sciences. I take immense pleasure in presenting Vol-10, issue-1 of RJNS, June 2019. The RGUHS editorial board extends its gratitude to all the authors who have contributed articles for this issue. Nurses work 24 x 7 hours with patients and community, experiences creative and critical valuable information that needs to share. We encourage the nursing fraternity to contribute scientific and research papers to this journal and thus empower knowledge on nursing profession. The editorial of this issue focuses on upholding clinical competency in nursing.

Getting an article published in nursing journal may seems daunting to novice writers, but the rewards for outweigh the challenges. RN editors and authors offer these pointers to help aspiring authors convert good ideas into published work. Writing a clinical article is an important way of getting your message to frontline healthcare staff who are expected to implement evidence-based practice. Frontline healthcare staff are looking for many ways to improve their practice and if this can be found in well-written articles which explained clearly this is likely to have a positive impact on healthcare. In addition, research funders are also looking at the outputs from research that demonstrates is an impact on improving health, care such as policy changes. Therefore, taking into consideration the frontline users of research when writing is an important part of any research publication strategy’s.

It is important to discuss on publication strategy at the very beginning of research work for a master degree dissertation or doctoral thesis. supervisor(s) will play a major role in helping to develop ideas, carry out the work, and write up the thesis. Therefore, it is appropriate that issues such as co-authorship have been discussed and agreed. Journals are likely to have policy on who can be included as an author and who should be acknowledged as making a contribution, but not as an author. When supervisor(s) has participated in writing an article, then it is probably most appropriate that the first named author, followed by the name of the supervisor(s) in the order agreed. It is conventional that the first named author is recognized as doing the major part of the work, and the others are seen as making a lesser contribution. Authors should adhere to journal rules about authorship convention rather than those of individual universities.

Empower nursing by contributing and publishing their thoughts, experience, innovative and creative research.

Clinical Technology to Improve Nursing Care 

Patient care technology has become increasingly complex; transforming the way nursing care is conceptualized and delivered. Before extensive application of technology, nurses relied heavily on their senses of sight, touch, smell, and hearing to monitor patient status and to detect changes. Over time, the nurses’ unaided senses were replaced with technology designed to detect physical changes in patient conditions. Consider the case of pulse oxymetry. Before its widespread use, nurses relied on subtle changes in mental status and skin color to detect early changes in oxygen saturation, and they used arterial blood gasses to confirm their suspicions. Now pulse oxymetry allows nurses to identify decreased oxygenation before clinical symptoms appear, and thus more promptly diagnose and treat underlying causes. Technologies used by nurses offer the means for preventing errors and adverse events (e.g., medication errors, miscommunications, delays in treatment, and adverse events-such as failure to rescue, nosocomial infections, pressure ulcers, falls, and complications of immobility).

Four-pronged strategy by WHO

The approach offered for nurses is consistent with the following four-pronged strategy developed by the World Health Organization Medical Devices and Equipment team:  

Policy: Nurses providing direct patient care should be involved in setting and evaluating institutional, organizational, and public policy related to technologies.

Quality and Safety: Nurses providing direct patient care can ensure that the technologies they use meet international quality and safety standards and technical specifications needed to perform in the clinical environment in which they are used.

Access: Nurses providing direct patient care can ensure that institutional decisions are made with their input and the input of other critical stakeholders.

Use: Nurses providing direct patient care should be involved in their intuitional policies and processes related to maintenance, training, monitoring, and reporting adverse events related to technology.

There are 7 stands out technologies transforming medical care, and as nurses are educated about new medical technologies and practices, patients and providers benefit 

1.  Automated IV pumps 
2. Portable monitors 
3. Smart beds 
4. Wearable devices 
5. Electronic health records 
6. Centralized command centers 
7. Telehealth and apps

Automated IV pumps: Automated IV pumps control the dosages and drips given to patients. Software and medical tech allows nurses to change the drip amounts and medication doses so patients aren’t waiting for changes. There are IV pumps for nutrition, which gives needed meals at the right times. Additionally, there are self-pumps which allow patients to increase a controlled amount of pain medication for themselves.

Automated IV pumps help speed up nursing processes, and can be crucial if there is a need for immediate adjustment. Changing medication through an automated process also removes elements of human error that could present issues for clinical patients and hospitals. Automated IV kits give nurses opportunities to focus on other areas of work, instead of having to measure and give medication or food. Hospitals all have different kinds of automated IV pumps, so training and education is often based on the specific hospital or clinic where nurses work.

Portable monitors: Portable monitor equipment allows nursing professionals to check up on patients even if they are on the move, or busy helping someone else. Portable devices monitor vital signs like ECG, respiratory rates, and oxygen saturations while transmitting the information back to a central monitor. This means that nurses will get an alarm notification if there is any emergency. 

Most hospitals have nurses check on levels hourly. Portable monitoring technology allows nurses to track and note stats at the right time, even if there are a lot of other things going on. This helps patients be constantly monitored from anywhere in the hospital, and the alerts and alarms sent to nurses through the portable monitor can save lives. 

Smart beds: Smart bed technology can help nurses track movement, weight, and even vitals. Smart beds also play a major role in keeping patients safe and comfortable during a long hospital stay. With the number of falls and patient injuries inside hospitals, smart beds are very important for patient safety. 

Smart bed technology gives nurses a constant monitor in a room that provides them with regular updates and communications on a patient’s activities. It can also help them identify patterns, which can lead to a new diagnosis or a different understanding of a condition.

Nurses also spend less time coming in and adjusting supplies and medical equipment for comfort or safety, because they can help control that with their smart bed. It allows providers to get back to other important work that needs to be done by humans.

Wearable devices: Wearable devices and mobile apps are transforming the healthcare industry. Devices that help track heart rates, exercise, sleep, respiration, and more, are helping people take their health into their own hands. With increased accessibility to iPhones, nurses also benefit from apps and devices that help them care for patients. For example, the seth IO steth, IO Smartphone, stethoscope is essentially a stethoscope app that allows nurses and doctors to simply use their Smartphone to get breathing sounds and see heart rates. Using a phone can be less intimidating, especially for younger patients, and gives providers a full range of information and easy tracking of medical needs.

Wearable devices from health tracking, to specific patient monitoring, are often called the future of healthcare. With access to huge amounts of data, wearable devices can help the entire healthcare process; from diagnosis to recovery. Wearable devices help remove elements of human error for nurses, because the communication of data comes directly from the device itself. It allows for faster record keeping, and helps patients and nurses maintain consistent monitoring of health.

Electronic health records: Electronic health records (EHR) are taking over older paper filing methods. Electronic health records allow nursing experts to document care provided to patients, and retrieve information that can help prioritize care. Additionally information entered into computer systems, can then be accessed by the care team, including doctors and even patients themselves when necessary. EHR’s can tell registered nurses (RNs) whether steps still need to be taken for a patient, can monitor small condition changes, and can give them information immediately as alerts or reminders. Real-time health updates impact the speed and accuracy of medical care. RNs learn how to use software systems on the job, but their education and training will help them quickly understand what different indications on medical records mean, and what their course of action should be; to ensure improved patient outcomes.

Centralized command centers: One of the newest ideas for hospitals, centralized command centers, promise improved patient experiences and better ways for RNs and doctors to manage supplies, clinical technology, and capacity. This is done through software applications such as dashboards that provide real-time updates for an organization. 

With shorter or non-existent delays between transitions of care, nurses and doctors can actively be aware of room availability, OR schedules, and what individual patients still need in order to be discharged. This allows everyone to do their job more efficiently, and help patients more effectively. Specifically designed for capacity management, command centers being piloted around the country are performing well. Many hospitals report operating at higher capacity, and overall improved patient experiences. 

Telehealth and apps: Telehealth is a new and valuable element in healthcare. Hospitals and clinics allow patients to virtually video-chat with a doctor or nurse. Patients are able to describe their symptoms, or show doctors things like rashes or bumps. This allows patients to quickly be diagnosed, without leaving the comfort of their own home. They can be told if they need to come in for further testing or diagnosis, be prescribed medicine, or given medical advice.

Telehealth saves patients and doctors alike money and time. Similarly, it prevents sick patients from coming to public places, and exposing other patients. This technology is changing the way clinics operate and how patients are cared for. Similarly, medical apps and wearables help patients and doctors work to improve health. Doctors and nurses can monitor vital signs of patients without them being in the office. They can be utilized for overall health and wellness, or for specific medical concerns such as seizures or diabetes.

Nursing education: New clinical healthcare technology is exciting and transformative for healthcare. With new innovations impacting the industry every day, now is the perfect time to advance your nursing career. Using software for online college programs will help you be more comfortable with the computer skills required by advances in health IT (health information technology), and the flexibility to do coursework on your schedule will help you keep your life on track. Competency-based education (CBE) means you can take your work experience and use it to help you move faster through courses where you already have knowledge and experience.

CONCLUSION:

Patient care technologies of interest to nurses range from relatively simple devices, such as catheters and syringes, to highly complex devices, such as barcode medication administration systems and electronic health records. Technology can be broadly defined to include clinical protocols and other “paper” based tools, but for the purpose of this chapter, we will focus more on equipment and devices that nurses are likely to encounter in delivering direct care to patients.