Implications of a wireless network on patient care

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Implications of a wireless network on patient care

• Kimmith Jones, MS, RN, CCNS
• Advanced Practice Nurse
• Sinai Hospital of Baltimore

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Changing Worlds

• Newtonian

• Age of Technology

• Vertical orientation
• Hierarchical structures
• Focus on control
• Top-down decision making
• Mechanistic models of design
• Process-driven actions

• Heterarchy
• Nonlinear structures
• Focus on relatedness
• Center-out decision making
• Complexity based models of design
• Value-driven actions

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Newtonian Age versus Age of Technology
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Changing Mental Models
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Wireless Technology to Support Patient Care
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Vocera

• 13,000 calls per day
• 1800 Vocera Badges in use
• 930 concurrent users on a typical week day
• Provides immediate and direct communication with
  providers
• Urgent evaluation
• Increased access to experts
• Advanced Practice Nurses
• Physicians/Nurse Practitioners
• Ancillary Departments
• Dead zones

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Computers on Wheels (COWS)

• Access Cerner, GroupWise, Intranet, and other
  Citrix applications
• Decreased time to obtain orders
• STAT medications
• Restraints
• Allows providers to enter orders from anywhere
• Documentation at the point of service
• Challenge obtaining buy-in from staff
• Equipment maintenance

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InTouch Health Robot

• Physician can make rounds from home
• Visualization of the provider and the patient
• Provider can connect when called by staff
  regarding concerns

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Alaris Infusion Pumps

• 900 infusion pumps
• Network allows the data set to be uploaded
  wirelessly
• Decreased Clinical Engineering time
• Emergent changes can be made quickly

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Laptops

• Used by ancillary departments
• Social Work
• Case Management
• Pharmacy
• Increased productivity
• Direct charting into EMR

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TUG

• Used for medication delivery
• Decreased pharmacy technician time
• Delivery of non-stat medications to inpatient
  units
• Every 30 minute delivery
• Decrease time from order to administration

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Pyramis

• Carts upload test results to server
• Allows Cardiologist to interpret 12 lead EKG
  quicker
• Faster initiation of interventions

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Clinical Engineering Handheld Device

• Receive work tickets wirelessly
• Access documentation for bio-medical equipment
• Improved workflow efficiency

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Secure Guest Network

• 75 guests logged in on typical day
• Can only access internet
• Bandwidth restricted
• Increased patient and family satisfaction

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Education
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Impact of Wireless Technology on Patient Care

• Benefits

• Limitations

• Faster provider response time
• Medication process
• Drug ordering to administration
• Documentation at the point of care
• Improved efficiency
• Increased Patient and Family Satisfaction

• Buy-in from providers/staff
• Use of Cows
• Equipment maintenance

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Future Applications

• Nurse call system
• Interface with Vocera
• Interface between clinical devices and network
• Upload monitor data to electronic medical record
• Send monitor alarms to Vocera and/or pagers
• Cardiac monitors, vital signs monitors, fetal
  monitors, etc.
• Order entry to Alaris infusion pump
• Associate pump to patient
• Match order, patient, medication and pump
• Pump is pre-programmed, just needs approval

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• More options for handheld devices, tablet PCs and
  Laptops
• Allow for broader connectivity options while
  maintaining security and supportability
• Provide more bandwidth for expanded applications
• Dual Band Mobile Phones
• Allow for roaming between broadband and WiFi
  network
• Users telephone number can follow them with one
  device
• Equipment and patient location utilizing
  radio-frequency identification (RFID)