When treating patients with COVID-19, every second a clinician is exposed to the patient could mean a higher chance of infection and spreading it to others. One hospital found a creative way to increase patient safety and reduce clinician exposure.
New Jersey was one of the first states to be hit hard by the pandemic. At one point, St. Joseph’s Health, made up of two acute facilities, a subacute/long-term care facility and more than 40 ambulatory facilities located across New Jersey, had more than 80% of one of its facilities' capacity treating COVID-19 patients.1
“Some of our COVID-19 patients were very sick and ended up spending a lot of time in the hospital, as we were trying to care for them and get them to a better place to be discharged. We had patients who required a lot of care, and to be able to meet these challenges required us to be flexible and adapt on the fly to whatever was occurring each day,” said Matt Orlando, respiratory therapy director.
Clinicians created isolation rooms for COVID-19 patients. They typically used workstations on wheels (WOWs) to assist with patient care, but they required extensive disinfection after each patient’s use to prevent COVID-19 spread, which took time to complete.
“The WOWs are typically very convenient for staff to use since they have screens, scanners and locked drawers for patient medications, but it became a burden and a safety risk to have to disinfect one after it was used in an isolation room,” said Janice Wojcik, director of Nursing Informatics. “With a large number of our inpatients dealing with COVID-19, the time it took to disinfect the carts added up fast.”
To save time, they put Zebra smartphones in plastic bags and walked into the isolation room to take pictures of the data on a patient’s ventilator using Camera CaptureTM, a standalone mobile app that makes it easy to add photos to a patient's electronic chart. They would then manually enter the data into the chart in the ventilator flowsheet. This method assisted with getting a more accurate time stamp of when the ventilator data were read. It also worked with older ventilators that cannot integrate with CareAware iBus®.
“The respiratory therapists were already using the Zebra phone for their primary source of communication, and Camera Capture was already on the devices,” said Orlando. “We came up with the idea that if we use Camera Capture in certain patients' rooms to capture the ventilator data, it would actually save us from having to bring the WOW into the room. Putting the phone into a plastic bag, taking it into the room and then disposing of the bag when you came back out was not a problem.”
St. Joseph's Health staff use a Zebra phone to take a picture of a ventilator screen. (Source: St. Joseph's Health)
“The use of Camera Capture helped us minimize the movement of equipment in and out of COVID-19 isolation rooms as well as the amount of time staff had to spend in the room,” said Wojcik. “It helped them to focus more time on patient care and less time in the room documenting.”
Using Camera Capture, St. Joseph’s Health reduced the number of times they had to disinfect a WOW daily, which on average takes a little over three minutes to disinfect per unit per patient, plus additional time to dry.2
“In addition to the time saved, there was a degree of clinician comfort that came out of using the smaller device and feeling that they didn't have to take as much of a risk to go into an isolation room with bigger equipment and then drag it back out and have to spend time disinfecting it,” said Orlando.
Staff at St. Joseph hope other clinicians can learn from their creativity to help reduce COVID-19 exposure and save time to focus more on patient care.
1Based on occupancy data from April 2020.
2Based on 10 timed trials to disinfect a WOW.