ANIA 2024 Annual Conference

P042 - Pump It Up! Elevating Smart Pump Interoperability through Education and Training

Paul Filipski, MSN, RN, NI-BC

Tags: interoperability integration outcomes Quality training

Updated: 05/06/24

Purpose: This is an overall review of the method, length, and content of nursing training to increase overall compliance and success with smart pump interoperability in a staggered rollout at a large multi-facility health system. The objective was to implement a system-wide continuous quality improvement (CQI) project with a focus on creating a standardized training approach. An auto-programming compliance target of >90% was established to gauge project success. Industry average auto-programming compliance rates are 70%-80%, suggesting opportunities to optimize training, goal setting, and implementation success.

Description: This is a comparative analysis of auto-programming compliance reports between site 1’s go-live (October 10th, 2022) and site 2’s go-live (February 2nd, 2023) with smart pump interoperability. A collaborative multidisciplinary approach was utilized drawing on the expertise of nurse informaticists, pharmacy leaders, nursing leadership within the health system, and our vendor partners. This collaborative effort focused on a comprehensive review of training materials, duration and content of hands-on training sessions, supplemental support materials provided to site 1, and a review of the safety and efficacy of the new system-wide drug library. After a review of site 1’s auto-programming compliance rates, observations of nursing workflows, and a lessons learned debrief, it was determined that enhancements were needed to effectively improve auto-programming compliance and success, not only at site 1, but also across subsequent sites. The nurse informatics project team revised the initial training incorporating several enhancements: one nurse per pump for hands-on training (previously 2:1), mandatory completion of a comprehensive two-hour training module (previously optional), an extended training session with additional workflow scenarios (previously condensed with basic workflows), a competency quiz to evaluate comprehension, and more accessible training reference materials. Early manager involvement and weekly check-in calls were implemented to ensure and cultivate engagement.

Evaluation/outcome: Managers’ active involvement in promoting and mandating hands-on training led to a substantial rise in classroom attendance, from 73% attendance at site 1 to 97% attendance at site 2. After adopting the enhanced training methodology (additional workflow scenarios, competency evaluation, and more accessible training materials) at site 2, auto-programming compliance soared to 97% overall average during the first week of go-live, surpassing our established goal of >90%. Site 1 also substantially increased auto-programming compliance from 64% to an impressive 86% following re-education with the enhanced training materials. Additionally, at site 1, 6 months after go-live, drug library override rates decreased from 26% to 7% and infusion-related adverse drug events were zero (Q1 2023).

Conclusion: By integrating comparative analysis and a CQI approach into our training methodology, we have effectively enhanced the understanding of the new nursing-integrated infusion pump workflows. As a result, we observed a significant boost in auto-programming compliance rates during the go-live phases at subsequent sites. Nurse informaticists are critical to help provide training oversight, establish targets, and measure outcomes. However, achieving long-term success and maintaining continuous quality improvement necessitates active engagement from stakeholders at the site level including leadership, nursing, pharmacy, IT, and biomed. Interoperability requires constant vigilance, ongoing support, and a plan for sustaining success.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P041 - Prioritizing the Patient, Not the Documentation

Christina Dansky, BSN, RN, NI-BC, CPN | Valerie DeMarchi, MSN, RN, NI-BC, CPN

Tags: electronic health record documentation burden nursing efficiency

Updated: 05/06/24

Addressing the intricate challenges presented by documentation burden, involving a multitude of stakeholders, processes, policies, and external regulations, is imperative for sustaining meaningful and efficient healthcare practices. The repercussions of documentation burden extend to a loss of significance in documentation, increased time diverted from patient care, and a diminished sense of joy in practice. Admission time is notably hectic, and capturing the most relevant admission history proves invaluable, provided the right questions are posed at the opportune moment. This enhancement project aimed to streamline the admission documentation process for nurses, reducing the required documentation while optimizing workflow efficiency, all the while ensuring that the retained data contributes meaningfully to the patient's story. The overarching goal is to give nurses more time for direct patient care without being encumbered by excessive documentation requirements.

Originally implemented in 2007, the admission screening tool (AST) underwent continuous question additions without a comprehensive refresh. Subsequent data analysis revealed that the existing AST posed a burden, lacked efficiency, and failed to contribute meaningfully to the patient narrative. Examination of EHR data tools uncovered that the AST comprised 169 questions, consuming nearly 7 minutes, 300 keypresses, and 139 clicks to complete. The data stagnated, hindering effective communication within the organization and often resulting in redundant documentation, leaving nurses dissatisfied.

A survey of nurses (n=104) reflected widespread dissatisfaction, with respondents deeming the AST inefficient and devoid of meaning. Only 22% expressed satisfaction, 20% agreed on its efficiency, and 37% found it meaningful. Furthermore, 80% perceived redundancy in information, duplicable from other chart sources. In response, an in-depth review and comprehensive overhaul were initiated to enhance the admission workflow.
Under the leadership of nursing informatics, an interdisciplinary team was assembled, comprising clinical RNs, therapists, nutritionists, accreditation, infection preventionists, family services, and information management. The team meticulously reviewed the AST, pinpointing key elements that significantly contribute to the patient story and yield meaningful data at admission. The redesigned AST prioritizes these identified elements, aligning with the project's goals: enhancing efficiency and meaningfulness, eliminating redundant documentation, and bolstering nurse satisfaction.
To evaluate the outcomes of the new AST, a comprehensive evaluation was conducted, involving a review of EHR data and a follow-up survey of nurses one-month post-implementation. The organizational enhancements resulted in a remarkable reduction of 53% in required admission questions, a 63% decrease in completion time, and substantial drops of 80% in keypresses and 50% in clicks associated with the AST.

Following the implementation, a resounding 96% of surveyed nurses (n=50) expressed satisfaction and confirmed the efficiency of the new AST. Notably, nurses reported that the updated admission information was more useful and meaningful (92%) and a significant proportion (64%) no longer perceived the documentation as duplicative. The overall sentiment among survey respondents was unanimous, with 100% concurring that they could now swiftly and efficiently document the AST. This positive transformation translated into nurses having more time at the bedside, fostering improved patient care, and alleviating the burden of EHR documentation.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P040 - Learning Activities in Nursing Informatics Education: An Integrative Review of Strategies for Prelicensure Nursing Students

Cynthia Bradley, PhD, RN, CNE, CHSE, ANEF | Theresa Harvath, PhD, RN, FAAN, FGSA | Marshall Muehlbauer, PhD(c), RN, PHN, Doctoral Candidate, University of Minnesota, School of Nursing

Tags: nursing education teaching informatics learning prelicensure

Updated: 05/06/24

Background: Learning nursing informatics and mastering informatics skills are becoming essential components of entry-level baccalaureate nursing education. Nurses must not only perform and document nursing actions but also effectively use health data transmitted through informatics infrastructures to shape nursing practice. This poster presents an integrative review aimed at examining the pedagogical strategies used to educate prelicensure nursing students in the field of nursing informatics.

Problem: The American Association of Colleges of Nursing (AACN) has outlined competencies and essentials to ensure that prelicensure nurses are prepared to enter the practice. However, informatics competencies are often content-based versus psychomotor in nature, and conventional theory-based teaching methods may not adequately equip students to navigate complex, multi-dimensional informatics challenges.

Purpose: The purpose of this integrative review is to review learning activities being employed to teach nursing informatics skills in prelicensure nursing students.

Methods: This review followed an integrative review methodology and was reported using the PRISMA standards for reporting integrative reviews. Studies were searched using the MEDLINE and CINAHL databases. Studies of pedagogical interventions in diploma, undergraduate, and graduate entry-level nursing programs were eligible for review. Studies eligible for review were limited to publication between 2017 to 2022, capturing the period leading to the publication of the AACN 2021 Essentials.

Results: The search resulted in 10 articles eligible for review. The selected articles featured diverse populations of prelicensure nursing students from various countries across the globe. Educators employed five distinct pedagogical strategies to facilitate nursing informatics learning, including academic electronic health records (AEHR), flipped classrooms, case studies, specialized seminars, and clinical experiences.

Discussion: AEHR emerged as a popular approach, with studies revealing that the use of AEHR during nursing simulations significantly enhanced students' competence in charting, understanding provider prescriptions, and managing patient medications. Flipped classrooms, involving the use of cinema clips to teach key informatics concepts, also yielded positive results, with students reporting increased knowledge and a willingness to recommend this learning method to others. Case studies were used to teach standardized taxonomy in nursing documentation, improving students' understanding of nursing documentation through the application of a standardized nursing language. Specialized seminars demonstrated the effectiveness of comprehensive nursing documentation in improving students' documentation practices. Clinical experiences played a vital role in preparing nurses for digital health, but students struggled to grasp their role in nursing informatics.

Conclusion: In conclusion, this integrative review highlights the need for a more comprehensive understanding of the pedagogical strategies employed in nursing informatics education. While the studies discussed in this review provide a promising foundation for further research, future efforts should focus on clarifying the conceptual and operational aspects of informatics education, as well as exploring the timing and duration of informatics education to enhance its impact on prelicensure nursing students. This research will play a crucial role in strengthening nursing informatics education and equipping future nurses to meet the evolving challenges of modern healthcare practice.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P039 - Implementation of an All-in-One Device for Inpatient Nursing

Mollie Maggied, MSN, MHA, RN, AT-C

Tags: emr technology mobile device nurse training

Updated: 05/06/24

This presentation will discuss OSUWMC's implementation of the all-in-one device for inpatient nurses. The implementation began with a pilot on designated units and accumulated lessons learned to improve the rollout for additional units. This presentation will also cover change management and how to effectively promote adoption and optimization of this device.
The outcomes are measured with the use of nursing data from our vendor. We reviewed the usage of Rover prior to the AIO go-live and post-AIO go-live which included usage of flowsheets, labs collection, and medication administration. The data shows the metrics have increase with the use of the AIO device.

Previously our organization used Rover but didn't have the adoption we hoped due to not having a device for all users. The prior device used for Rover did not have calling capability and this limitation deterred adoption. A decision was made to transition to the all-in-one device.

To roll this out, we first developed a training and optimization plan. This consisted of online sessions prior to go-live and just-in-time training for staff on the day of implementation. It was determined to implement as a pilot on units in our heart hospital. Barriers to implementation included staff resistant to change, communication challenges with nurses on different shifts, change fatigue from past system updates, and 10-digit dialing from 5-digit dialing. To overcome these difficulties, we improved the rollout plan when we implemented additional areas within the hospital. We capitalized on nursing vendor data to give us direction to develop a plan for future optimization by drilling down to the hospital, unit, and user level.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P038 - Ensuring Organizational Continuity: A Strategic Approach to Professional Organizational Leadership Succession Planning

Julie Luengas, DNP, MBA, RN, NI-BC, FHIMSS | Sarah Marshall, DNP, MS, RNC

Tags: leadership networking mentorship organization success

Updated: 05/06/24

Purpose: Effective leadership succession planning is a critical component of sustaining the vitality and success of professional organizations. As stated by Cline et al. (2019), personal growth, networking, and uniting your view with others to elevate the profession are benefits of belonging to a professional nursing organization. These organizations serve as a platform for cultivating the next generation of nurses through leadership mentoring.
Our purpose is two-fold: Develop a pathway to engage members with professional development for the seamless transition of future leaders and sustain the professional organization through potential challenges that transcend generations.

Description: This poster summarizes strategies to ensure leadership succession for professional organizations, including ANIA. This poster presentation aligns with the review of literature which supports involvement in a professional organization that provides nurses the opportunity to obtain mentors, build a professional network, and obtain leadership experience through various roles, Backonja et al. (2021). The organization must be adaptable and flexible to continue recruitment and sustainment of the membership.

Participation in professional organizations cultivates leadership skills and allows opportunities for networking and development. Networking offers the opportunity to integrate self-awareness, engagement, and diversity to interject energy into the organization. Membership provides awareness of current issues, innovation, and best practices through education.
Attrition of leaders can be combated by the inclusion of procedures for retention via a pipeline using a robust mentorship process. The research on mentoring validates an approach for associations to deliver on their purpose of support and connection. The mentors are non-judgmental and create a trusting environment with constructive advice.

Evaluation/outcome: Over the course of 5 years, the leadership succession journey has been successful, realizing a two-fold increase in executive roles. Invitations from leaders and the mentor/mentee program led to an increase in candidates for open positions. Board membership grew from 6 to 13 (54%) with the implementation of this program and networking opportunities.

The strategy of a two-year board term facilitated succession planning for future leaders with the first year mentored by the past leader to build confidence in their new role and maintain institutional knowledge. Another initiative was the implementation of open board of directors meetings throughout the year. This transparency minimizes imposter syndrome with the perceived qualifications and experience associated with leadership roles and responsibilities. To sustain a successful leadership plan, the implemented strategies will be analyzed and adjusted to ensure professional growth for the future organization.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P036 - Factors Influencing the Use of Dashboards to Improve Patient Care at the Bedside: Perspectives of Hospital Nurse Managers

Lisa Young, PhD, RN, NI-BC

Tags: quality improvement dashboards usability education nurse managers

Updated: 05/06/24

Purpose: To identify and describe perceived factors that influence hospital nurse managers’ use of dashboards for unit-level quality and performance improvement.

Background/significance: Hospital quality and patient safety measures are often displayed on dashboards, yet little is known about factors that influence dashboard use by hospital nurse managers. Hospital nurse managers play a pivotal role in influencing unit-level patient outcomes and often rely on dashboards as tools to perform quality and performance improvement work. Dashboards contain visual representations of data and interactive functionalities that support decision-making. The dashboard literature suggests these tools should be developed with user involvement and tested for usability and usefulness to be effective.

Methods: Using a descriptive qualitative design, we conducted semi-structured interviews with hospital nurse managers from one health system in the Midwestern United States. Eligibility criteria included at least three months of nurse manager experience, participation in quality improvement (QI), and supervision of at least one patient care unit. Interviews were conducted over videoconferencing and transcribed verbatim for analysis. Thematic analysis was conducted by the principal investigator with input from four senior qualitative researchers.

Results: 11 nurse managers from 7 hospitals participated. Most were female (n=9), identified as generation X (n=8), and had more than 6 years of management experience (n=7). All held a bachelor’s degree or higher and rated high comfort with using data and dashboards. Interview findings suggested dashboard use is influenced by four primary factors: external, data, personal, and technology features. External factors included standards set by regulatory bodies, professional standards of care, organizational leadership expectations, and organizational resources. Data factors included dashboard data availability, accuracy, timeliness, and usefulness. Personal factors included individual’s inherent qualities such as being data-driven or competitive, differences in knowledge levels, and perceived need for education and training to optimize dashboards for quality and performance improvement. Technology features included preferences for simple, easy-to-use, and interactive visual displays. Additionally, some managers described workarounds to create separate unit-level data displays from existing dashboard data using desktop tools, primarily spreadsheets, suggesting a need for custom reporting and data visualization features.

Conclusions/implications: Informatics education and training in formal nursing programs and within healthcare organizations are needed to prepare hospital nurse managers for the proficient use and interpretation of dashboards. User-centered design research involving hospital nurse managers is needed to develop and evaluate useable and useful dashboards so they can effectively communicate, engage, and support unit quality and performance improvement initiatives impacting patient outcomes.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P035 - Informatic Innovations to Surgical Preference Card Processes

Alexis Carlson, MSN, RN, CNOR

Tags: analytics process improvement electronic health record surgery preference cards

Updated: 05/06/24

Each year over 234 million surgeries are performed globally, with approximately 3-16% of patients experiencing major complications. The structure of the operating room (O.R.) team is comprised of interprofessional members with various levels of education, experience, and specialties. Unfortunately, care coordination and collaboration issues among providers can lead to breakdowns in communication, collaboration, and patient harm. Preference cards are detailed instructions with items, instruments, implants, nursing notes, and special requests for each surgeon for every procedure they conduct. In the OR, preference cards are a utilized tool to communicate required items, nursing notes, and special comments to the team to provide safe, high-quality care to patients. Preference cards are built and housed via cloud technology into the electronic health record (EHR) to allow easy access, shared storage, and linkage to the patients chart for documentation and billing purposes.

Inaccurate preference cards can lead to inefficient use of staff time, surgical delays, increased turnover times, increased safety risks, excess waste and costs, poor team dynamics and collaboration, hindered communication, and dissatisfaction among staff. It is common in the perioperative world that staff recieve negative feedback from a surgeon regarding preference card updates that do not get completed with cards that he or she have already asked for in the past – once, twice, or even three times or more. A level of frustration typically revolves around surgeon preference cards for the surgeon, assistants, nurses, and scrub technicians alike due to communication breakdowns with the preference cards. But who does the responsibility of surgical preference cards ultimately lie with? The OR suite is a fast-paced, stressful, and stimulating environment that pulls the staffs attention in a multitude of directions and the team should not have to worry about if the information they have is inaccurate or not up to date.

To improve coordination and collaboration in the perioperative environment, a three-tiered approach to addressing surgical preference card issues and process improvements (PI) is explored. Tier one of the PI project is the creation or bolstering of surgical service leads that have autonomy for their service’s preference cards. Tier two involves the on-boarding of new surgeons to the facility with the surgical services nursing informatics team, sterile processing department (SPD) leads, and their service lead for preference card creation. Tier three includes three parts: electronic health record (EHR) preference card inbox tool and utilization implementation, a preference card working group, and quarterly reviews of preference cards with surgical services NIs, service leads, and surgeons for accuracy and updates. The three-tiered intervention utilizes nursing informatics expertise and technology adjuncts in the EHR to improve processes, bolster collaboration among interdisciplinary members, enhance communication, and improve team dynamics. This PI project relied on evidence-based practice (EBP), nursing and analytic theories, and literature reviews to help structure the PI project. The methodology utilized in this project for research gathering included questionnaires to circulating nurses and scrub technician and interviews of stakeholders outside of the OR nursing team – surgeons, leadership, administration members, SPD leads, logistic officers, managers, and the nursing director of surgical services. The analysis of the data and needs assessment demonstrated the need for PI of preference card creation and management. The three-tiered intervention approach was developed and presented to the hospital review committee for approval at four organizational OR hospital affiliates in December 2024. The learning outcome identified is understanding how to leverage technology to streamline OR processes, decrease waste and unnecessary costs, improve collaboration/teamwork, improve safety, and facilitate high-quality surgical patient outcomes.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P034 - Feasibility of Real-Time Continuous Glucose Monitoring of Critical Care Patients with Diabetes

Kafayat Abba, MSN, RN, CDP, CCRN-CMC, NE-BC

Tags: diabetes CGM wearable dexcom

Updated: 05/06/24

Learning outcome: Learn about the process of implementing a hybrid protocol for continuous glucose monitoring in the inpatient setting with the Dexcom CGM ecosystem. Discussion to include implementation plan, efficacy, benefits, and challenges.

Purpose: This study aims to evaluate the feasibility of CGM in patients with hyperglycemia or diabetes mellitus in the critical care setting. We investigate the efficacy [NS1] of CGM technology in the management of glucose levels and explore whether CGM can be used in a hybrid protocol with point-of-care testing and as an accurate and safe alternative to current practice.

Background: Evidence shows there are adverse outcomes for hospitalized patients with poorly controlled diabetes, such as increased risk of infection, 90-day mortality, and other complications. To reduce potential harm to patients, glucose levels should be maintained between 140-180 mg/dl in the critical care setting. Continuous glucose monitoring (CGM) is an alternative to point-of-care testing (POCT) with finger sticks. Fingersticks are painful for the patient and expose nurses to blood-borne pathogens and other infectious diseases. Studies demonstrate a 33% reduction in POCT when CGM technology was used to guide monitoring, reduction of hypoglycemic events with predictive alerts, and improved patient outcomes. However, more research is needed in the critical care environment.

Methods: Over a one-year period ending April 1, 2024, eligible patients were enrolled to receive CGM alongside standard POCT during their stay in a 22-bed combined critical care unit within a 455-bed tertiary care hospital in New York. Clinical care will not be determined by the CGM data. Data will be abstracted and analyzed from the enrolled patients to evaluate the efficacy of the values based on mean absolute relative difference (MARD). POCT glucose will be used as the standard reference. In addition to POCT and CGM data, we will collect data on demographics, diabetes type, comorbidities, body mass index, medication use, and medical history. Univariate associations between variables will be measured using Wilcoxon rank-sum and Spearman rank correlation. A 2-sided significance level of 0.05 will be used for all the statistical tests.

Results: This is an ongoing study. Data analysis will begin at the closure of enrollment.

Implications for clinical practice: There are benefits and challenges to the implementation of CGM in the critical care environment. Similar studies have confirmed accuracy in critically ill patients. Essential components of a standardized workflow for implementation have been identified, and the nursing staff and providers have supported this technology as an alternative to point-of-care testing. Automatic integration into electronic medical records and financial cost analysis would be beneficial towards a more comprehensive argument for feasibility.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P033 - Barcode Medication Administration (BCMA): A Quality Improvement Initiative in the Ambulatory Care Setting

Marina Palladino, MSN, RN

Tags: patient safety bcma ambulatory care medication administration safe medication administration medication administration

Updated: 05/06/24

Barcode medication administration (BCMA), a standard workflow in the acute care environment, is rarely used in the ambulatory care setting where medications and vaccines are frequently administered. The goal of BCMA is to align with principles and behaviors of causing no harm by providing a safe, consistent workflow to mitigate medication errors. As noted by Seibert (2014), the most common method of identifying medication administration errors is through voluntary reporting. An online portal for adverse event reporting was utilized throughout the project. To prepare for the pilot, multidisciplinary site visits were conducted to assess the quantity of scanners needed, current inventory of hardware, subsequent configuration, and team member training. BCMA project launched at 5 pilot practices (3 family medicine, 1 internal medicine, and 1 pediatric) to provide an additional layer of patient safety. The pilot reinforced verifying the five rights of medication administration: right patient (identified verbally with two identifiers), right medication, right dose, right time, and right route. Post go-live surveys were sent at 30-day and 60-day intervals to assess team members’ adaptiveness of the BCMA workflow, and site visits were conducted to provide support and education. Monthly adverse event reports were analyzed to trend medication administration related errors. Additionally, a BCMA Microsoft Power BI dashboard was utilized to review scanning rates and details, including scanning compliance and near misses. The scanning compliance goal was 95%, and after 8 months the pilot practices demonstrated a 94.3% compliance. BCMA utilization demonstrated a 40% decrease in self-reported medication administration errors during Q1 and Q2 2023, versus errors which occurred in the same period in 2022. Data collection is ongoing and continues to be analyzed by the project team. Epic development requests have been submitted to further improve Epic’s functionality with BCMA in the ambulatory care setting. After 6 months of BCMA, the results were favorable, and the decision was made to expand BCMA to 2 additional pediatric practices for fall 2023. Furthermore, BCMA is planned to expand throughout primary care practices in 2024. BCMA implementation has successfully decreased medication administration events. Team member survey results indicate there was overall satisfaction with BCMA.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P032 - Moxi Robots: Working Side by Side with the Clinical Team

Jennifer Sheinberg, DNP, RN, NI-BC, CPHIMS, Director of Nursing Informatics and Clinical Technology, Penn Medicine Lancaster General Health

Tags: innovation robot staff efficiency resource management

Updated: 05/06/24

Penn Medicine Lancaster General Hospital (LGH) is a non-profit organization located in Lancaster, Pennsylvania, with over 500-bed community hospital. With 10 floors, including two non-clinical floors, staff members spend valuable time delivering and retrieving tasks throughout their shift. In August 2023, our organization implemented two Moxi robots to help clinical staff with non-clinical tasks. The robots, named Roxy and Rosie by nursing staff, operate 24/7, seven days a week enabling the nurses to focus on patient care.

Challenge: Staff members leaving the unit to deliver non-clinical assist clinical staff with non-clinical tasks allowing them to spend more of their time at the bedside on direct patient care, improving patient satisfaction, service, and quality. For example, retrieving items from the patient care equipment services (PCES) and delivering telemetry boxes to our central monitoring unit (CMU) from the 8th floor patient care unit added increased time away from patient care responsibilities.

Impact: Roxy and Rosie have proven benefit to our clinical team by allowing them to focus on more patient centric tasks. Phase 1 workflows including non-tubable lab specimens and CMU telebox delivery and retrieval. Through data analysis, we quickly identified additional workflow and implemented PCES during night shift hours.

CMU: Since go-live, the total number of deliveries from CMU to the patient care units is 2,545 telemetry boxes. Overall average delivery task volume is 83 deliveries; 68.8% of deliveries under 30 minutes. The average delivery time for telemetry box from CMU to patient care units is 69% of deliveries received under 30 minutes, with the highest volume between 7:00 am and 9:30 pm.

Lab: The total number of lab specimen deliveries since August 2, 2023, is 248. The average delivery time for lab drop off from unit to specimen drop off is 72% of deliveries under 30 minutes.

PCES: Since go-live, the average equipment delivery time for PCES (night shift only) to the patient care unit is 50% of tasks delivered under 30 minutes. A total of 15 deliveries have been completed from PCES to a patient care unit. Current workflow only includes nightshift, but we are evaluating bandwidth to expand in the near future.

Future state: We are continuing monitoring the impact of the two robots to determine effective workflows to support the clinical staff. Through routine steer committee meetings, the organization discusses the overall system success and ability to add additional to further support the clinical staff. Roxy and Rosie are wildly popular throughout the hospital, often posing for selfies with staff. We have seen a positive impact with acceptance and utilization as evident in our high-task volume.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.