Nurses de­vise their own in­no­va­tions

Modern Healthcare - - INNOVATIONS - By Sabriya Rice

If ne­ces­sity is the mother of in­ven­tion, Mas­sachusetts In­sti­tute of Tech­nol­ogy re­searchers Anna Young and José Gómez-Márquez fig­ured they would find cheap, prac­ti­cal in­no­va­tions in the small Nicaraguan town of Oco­tal, 3,000 miles from Cam­bridge. The ob­ject of their 2011 search was to find cre­ative doc­tors de­liv­er­ing qual­ity care at low cost by us­ing lo­cally pro­cured fab­rics, elec­tron­ics and other sup­plies.

“We thought we were go­ing to find MacGyver-like doc­tors com­ing up with their own med­i­cal de­vices,” Young said. But af­ter more than five months of search­ing, “we couldn’t find said doc­tors any­where.” What they found were nurses. From IV alarms made from parts of de­con­structed elec­tronic toys to gog­gles to pro­tect the eyes of neona­tal pa­tients un­der­go­ing pho­tother­apy treat­ments, they found nurses “MacGyver­ing” ideas left and right.

That find­ing led to fund­ing from the Robert Wood John­son Foundation and oth­ers for a project to in­ves­ti­gate whether the nurse-in­no­va­tor phe­nom­e­non could be honed in the U.S. In Septem­ber 2013, Young and Gómez-Márquez co-founded Maker Nurse and launched a study that set up tem­po­rary do-it-your­self med­i­calde­vice workspaces in six U.S. hos­pi­tals.

The “maker” spa­ces func­tion as a cross be­tween a sci­ence lab and a builder’s work­shop. They are stocked with ad­he­sives, fas­ten­ers, elec­tron­ics, pli­ers, sewing nee­dles, laser cut­ters and even 3-D prin­ters. Nurses with bright ideas can use the spa­ces to cre­ate ob­jects that im­prove pa­tient care.

In­no­va­tions of­ten rise out of prac­ti­cal is­sues, said David Mar­shall, chief nurs­ing of­fi­cer of the Univer­sity of Texas Med­i­cal Branch at Galve­ston, a U.S. test site for Maker Nurse. Based on the re­sults of the pi­lot, UTMB un­veiled the first per­ma­nent space for its providers last month.

Even be­fore the pi­lot, a nurse at UTMB made week­end trips to Home De­pot to cre­ate a de­vice for the car­diac catheter lab that el­e­vates and secures pa­tients’ wrists dur­ing pro­ce­dures. It used to be done by us­ing a stack of tow­els. An­other nurse cre­ated a med­i­ca­tion belt so she could re­main hands-free while de­liv­er­ing pre­scrip­tions to im­pris­oned pa­tients.

Nurses’ in­no­va­tions don’t al­ways get the lime­light and are of­ten over­shad­owed by big­ger, more ex­pen­sive tech­nolo­gies, Mar­shall said. “But if what they make helps pa­tients to be more com­fort­able or as­sist with pro­vid­ing care, we’re happy to sup­port them.”

See­ing an idea they con­ceived ma­te­ri­al­ize and put to good use is sat­is­fy­ing and taps staffers’ full po­ten­tial, said Dr. Mark Smith, di­rec­tor of the MedS­tar In­sti­tute for In­no­va­tion, Wash­ing­ton, D.C. MedS­tar has been cre­at­ing an “ecosys­tem for in­no­va­tion” that in­cludes an in­ven­tor pro­gram for cre­ative health in­for­ma­tion tech­nol­ogy ideas, sim­u­la­tion lab­o­ra­to­ries to test so­phis­ti­cated med­i­cal equip­ment and hu­man fac­tor and us­abil­ity test­ing to pre­vent safety mishaps from newly in­tro­duced med­i­cal de­vices.

Though not a par­tic­i­pant in the Maker-Nurse project, Smith said he finds the con­cept “def­i­nitely in­trigu­ing. It fits into the broader con­struct of try­ing to de­liver the tools, sys­tems and as­sis­tance that en­ables staff to be the best they can be.”

Young said the Maker Nurse con­cept thrives in places where the re­view process lasts weeks, not months. Any cre­ation made by hos­pi­tals in the study is sub­mit­ted for an in­ter­nal re­view be­fore be­ing used on ac­tual pa­tients. Meet­ing Food and Drug Ad­min­is­tra­tion re­quire­ments can also be a fac­tor.

The labs in the study are sta­tioned at Bon Se­cours St. Mary’s Hospi­tal in Rich­mond, Va.; Driscoll Chil­dren’s Hospi­tal of Cor­pus Christi, Texas; Mai­monides Med­i­cal Cen­ter in New York City; the Mayo Clinic in Rochester, Minn.; South Shore Hospi­tal in South Wey­mouth, Mass.; and the Sierra Prov­i­dence Health Net­work and the Texas Tech Univer­sity Health Sys­tem, both in El Paso.

Young and Gómez-Márquez ex­pect to pub­lish find­ings by early 2016. Their goal is to cre­ate a na­tional net­work for shar­ing maker space in­no­va­tions. Al­though the ini­tial project fo­cused on nurses, the do-ity­our­self con­cept can be used by any hospi­tal staffers.

Health­care works best when peo­ple share ideas col­lab­o­ra­tively, said Young, one of a few peo­ple se­lected to speak at the an­nual TEDMED con­fer­ence in Novem­ber. “There is this stealth com­mu­nity of in­no­va­tors in health­care. But they are not con­nected and are not shar­ing what they are mak­ing.”

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