Due to strides in healthcare, education and infrastructure, people all around the world are living longer lives. As a result, one in six people were aged 60 or over by the end of 2023. While this is wonderful news for well-behaved grandchildren, it means that healthcare workers are busier than ever. Yet due to the pandemic, nurses are tired, traumatised and leaving the sector.
In Nantong, China, the healthcare industry is experiencing a growing problem of the ongoing ageing population and the shortage of nurses.
“In our current ageing society, there is a prevalence of cardiovascular diseases,” says Chen Yong, Director of the Equipment Department at Nantong First People’s Hospital.
Such instances need to be carefully observed by nurses, which is a struggle with the current staff shortage. Wang Lihua, Nursing Manager, knows that attention needs to be paid to both technical support and the improvement of personnel skills.
In this context, nurses at the hospital are burdened with significant time-consuming manual transcription tasks and can lead to lost and misread patient information. To address the issue, the Nantong First People’s Hospital has developed the ‘Digital Nursing Network’. This programme integrates digitalisation with nursing work to facilitate connectivity and data exchange between medical equipment and electronic health records. By using the network, nurses at the hospital can allocate more time to providing direct and quality patient care.
In July 2021, the pilot programme was introduced in the Emergency Department. More than 90% of inpatient vital sign data was automatically collected and intelligently recorded. On average, this led to the entire hospital saving the equivalent of 81 nurses and 648 hours of nursing record workload per day. The Digital Nursing Network’s clear success led to its hospital-wide expansion in July 2022.
The Digital Nursing Network has reduced the number of problems for healthcare staff and improved the patient experience
Guan Haiyang, Nursing Director of the Emergency Department introduces the Emergency Department at the hospital. “Our department handles cases of poisoning, whether it's gas poisoning, drug overdose or other self-harm-related poisonings. In addition to handling poisoning cases, we also deal with neurology, cardiology, respiratory medicine and gastrointestinal diseases.
“Our nurses here actually have a tougher job. They are required to have comprehensive professional knowledge and skills in everything. Our department has 27 nurses, each of whom must work three-night shifts per month.
“Recently, there has been a peak in influenza and mycoplasma infections, and some nurses have developed fevers and need treatment and rest. However, sometimes they still have to do paperwork such as nursing documentation. To ensure patient safety, we do not support working while ill.”
Before introducing the Digital Nursing Network, it took nursing staff about six minutes to measure, collect and transcribe a set of vital sign data for non-monitoring patients.
“Nurses had to manually transcribe a large amount of vital sign data from the patient monitor every day and then transcribe it into the mobile nursing system manually,” explains Lihua. “These writing tasks took up a lot of valuable time.”
While the data is critical for patients and cannot afford to be incorrect, manual transcription can lead to potential omissions and errors.
“Now, it only takes 30 seconds to measure, collect and transcribe patients' vital signs data,” she continues. “This improves patients’ sense of experience and enables nurses to create a high-quality and efficient nursing service system for patients.”
In addition, the Digital Nursing Network realises the interconnection between monitors, monitoring systems and mobile nursing systems.
Lihua emphasises the impact of the technology: “The time required for collecting and transcribing vital sign data from monitors has been reduced from one to two minutes per set to one to two seconds, greatly improving efficiency and ensuring the consistency and quality of the data.”
For Nantong First People’s Hospital, the Digital Nursing Network has created significant cost savings in interface development and strengthened interoperability across different systems. But, more importantly, it has helped nurses work more efficiently and helped them care for patients of all ages.
Staff at Nantong First People’s Hospital see success in using digital nursing network: A collaborative effort
The successful implementation of Digital Nursing Network is a collaborative effort involving multiple departments at the hospital. The nursing department streamlines the collection of medical device data, the Information Department designs methods for smart data processing, and the Equipment Department provides standardised interface solutions compatible with devices from different manufacturers.
At Nantong First People’s Hospital, equipment digitalisation has gradually been introduced over the past five years.
“Previously, equipment was purchased as standalone units, but now we consider their interconnectivity,” says Yong. “All equipment that can be connected must be integrated into our system.”
Yet the hospital encountered various challenges during the exploration phase of equipment digitalisation, such as equipment isolation, primarily due to a lack of standardisation.
“The interconnection between devices from different manufacturers posed a problem,” he details. “Although devices from the same manufacturer could be connected, incompatible brands couldn't. If we couldn't find a good solution for interconnectivity, it would affect the utilisation rate.”
In order to further advance the development of equipment digitalisation in the hospital, Yong and his team have proposed to establish a standardised structure similar to HIS, where everything can be interconnected. The digital nursing network is one such example.
“By integrating more manufacturers into this system, we can greatly increase utilisation rates while minimising procurement risks,” he says.
The hospital was prompted to introduce the digitalisation system due to the overwhelming need faced by nurses in their daily operations, particularly the complexity and error-prone nature of manually transferring vital signs and monitoring information.
“By implementing the intelligent linkage system, we have successfully alleviated the workload of our nursing staff and streamlined the collection and recording of vital signs and monitoring data,” he shares. “This has resulted in significant time and resource savings.”
Through the adoption of this digital system and the digital nursing network, nursing staff can now devote more attention to patient care, thereby enhancing overall efficiency and resource utilisation.
Yong continues: “To ensure the accuracy and reliability of the data, we established data standardisation and extraction agreements with the nursing department and relevant companies. This collaborative effort allowed us to minimise data discrepancies and ensure the integrity of the collected information.”
Embracing technological advancements for enhanced patient care: The potential of wearables
Top-quality patient care is at the core of what staff at Nantong First People’s Hospital provide. This commitment extends beyond utilising the digital nursing network, as the hospital proactively keeps up with modern healthcare technology trends.
For some patients, exercise is essential to avoid problems, such as blood clots, postoperative intestinal adhesions and constipation. Lihua has seen first-hand how wearable monitoring devices allow patients to move freely within the ward under monitoring. “With monitoring information displayed in real-time in the central monitoring system, patient safety is ensured, while moderate exercise and rehabilitation is promoted,” she says.
At the same time, wearable devices also reduce nursing work pressure and improve the satisfaction of medical staff and patients. It is mainly used in emergency and special care wards.
“The fixed end before the announcement of precautions is crucial for patients,” says Lihua. “First, we need to ensure that this step is done well and then explain the range of motion, precautions and other contents to the patient.”
In this process, healthcare professionals need to pay attention to the patient because the entire collection process includes remote monitoring.
Haiyang shares his expectation for the application of wearable devices. “In the future, this will definitely be a major trend. Some patients may receive treatment at our hospital but will later be transferred to community healthcare or home care. In such cases, wearable devices are needed to transmit information back to the hospital so that problems can be identified and the patients can seek medical attention. Furthermore, patients may hope for extended home care services, where they can monitor any abnormalities at home.
“First and foremost, accuracy in measurement needs to be ensured. Additionally, better modular integration of functions, improved portability, and efficiency are necessary.”