Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, April 30, 1995 TAG: 9505020010
SECTION: NURSES PAGE: N-8 EDITION: METRO
SOURCE: STEWART MACINNIS
DATELINE: LENGTH: Medium
At the Veterans Affairs Medical Center in Salem those tasks have fallen to nurses.
Kathleen Wood, the nursing computer coordinator at the center, has the job of making computers work for the 540 nurses there. She also teaches them how to make the best use of computers.
"It all comes down to the patient," she says. "We need to help the patient through the proper use of computers."
Nurses at the Salem center have literally at their fingertips enormous amounts of information from the center's various laboratories, the pharmacy, the dietary department, the radiology department, and from detailed medical records on each patient. They also make use of the time-saving and efficiency-boosting attributes of electronic mail.
"There's a movement toward paperless records," says Wood. "All our nurses have access to computers. We have become so fully automated that to do patient care, nurses must have computer expertise. Nurses need to know how to use computers to do their jobs."
Wood has been a nurse for 16 years, and she has been involved with computers for 10. When the private hospital in South Carolina where she worked first introduced computers, she was given the job of helping adapt the system to the hospital. She has been at the point where computers and nurses meet ever since.
Wood teaches nurses how to use the programs available on their systems, how to enter and retrieve information stored in the medical center's main frame computer, she develops programs to make computers do what nurses need them to do, and she helps solve problems.
The handful of terminals on each ward and in the clinics give nurses access to information that would fill a daunting number of file cabinets. And they give nurses instant communications with all departments of the medical center, the team treating individual patients, and even the more than 170 VA hospitals nationwide.
John Rowland says he thinks the purpose of technology is to benefit the patient, too. An RN who specializes in urology and orthopaedic surgery, Rowland was able to use the knowledge he gained in using technology in one a technology in the other.
His experience in the orthopaedic operating room exposed him to the video-imaging system equipped with tiny flexible lenses that helps doctors perform delicate knee surgery through small incisions.
One day last summer, one of the urology doctors asked Rowland in passing if that equipment could be used in urology surgery. Rowland went to work, taking parts from the orthopaedic video equipment and from similar equipment used in gall bladder surgery, making modifications and ordering a few new parts.
After about a month he had assembled the equipment, tested it and refined it. "I didn't know where to turn for advice on this, so I was pretty much on my own," Rowland says. "I just used my own knowledge and worked around with it. It worked out wonderfully."
He said there is similar equipment available commercially, but it costs about $100,000. Because of that, he didn't expect to be able to gain authority to purchase the urology-specific equipment. Therefore, he went about piecing the equipment together on his own.
The benefits of the system are many, Rowland says. The surgeon can now move away from the patient while working, reducing the possibility of being splashed with body fluids. The entire surgical team can now monitor the operation. And, because the VA center is a location where medical and nursing students come to observe procedures, students can now see what the surgeon sees and they don't have to try to imagine what he is doing based on his comments.
Patients also can see what the physician sees, and the video images can help involve them in their health care.
"They have a better understanding of what is causing their problem," Rowland says.
Patients who have had bladder cancer require periodic screenings to ensure they are still free from cancer. The video equipment is used 10-12 times a week for such screenings. In addition, it is now being used in bladder surgery using lasers, an innovation locally. The new procedures reduce complications and drastically cut the patient's stay in the hospital, he said.
The equipment has been so successful, the VA is expected to purchase commercial equipment dedicated to urology surgery. Rowland figures that in the 10 months his pieced-together equipment has been in use, it has saved the VA enough money to pay for the new equipment.
by CNB