Silver linings aren’t easy to come by during a global health crisis. Just ask any nurse who’s worked the front lines during COVID-19.
And yet the pandemic provided an opportunity for nurses to show just how innovative they can be. Indeed, an August 2020 survey of 4,000 healthcare providers—1,000 of them nurses—commissioned by Johnson & Johnson in partnership with the American Nurses Association and the American Organization for Nursing Leadership found that the pandemic accelerated progress within the nursing profession, raising expectations of what nurses are able to do and become.
Johnson & Johnson is doing its part to nurture this progress with its Nurses Innovate QuickFire Challenge series. The goal: help make nurses’ ideas for how to improve healthcare a reality through mentorship, access to the Johnson & Johnson Innovation JLABS ecosystem and up to $100,000 in grant funding. Past Challenges have focused on themes such as maternal and newborn health.
The most recent Nurses Innovate QuickFire Challenge, which launched in November 2021, sought out ideas for new healthcare technologies that might improve outcomes for patients—and even the practice of nursing as a whole.
Given the role of telehealth in the pandemic, it’s no surprise that the Challenge’s two awardees are pushing the boundaries of virtual nursing, though in very different ways. For National Nurses Day, we talked with them via Zoom (naturally) to find out where they get their drive to invent and why they believe their high-tech tools might just transform the future of healthcare.
A Virtual Solution for the Nursing Shortage
Jean Putnam, DNP, MS, RN, CPHQ, Executive Vice President and Chief Nursing Officer of Community Health Network in Indianapolis
Jean Putnam knew she wanted to be a nurse from the age of 5. That’s when she fell out of a moving car and ended up in the hospital with serious injuries.
“I almost lost an arm, and the nurses who cared for me made a vivid impression—both the kind ones and the mean ones,” she says. “With the mean ones, I remember thinking, ‘I could do this better.’ ”
That’s what Putnam is aiming for with Virtual Innovative Transformational nursing care (VITAL).
Long before the pandemic, Putnam realized that nurses need an alternative to the 12-hour shifts they commonly work. “It’s exhausting, and it can be dangerous,” she explains. That problem only intensified once COVID-19 hit. “Now, we have a nursing shortage. There are so many wonderful nurses out there who are recently retired or who maybe aren’t physically able to do shift work but who can, and want to, contribute their knowledge and expertise.”
Enter VITAL, in which virtual nurses step in to help with tasks like admissions assessments or taking medication histories so that in-person nurses can focus on patients’ well-being, while also mentoring young nurses.
“New nurses coming out of school during the pandemic are suddenly dealing with five or six patients, and they may not feel confident, or even competent,” says Putnam. The VITAL program’s virtual nurses, in contrast, have 15 years’ experience, on average. “As part of the team, these nurses are available not only to help patients and do administrative tasks, but also to brainstorm with bedside nurses directly through a smart TV installed in patients’ rooms.”
The VITAL pilot program, which begins in July, will connect 200 live nurses across three Community Health Network hospitals with dozens of virtual ones based out of a digital hospital in Nebraska. But this is not garden-variety telehealth. “What’s unique about VITAL is that it’s interactive,” says Putnam. “If a virtual nurse notices a potential problem on a patient’s electronic health record, they can ring into a patient’s room, get permission to enter, check things out and alert a bedside nurse, if necessary. It’s easy to get distracted in the hospital with families there and so much going on. Having a second set of eyes has the potential to make a difference in terms of patient safety.”
Putnam is optimistic that this team nursing approach will yield other benefits, as well. After the first six-month phase of the pilot, she expects a decrease in falls with injury, rates of catheter-associated infections and other problems related to hospital stays; she also expects patients to be released from the hospital sooner.
“We have lost so many nurses because of the trauma of the pandemic,” says Putnam, who is hopeful that VITAL will help usher in the dawn of a new nursing model. “To keep nurses at the bedside, we need to help them feel successful. For that to happen, they need help and support, including a team member they can turn to when they have a question they might otherwise be too embarrassed to ask. With VITAL, we’re giving them that and making it clear that we not only care about patients’ well-being, but that we care about our nurses, too.”
A High-Tech Bandage That Monitors Healing 24/7
Paulo Alves, Ph.D., MSc, RN, Assistant Professor at Universidade Católica Portuguesa in Porto, Portugal
From the start of his 23-year career as a nurse, much of it spent in hospital Intensive Care Units, Paulo Alves was struck by how many of his patients were suffering with wounds that wouldn’t heal, whether from pressure injuries after surgery or because of other medical conditions. “Even as a student, I wanted to do something for these people,” he says.
Indeed, chronic wounds are a devastating public health problem, affecting upwards of 6.5 million people in the U.S.
Take, for example, wound healing after surgery. In most cases, a surgical incision heals in about two weeks; more complex incisions might take longer. Chronic wounds, on the other hand, are those that stall at some point in the healing process, often in the inflammation phase. They are more common in elderly people, obese people or people with diabetes or high blood pressure.
They’re also a problem that is often hidden. “It’s one thing to be in a hospital with a wound and have access to a doctor and a nurse,” says Alves. “But 70% of people with chronic wounds are out in the community, often hundreds of miles from a hospital.”
Well before COVID-19, Alves—a habitual inventor who has developed several wound-healing technologies—surmised that it might be possible to minimize the distance between healthcare providers and patients with potentially troublesome wounds. “The ideal would be to get continuous information on how a wound is healing, 24 hours a day, wherever a patient happens to be,” he says. That’s because patients often sit with a bandage on for three or four days and have no idea what is happening underneath, he adds. “It’s only when it’s time to change the dressing or they feel pain that they discover an infection, leakage or other problem.”
Sónia Ferreira is intimately familiar with these kinds of painful wound issues. The founder and CEO of the Portugal-based company BH4U, she is also a biomedical engineer and someone who has lived for 35 years with an ostomy bag, which connects through a hole in the abdomen to collect bodily waste. She and Alves are working together with a team of scientists and engineers to develop adhesive.Ai—a bandage with embedded sensors that enable caregivers to monitor a wound 24/7 using app-provided artificial intelligence.
“Sonia had the same feeling that I did,” says Alves. “We needed to find a way to reduce complications and improve these patients’ lives.”
One promising benefit of adhesive.Ai is that patients can potentially be discharged from the hospital earlier, feeling more confident that their wound will continue to be monitored and managed. Sensors in the bandage will measure factors such as pH balance and skin temperature, alerting a nurse via the app if something changes so quick action can be taken. “This frees up nurses to do other things and could reduce the chances of complications, which can require more hospitalization for patients—and more nursing care,” says Alves.
Nurses who may not be expert in wound care could also benefit from the additional information that adhesive.Ai provides. “The extra monitoring has the potential to increase the quality of care,” says Alves. “It’s not a substitute for a real-life nurse, who sees, smells and touches the wound, but it enables nurses to get information from a distance, then speak to patients or ask for a second opinion.”
The first clinical trials of adhesive.Ai will begin in 2023; meanwhile, a team of engineers, scientists and nurses is conducting focus groups and other testing.
“This is a huge opportunity, and it’s thrilling,” says Alves. “It has the potential to benefit every single surgical patient with an acute wound, all over the world.”
