Marcia Frellick

March 09, 2015

Nurses in the operating room will soon be able to access best practices with a simple tap on a tablet, using new technology to replace what has been for many an inefficient system of monitoring guidelines with paper and pencil.

"You can imagine what it would be like to monitor 12, 15 cases a day, then try to analyze all the data," said Linda Groah, MSN, chief executive officer and executive director of the Association of Perioperative Registered Nurses (AORN).

It is a tedious process, and "frequently didn't get done, to be honest," she told Medscape Medical News.

The technology, the result of a partnership between AORN and the Denver-based MyRounding, was announced at the AORN Surgical Conference 2015 in Denver, and will be available by subscription this summer.

myAORNguidelines can be used to easily document routine steps such as hand-washing, marking the side and site of surgery, and verifying proper surgical attire.

Information can be entered in real time by a trained nurse observer, and can be used to quickly spot gaps in practice. And operating room managers and administrators can use the data to conduct quality-assessment analyses and to monitor adherence to AORN Guidelines for Perioperative Practice.

Member nurses have been asking for an alternative to the time-consuming reports on quality assessment and user compliance they now write, said Ms Groah.

Time Saving, Encouraging Improvements

Automating the data saves time, encourages use, and speeds up the implementation of improvements, she explained. The technology allows more time for patient care and more consistent practice across hospitals.

The first four guidelines to be automated are hand hygiene, preoperative patient skin antisepsis, cleaning and care of surgical instruments, and sterilization.

The use of a tablet will save nurses having to cart around binders full of documents. When the attire of someone on the surgical team does not meet the guidelines, for example, a nurse can instantly show a screen depicting the correct attire and provide supporting evidence for the policy.

We could really listen, instead of focusing on writing notes.

The technology, which is compliant with the Health Insurance Portability and Accountability Act, can also be used to benchmark members of the surgical team and compare their performance with that of their colleagues in the region or the country, Ms Groah explained.

Although the guidelines will be available on mobile devices, the visual experience will be best on a tablet.

The potential in the operating room is exciting, said Mary Jo Steiert, RN, from St. Anthony North Health Campus in Westminster, Colorado, who is president of Surgery Direct, a surgery center strategy company, and a past president of AORN.

She explained that her leadership team at the Vail Valley Medical Center in Colorado has used MyRounding technology during their daily huddle to track issues and review schedules and for infection prevention, environmental safety, and patient and family rounds.

A perioperative patient liaison was able to track issues and the concerns of patients and their families during the surgical experience, she told Medscape Medical News. Instead of having them fill out a survey, the results of which would then have had to be entered into a database, the respondents entered their responses directly on the tablet, triggering immediate action to resolve issues.

Hand-washing audits became much easier to track with the technology, Ms Steiert reported.

"We could do it in real time. We could collect the data for 30-, 60-, or 90-day periods and see what the trends are," she said.

Another useful feature is the ability to record what physicians say. "We could really listen to them" instead of focusing on writing notes, and we could play the recording back for clarification.

"I'm very excited to have the AORN guidelines incorporated into this technology because we can have quick references available to our staffs," she said.

Ms Groah and Ms Steiert have disclosed no relevant financial relationships.

Association of Perioperative Registered Nurses (AORN) Surgical Conference 2015. Presented March 9, 2015.


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