Using Electronic Devices to Improve the Patient Care Experience on an Inpatient Behavioral Health Unit

Transcription

1 Using Electronic Devices to Improve the Patient Care Experience on an Inpatient Behavioral Health Unit John Wagner MA, M.Th., RN Director of Behavioral Health Nursing University of Iowa Hospitals and Clinics 1 Disclosure This presenter has no conflict of interest to disclose. 2 Objectives Participants will identify security and privacy concerns regarding patient use of cell phones and personal electronic devices on inpatient psychiatric units. Participants will be able to identify interventions that can be taken to minimize the security and privacy risk of cell phones on BHS units. Participants will identify the benefits to behavioral health patients, of maintaining contact with family and friends throughout the hospitalization. 3 John J. Wagner, MA, RN-BC 1

2 History of Cell Phones Development 1992 The first digital cellphone 1996 The first flip phone 2002 The first camera phone 2003 The first Blackberry 2004 The first Smartphone 2007 The first I-Phone 4 Adults in the USA who own a: Cellphone Smartphone % 0% % 0% % 0% % 35% % 45% % 58% % 68% 5 Cellphones have become imbedded into the lives of many adults. Much like individuals who smoke or drink may experience varying withdrawal reactions when hospitalized Loss of access to cell phones can cause anxiety ranging from minimal to severe 6 John J. Wagner, MA, RN-BC 2

3 Cellphone use by hospitalized patients Once use was prohibited o Safety Concerns Now use is common o Even expected Tool to increase patient satisfaction oavoidance of negative encounters omaintain contact with friends and family 7 Smart phone use in hospitals? Study done at a large hospital in California 79% for Entertainment or Games 48% Access their Personal Health Record (PHR) 44% Read about Condition/Treatment 29% Read about Providers 27%Read about Hospital Polices 8 Use of cellphones by those with persistent mental illness 2014 Study involving over 1,500 individuals 98.8% owned a mobile device 91.6% used it to talk 38.8% used it to text 33.2% used it to access the internet 9 John J. Wagner, MA, RN-BC 3

4 Things Change? Most patients on BHS units own cellphones o Of these, more and more are smart phones BHS patients like to use their cell/smart phones o Just like everyone else Not allowing access to cell phone causes issues o Don t know the phone numbers of family and friends o Text is often the preferred method to communicate o View this restriction more and more as unacceptable 10 Why cellphones aren t allowed on Behavioral Health Units Confidentiality o Cameras o Sound recording Expense Perceived danger 11 Why Cell Phones aren t allowed on BHS units (cont.) Unforeseen consequences Unknown Contacts Illicit contacts Loss of control 12 John J. Wagner, MA, RN-BC 4

5 Why we considered change at UIHC Patients were becoming increasingly affected Staff spending more effort on this issue An unnecessary restriction for most patients obecause of the concerns of a few Inconsistent with other precautions o Suicide o Phone Restrictions o Sexually acting out behaviors 13 In the end, the difficulties were to great Psychiatrists Administration Hospital Legal Compliance Security And then it all changed with one visit And a strong partnership with Psychiatry 14 Cellphone Camera Industrial Espionage Tape o Changes color when removed o Check the phones daily to determine if phone has been removed o Zero tolerance for removal of strip o Collaboration with Hospital Legal and Security o Most Wired Hospital status is helpful 15 John J. Wagner, MA, RN-BC 5

6 Develop patient cellphone expectations All staff/disciplines need to be in agreement o Use of cellphone is a privilege not a right o No use of cellphones in groups o Camera strip must remain in place o No use of sound recording o Patient cannot choose to use phone instead of attending therapies o Assess every patient for risk Sexually Acting Out Behaviors Manic patients 16 Lessons learned from previous innovation There is an expectation to determine what success looks like To determine an intervention Measure the effect of the intervention Evaluate the data Make decisions improvements based on that data o The Iowa Model 17 Methodology of the Study Established survey tool Social and Emotional Loneliness Scale for Adults UIHC developed survey tool No survey tool existed to meet our needs odeveloped for inpatient psychiatric unit omeasured perception of remaining connected omeasure connectedness to society 18 John J. Wagner, MA, RN-BC 6

7 Methodology of the Study (cont.) Pre and Post Survey Strategy o Magnet Project o One pre survey group o Three follow up survey groups Survey population Types of units involved o Types of patients 19 John J. Wagner, MA, RN-BC 7