Feb. 13, 2007
If patients in some area intensive care centers get the feeling someone is watching over them, they might be spot-on. Veteran Froedtert Hospital nurses are now able to remotely monitor critical care cases from a virtual intensive care unit, an innovative system which is now being studied as a way to retain the skilled workers of an aging nurse population.
Bob Herdrich of West Bend, director of special projects in nursing for Froedtert, is administering study, paid for by a $45,808 grant from the Robert Wood Johnson Foundation. The prestigious healthcare foundation is funding projects which could keep qualified nurses working longer as a way to combat what many in the healthcare industry see as looming and disastrous nurse shortage.
The virtual ICU was created in October 2005, as an added level of medical information analysis designed to lower mortality rates, increase quality of care, reduce the length of ICU stays, decrease malpractice lawsuits and ultimately reduce costs. Once in place, nurses with years of experience showed the most interest in staffing the project.
“What we’ve noticed is that it was attracting nurses from our ICU, and older, more experienced nurses from Froedtert,” Herdrich said. “We’re seeing that this is a workplace that’s supportive of older nurses. We believe the virtual ICU provides the environment where experienced nurses can exercise the skills in a less physically taxing environment.”
About half of the dozen nurses in the virtual ICU meet the foundation’s definition of an older nurse as on 45 years or older, but all meet the minimum requirement of five years experience in an on-site ICU. From a room in an office building, nurses can watch vital signs on monitors, communicate with on-site staff and even zoom in cameras to get a close look on a patient’s IV bag.
“We’re kind of like an extra security blanket,” said Erin Green, virtual ICU nursing supervisor. “Nursing has become very task-oriented because our patients are so sick and there isn’t enough staff just to do all the things you need during the day.”
Each day two or three nurses monitor the ICUs of five hospitals with the help of a communications staff. Green said on-site ICU cameras are only turned on at the request of on-site staff for help in diagnosing changes in patients.
A switch in patients’ rooms called the “eLert” button can be triggered to alert nurses of a rapidly deteriorating health situation. If on-site ICU staff was shorthanded during an patient emergency – a sudden cardiac arrest for example – virtual ICU nurses could instruct on-site staff on emergency procedure until a physician arrived, although a physician is usually on hand.
“It gives them a chance to really use their critical thinking skills,” Green said. “They’ve seen a lot of things that the younger nurses maybe haven’t seen.”
Herdrich said some on-site ICU nurses had to adjust to the idea of being watched. But soon they realized the virtual ICU operates more like up-in-the-booth headset coordinators at a football game than over-the-shoulder spies, they welcome the opportunity for collaboration.
The virtual ICU nurses can focus their attention on the big picture of the patients status by monitoring trends in vital signs and medication, and contextualizing those changes in their health.
“Any place we can reduce errors by following patient trends and monitoring it’s going to save money,” Herdrich said.
Herdrich will compile demographic information about the virtual ICU nurses, record their motivations for seeking the job, measure their likelihood of retirement, conduct focus groups and interviews and compare the data to nurses in on-site ICUs. His findings will be added to other Robert Wood Johnson-funded research projects around the country on how to retain gifted, aging nurses.
Although the start-up costs might be currently prohibitive for smaller healthcare organizations, the potential uses for the virtual ICU are exciting, Herdrich said. Similar technology could be used to monitor emergency or organ donor patients, and possibly for home-stay, ambulatory patients. School nurses could one day assess children’s illness from a remote location, and expert consultations could be called in from around the world.
“When you think about radiologists reading X-ray reports, why can’t that be read by some expert out in California?” Herdrich said.
Green said when she first saw the banks of monitors at the virtual ICU she was not exactly impressed. Like most on-site nurses who visit the setup for the first time, she was expecting something a little more futuristic-looking.
But watching the technology improve care each day has proved to be the real marvel.
“It’s pretty cool,” she said.