Being a nurse is a very demanding but very rewarding job with the possibility of touching the lives of many people. This was no better highlighted than during the COVID-19 pandemic.
When the entire world is struck by fear and uncertainty, with many under lockdown 2.0, nurses are actively on the front lines assisting patients and doctors. Because the nursing profession requires the core of what makes us human – paying attention, being empathetic and caring – it will never be replaced by technology. However, technological innovations can relieve nurses of the burden of many monotonous and repetitive tasks; especially in a pandemic where time is of the essence. These tools may further become common in the daily working life of nurses in the near future.
In fact, the 2020 Report (https://www.who.int/publications/i/item/9789240003279) on WHO Global Nursing highlights the importance of technology in both nursing education and practice. Let's see which ones are the most promising.
Robotics reduces monotonous tasks
Medication management, disinfection, carrying medical devices from A to B, lifting bedridden patients, navigating and greeting patients and relatives in the hospital are all activities that robots could support.
The robust TUG robot (https://aethon.com/mobile-robots-for-healthcare/) and the simplified Relay robot by Simeks (https://www.simeks.com.tr/en/portfolio-item/relay-autonomous-mobile-robot/) facilitate the transportation of medical devices, medications, laboratory samples or sensitive supplies to the hospital. They can carry around a multitude of shelves, carts or bins working all day. Both could allow nurses to spend more time with their patients instead of running up and down the floors of the building.
Another robot, Moxie from Diligent Robotics (https://spectrum.ieee.org/automaton/robotics/medical-robots/how-diligents-robots-are-making-a-difference-in-texas-hospitals), is taking repetitive tasks away from nurses in Texas hospitals. He takes supplies from closets and delivers them to patients' rooms; completely autonomously.
Helping nurses maintain the highest level of hygiene is the Xenex LightStrike robot (https://xenex.com/). This UV disinfection robot disinfects a patient room quickly in 10 minutes and a surgical suite within 20 minutes. Its effectiveness has even been proven in over 40 peer-reviewed studies.
In addition to robots that support nurses in soulless tasks, there are several innovations that help them manage patients in more difficult situations. Some robot companions can keep lonely people company or help treat mental health problems. Jibo (https://jibo.com/), Pepper (https://www.softbankrobotics.com/emea/en/pepper), Paro (https://www.parorobots.com/), Dinsow (https://www.dinsow.com/) and Buddy (https://www.bluefrogrobotics.com/) are all notable examples. Paro is shaped like a baby seal and is especially cute and cuddly to help release stress and relieve sadness and loneliness. Pepper, the 1,2 meter tall humanoid “social robot”, is even “employed” as a receptionist in a Belgian and Czech hospital.
Remote communication reaching isolated communities
The COVID-19 pandemic has boosted telemedicine into current practice. It is an effective tool to reduce unnecessary hospital visits, reduce the risk of cross-infection and still provide clinical care. Taking advantage of the same technology is telematic nursing assistance (https://evisit.com/resources/what-is-telehealth-nursing/), which is used in both emergency and non-emergency situations.
In the first case, nurses from all over the world can participate in telephone triage programs. Additionally, nurses can monitor the patient's oxygen levels, heart rate, breathing, blood sugar and more. In non-emergency situations, nurses can get their patients' blood pressure readings or glucose readings, for example. They can also instruct patients on how to dress a wound or treat a minor burn.
Telemedicine companies, such as GreatCall (https://www.greatcall.com/family-caregiving-solutions), are gaining ground and are offering their services to more and more patients.
Not only are telecommunications used to provide care, but they are also used to train nurses. “Some distance online programs have been shown to increase access to rural and remote clinical facilities previously not associated with a 'brick and mortar' educational institution,” notes the recent WHO report.
Blood sampling with technology
Most of the time, the blood drawing process is a pain point for both patients and nurses. It is known that patients do not usually like needles; but on the part of nurses, they often have to endure long and miserable moments before finding the appropriate vein. This adds to the uncomfortable patient experience and here robots and vein scanners can help speed up the procedure.
Veebot (https://www.veebot.com/), the “first phlebotomist robot,” uses a combination of infrared light and image analysis to detect a suitable vein, then applies ultrasound to see if the vessel has sufficient blood flow. While still in development, it can correctly identify the best vein with approximately 83% accuracy; comparable to an expert technician. This means less room for painful mistakes and less time spent on the procedure.
Another approach to drawing blood is to use AR technology, as illustrated in the video above. This is a light-based technology to illuminate peripheral veins to improve the success of the first stick. Devices like AccuVein and VeinViewer take this approach. For example, AccuVein (https://www.accuvein.com/) has been used on over 10 million patients and makes it 3,5 times more likely to detect blood vessels on the first stick. For a similar but cheaper solution, the $ 25 DIY device, 3D printable vein finder was designed by Alex Stanciu (https://www.instructables.com/3d-Printed-Medical-Vein-Finder/), a military automotive engineer.
Explaining a complex medical language with 3D printing
Finger splints, organ models, custom plaster casts, prosthetic parts, even biomaterials, food and, in the future, organs - there are amazing things we can already 3D print in healthcare. Many of these innovations could certainly improve the work of nurses.
For example, nurses tasked with describing medical procedures to patients can use detailed 3D printed models. This helps improve communication around complex procedures with better visualization.
Another way the technology can be used is to feed patients with specific diets. The Foodini project by Natural Machines collaborates with health institutions and authorities to print appealing foods for cancer patients or those on restricted diets. Another company, Biozoon (https://biozoon.de/en/), print gourmet-looking food for seniors who need to eat pureed meals.
Sometimes, nursing students themselves take the initiative to help patients via 3D printing (https://3dprint.com/134363/3d-printed-pill-boxes-hivaids/). Caldwell University nursing graduate students have developed a unique pill box for HIV/AIDS patients who need to swallow several pills a day but don't want to be asked to do so all the time. It's the meeting point of nursing, technology and innovation and we hope to see more of it in the future!
Portable diagnostics for greater access to care
The appearance of pocket-sized, easy-to-use and portable diagnostic devices makes it easier and faster for nurses to care for a patient. Measuring health parameters and vital signs will be reduced to a few minutes and huge, oversized machines for ultrasound, ECG or laboratory tests will become things of the past.
In fact, you can now literally pack a department's diagnostic tools into a briefcase. Most of these can upload readings online to share with a professional for further evaluation. Such portable tools greatly improve access to care in remote regions and facilities without specialists. In these cases, nurses themselves can take readings and share them remotely with doctors for more in-depth analysis.
For example, a nurse can track the vital signs of a COVID-19 positive patient with Viatom CheckMe Pro (https://www.viatomtech.com/checkme-pro?lang=it) and listen to lung sounds with Eko Core (https://shop.ekohealth.com/products/core-digital-attachment). Data can be sent to a physician to remotely monitor the patient's status and recommend hospitalization in case of suspicious readings.
Portable ultrasonic devices such as Philips Lumify (https://www.philips.it/healthcare/sites/lumify) and Clarius (https://clarius.com/) can further assist nurses in some critical tasks. Nurses trained to use such devices can accurately calculate fluid retention in both the pleural cavities of the lungs and the inferior vena cava of heart failure patients. This allows them to dispense diuretic drugs more precisely to prevent harmful fluid retention in those patients.
Artificial intelligence that assesses risk and eliminates alarm fatigue
Artificial intelligence (AI) has the potential to greatly optimize processes in hospitals and even eliminate the problem of alarm fatigue. By improving efficiency, AI will bring enormous benefits to nurses.
The researchers of the dukeuniversity have demonstrated such an application in nursing. Their deep learning algorithm Sepsis Watch (https://www.sepsiswatch.org/what-is-sepsis) helps assess a patient's risk of developing sepsis. Automatically alerts the hospital's rapid response team of a high-risk patient; and guides them through the first 3 hours of providing care. This is crucial to prevent complications.
Alarm fatigue refers to the point at which healthcare workers become desensitized to warning signals from the myriad of devices that emit a cacophony of beeps all day in the clinical environment. Healthcare institutions experience up to 187 alarms per bed per day, of which 72% to 99% are false alarms. These false alarms add to alarm fatigue, which in turn can lead nurses and doctors to miss those alarms that truly require clinical attention. AI can reduce the rate of false alarms and thus eliminate alarm fatigue. In a 2019 study, the researchers proved that their AI-powered system helped reduce notifications received by healthcare professionals by up to 99,3%! With such a system in place, nurses can be informed about cases that require attention and focus on those.
Virtual reality for education
Medical training, surgery, rehabilitation medicine, psychiatry, and psychology could all benefit from virtual reality (VR), and even the field of nursing could reap the benefits of the technology.
Virtual simulations could support the nurses' training phase. A Wolters Kluwer's survey it even found that 65% of nursing education programs use virtual simulations, including VR. This ensures that nurses are ready for practice and improves the training process. For example, Robert Morris University has developed a VR game that allows nursing students to practice urinary catheter insertion. Those students trained in virtual reality showed a higher pass rate than students who practiced on mannequins.
At another institution, the University of Nevada, Reno, nursing students use VR headsets to view doctors and nurses in scenarios with medical complications; scenes they may not always be exposed to during their upbringing.
Others like the University of New England and the University of Michigan use virtual reality to put students in simulations where they must train their communication and empathy skills.
New technology for better drug management
Managing your drugs can get a boost from new technologies like chatbots, companion robots, and digital pills.
I chatbot they are already an integral part of the health system. During the COVID-19 pandemic, several dedicated chatbots were launched for remote risk assessment and are still in use; but these chatbots can further alleviate the burden of nurses by integrating some of their duties. For example, Florence (https://florence.chat/) is an electronic “personal nurse” in the color blue. “She” can remind patients to take their pills, which could be a useful feature for older patients.
Rather than a virtual chatbot, Catalia Health (https://www.cataliahealth.com/) developed a physical robot for drug management. The sympathetic Mabu robot it not only reminds patients to swallow their medications, it also provides insights to healthcare professionals.
Sometimes, compliance starts with the medication itself. For this purpose, there are digital pills, which can be tracked to monitor adherence. Researchers also have demonstrated better adherence to treatment among tuberculosis patients who used such smart pills. EtectRx (https://etectrx.com/) and SIGUEMED (https://siguemed.com/) develop digital pills to help patients take their medications correctly.
Both nursing jobs and robots will remain
However, if nurses do not begin to understand and embrace new technologies as part of their work, the profession and the best interests of patients will suffer. The WHO report (https://apps.who.int/iris/bitstream/handle/10665/331673/9789240003293-eng.pdf) echoes a similar need for nurses to be equipped and familiar with digital health technologies.
It is a crucial necessity for improving the health landscape.
Bianca Stan – Graduated in Law, writer with several books published in Romania and journalist for the group "Anticipatia" (Bucharest). It focuses on the impact of exponential technologies, military robotics and their intersection with global trends, urbanization and long-term geopolitics. He lives in Naples.
