Promoting Pressure Injury Prevention Technology

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Introduction

Do you remember that cartoon from the 1960s (and later reproduced in the 1980s), The Jetsons? It was about a futuristic family that had all kinds of amazing robot helpers and automatic appliances. Rosie the Robot was the wonderbot that would whisk about the house, frantically preforming housekeeping duties, monitoring the security of the home, and generally making sure that everything was online and functioning. Do you ever feel like this as a clinician? Rushing about, multitasking, being pulled in what seems like a hundred different directions, all while expected to perform with “Rosie-like” perfect, machine-like efficiency. Wouldn’t it be wonderful to have Rosie’s artificial intelligence technology and functionality, to be able to successfully navigate your tasks of the day and make sure that all of your patients have optimal outcomes? That their care plans are enacted seamlessly and you leave your shift knowing that every box on your to-do list has been checked off? This may seem like a piece of fiction, right? Actually, there are some futuristic technologies that might have come straight out of the Jetsons and are available to us right now. These technologies may help us achieve such “Rosie-like” outcomes. It can be difficult for many clinicians to accept novel technology in their day-to-day routine, but let’s explain how it can be an important, time-saving tool.

Scenario for Technology Use in Pressure Injury Prevention

Let’s take pressure injury (PI) prevention, for example. It is well known that using offloading pressure devices, repositioning a patient frequently, optimizing hygiene as well as skin care, and managing any nutrient deficiencies can prevent and treat existing PIs. However, let’s say you have eight patients on a busy medical floor. Or 26 patients overnight on a skilled nursing facility unit. Or even three very ill intensive care unit patients. Completing a thorough risk assessment, turning a patient every 2 hours (or more if needed), checking skin moisture levels as well as incontinence, and monitoring dietary intake can seem like a big ask, or even an impossibility. How can we use the technology at our fingertips to help with this? Let’s consider a scenario where you do just that:

You arrive at work just before 3 pm and sit for report. You work on a busy medical floor in a large city hospital and find that you have eight patients. Two patients are walking around the unit as recommended to them by their physical therapist, and three patients sit in chairs next to their beds and are able to safely ambulate to the bathroom or to bed. You were warned that one of these patients (an elderly woman) tends to get confused in the evening and may need extra attention. The remaining three patients lie in bed, watching television or sleeping. Their medical needs vary, but you learn that two of the patients who are currently in bed require a large amount of pain medication. One of the seated patients is morbidly obese, and two are incontinent of feces and urine. There are many factors to assess here, but for the sake of this scenario, let’s focus on preventing a PI.

You log into the electronic medical record (EMR) on the tablet that you are given for the shift and learn that a risk assessment has been completed and logged in for each patient. The patients who are seated or in bed are using a wearable device that will alert you if that patient has been in one position for longer than two hours. On the tablet that you carry is a program that allows you to take a photograph of the patient’s skin to assess for temperature and moisture. This then goes through the PI prevention software that is loaded onto the tablet and alerts you if there are early stages of a new PI developing. You come up with a plan to introduce yourself to your ambulatory patients and then to go to each room to assess the seated and bed-bound patients. Using the risk assessment score that you already have from the EMR, you are able to quickly determine which of your patients will likely need more frequent repositioning, cleaning, and monitoring.

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You tell the seated patients that they may hear a recorded message for them to readjust themselves from the pressure monitoring device that they are wearing. They tell you that that has happened throughout the day, so they are accustomed to it and will be able to shift themselves accordingly. You then check in on your bed-bound patients. The two who are sleeping and are heavily medicated and are lying on a pressure monitoring device that you have set to alert you if they need repositioning. You and a coworker also take this opportunity to carefully reposition them, and while doing this, you are able to scan their skin with your tablet to look for any potential problems. One of the scans reveals that there is an area of increased heat to the left ischium of your sleeping patient. You carefully reposition this patient to relieve pressure and enter this finding into the EMR, so it can be assessed in the future.

Conclusion

This scenario illustrates how incorporating advanced risk assessment tools into the EMR and using advanced imaging can help identify and treat patients who are at higher risk of developing a PI. This technology can be particularly useful for staff who are faced with taking on extra shifts in a setting where they care for more acutely ill patients with less staff and resources. Instead of viewing this type of technology as burdensome and creating “more buttons to click,” we can instead see it for the potential that it has to create a smooth flow of work. It may take a bit of time up front to learn to use this technology and to incorporate it into daily use, but the time-saving benefits can be significant. Although we don’t yet have “Rosie” rolling along the floors, turning people with her robot arms, we do have our own pressure-relieving artificial intelligence that can help us have a less stressful, more efficient use of our time and efforts. Ultimately, as more clinicians accept and embrace these novel forms of technology, we can come to a point where the time-saving measures that they allow us will ultimately help us provide better care for our patients.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.

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