It’s the middle of the night. An elderly man in end-stage heart failure receiving at-home hospice awakes gasping for breath. His caregiver immediately phones the on-call nurse, but the drive could take her 30 minutes or more. The caregiver is too afraid to take action on her own, so she anxiously awaits the nurse. As the minutes tick by, the man becomes increasingly distressed and the caregiver grows more upset.
Shortness of breath (also known as dyspnea) is a common challenge faced by caregivers and patients in home hospice, and the leading cause of admissions to the emergency room for hospice patients.
Interested in shortening the time it takes to alleviate patient symptoms and caregiver anxiety, Kimberly Shea, PhD, RN, assistant professor at the University of Arizona College of Nursing, conceived of using tablet technology with real-time visualization for patients and caregivers to communicate with on-call hospice nurses in urgent situations.
To support testing her idea, Dr. Shea recently was awarded a grant from the Arizona Telemedicine Program as part of its Innovation Awards for her project: “Real-Time Visualization for Reducing Symptom Severity in End-of-Life Care.” The grant supports purchase of five iPad-minis with retina display.
“Previous studies evaluating tablet use in at-home hospice have been focused on overall quality of life and anxiety,” said Dr. Shea, who has 15 years of experience as a home health/hospice nurse. “What makes my study different is I’m evaluating tablet use in urgent situations. Patient and/or caregiver anxiety can often lead to unnecessary emergency room admissions.”
Each tablet will be equipped with real-time meeting software that allows the on-call nurse to immediately visualize important factors, such as a patient’s positioning (lying down, sitting up) or breathing patterns and medications available. Accordingly, more individualized guidance can be given to the caregiver for intervening appropriately prior to nurse arrival.
“I believe that many families wait until the nurse arrives to do anything they feel is too aggressive because they are afraid to overmedicate or do something harmful,” said Dr. Shea. “I believe there will be a quicker reduction in patient symptoms and caregiver anxiety in those utilizing the real-time visualization than in those relying only on the usual methods.”
Faculty at the University of Arizona College of Nursing envision, engage and innovate in education, research and practice to help people of all ages optimize health in the context of major life transitions, illnesses, injuries, symptoms and disabilities. Established in 1957, the college ranks among the top nursing programs in the United States. For more information about the college, please visit its website, www.nursing.arizona.edu