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“If the system is supportive of nursing rather than being counterproductive,” she says, “that may be a draw.”

Nursing informaticists believe young nurses, raised on cell phones, the Internet, and digital everything may provide the greatest impetus for hospitals to upgrade nursing technology once and for all.

Nurses come to El Camino Hospital from other parts of the country, attracted by its reputation as an early adopter of technology, Reinking says. A couple years ago, she realized how important that reputation was after moving to a job at a hospital in another state.

“Everything was still manual,” she says. “It was old-fashioned.”

Within a short time, she returned to El Camino with a new appreciation for the hospital’s cutting-edge culture.

“If technology can make it easier for our staff and safer for our patients,” she says, “we want to look at those things.”

Hot stuff
by Cathryn Domrose

Communications

What's here: Vocera, a voice-activated communicator worn around the neck. Nurses tell the device to dial a physician or the nurses station or an outside line, and can communicate directly with the person they want to talk to.

The pluses: Nursing informaticists report nurses love Vocera. It's easy to use, easy to carry and doesn't need to be connected with anything else. The direct communication eliminates having to play complex games of phone tag through the nurses station.

The bugs: Because the system is essentially a speaker phone, some nurses say they had to adjust their ways of taking a call to protect patient privacy, such as stepping into another room.

What's coming: Eventually, Vocera could be hooked up to nurse call buttons so nurses could have direct communication with their patients.

Lifting

What's here: Lifts stored in the ceilings of hospital rooms that allow nurses to lift and transfer patients.

The pluses: Nurses don't have to get bulky equipment out of storage to help lift patients and are more apt to use the in-room lifts. The lifts can help prevent patient falls and back injuries to caregivers.

The bugs: It is still often awkward to get patients into the lift slings.

What's coming: Researchers at the Veterans Health Administration Patient Safety Center of Inquiry in Florida are working to develop a slingless lift that disabled patients can operate without help.

Medication dispensing

What's here: Bar coded patient wristbands and medications. Nurses swipe the medication label across the patient's band to make sure they match.

The pluses: Nurses can be sure they are giving the right medication to the right patient. The documentation for the medication is automatically entered into the system so they don't have to do it manually.

The bugs: Bar codes can be difficult to scan and sometimes require four or five tries. It's an extra step the nurses didn't have to do before. If the patient is asleep or out of the room, the nurses need to explain why they didn't give the medication.

What's coming: Bar coding for screening devices such as blood tests (already being used in some hospitals) and glucose screening. Bar coding that allows patient information to be entered into a computer so it doesn't have to be manually entered each time.

Monitoring systems

What's here: Wireless devices that collect vital signs data allow the nurse to verify it and enter it into a computer system where nurses and physicians can access it as they need it.

The pluses: Nurses save time and risk fewer errors because they don't have to transcribe vital signs information to charts. They have patient information at their fingertips.

What's coming: Nurse leaders would eventually like to use electronically collected data in research projects to determine best-practices for their staffs.

Documentation systems

What's here: Documentation systems that allow nurses to do their charting, care plans and data collection by computer, as well as pull up lab results, procedures, and insurance information.

The pluses: Nurses who have computerized systems that they like say the process saves them hours of documenting per week. They can retrieve information easily. They say they spend more time with their patients.

The bugs: Not all electronic documentation systems are nurse-friendly. Many must be redesigned and customized for different departments. Also, no one has come up with a perfect method for transporting the computers. Handhelds are too small for documenting. Many nurses consider tablet PCs difficult to carry and easy to break. Some hospitals use laptops on mobile carts, but nurses have to push these in addition to any other equipment they have to carry.

What's coming: As researchers understand more of what nurses do, nursing documentation programs should improve. Nurse informaticists are waiting for a device somewhere between a handheld and a tablet PC that nurses can easily carry with them to document at the bedside. Some nurses think documentation will be done on computers in patient rooms, much the way charts were once kept at the foot of patients' beds. Patient entertainment and education stations.

What's here: Bedside computer screens that allow patients to watch television and movies, check and send e-mail, play computer games, and do Internet research.

The pluses: Patients can stay in touch with work and family. They can use the system to order meals or make requests, such as a room change. They can watch in-house videos about procedures they are going to have or health issues such as smoking cessation.

The bugs: There is usually a charge for movies and Internet access. Some visitors may become more focused on the computer than on the patient.

What's coming: Nurses see a huge potential in using patient stations as teaching tools, selecting information to show to patients and families on their condition and what they can do to improve their health after discharge. The stations also could be used to help dispense bar coded medications, register vital signs, or show visual information such as X-ray and wound pictures.

Cathryn Domrose is a staff writer for NurseWeek. Send e-mail to cathrynd@nurseweek.com.