Point-of-Care Engagement in Long-Term Care Decreasing Infections

Long-term Care Chronicles With Robbie Hilliard, MSN, RN, CDC

Nothing piques the interest of an infection prevention (IP) nurse more than hearing the phrase “31% decrease in hospital-acquired infection rates.”Several weeks ago, I heard this statistic during a project meeting for a new digital engagement tool being implemented in Veteran’s Administration facilities nationwide. The platform utilizes digital patient engagement to interact with patients and encourage involvement in their own care.

According to the press release:

Bethesda, MD (September 24, 2024) — Get Well, the leader in digital patient engagement, announced its cross-continuum digital patient engagement platform has earned Federal Risk and Authorization Management Program (FedRAMP) Authority to Operate (ATO) at the Moderate security impact level. Now on the FedRAMP Marketplace, Get Well can be contracted by any government agency through a streamlined security vetting process, removing onboarding costs and accelerating time to implementation.

‘Both the Defense Health Agency and Veterans Health Administration are actively pursuing digital transformation initiatives to bring more holistic, personalized care to beneficiaries and patients,’ said Get Well’s founder and CEO, Michael O’Neil. ‘To date, Get Well has driven a 45 percent improvement in patient experience scores, a 31 percent decrease in hospital-acquired infection rates, and a 14 percent decrease in the average length of stay at VA hospitals nationwide. Now, more facilities and federal agencies can join the more than 70 Veteran Affairs Medical Centers and Community Living Centers using Get Well Today and do it more seamlessly than ever before. Our FedRAMP certification adds to the value we deliver today through integrations with VistA/CPRS (VHA’s current electronic medical record) and will help accelerate the impact of our long-standing partnership with Oracle Health into the government market.’

How does this platform help decrease infections?

Patients have a flat-screen television in their rooms that will now have a “home” screen. This home screen is a digital smart board with the date, time, unit, and room number and welcomes the patient by name. Patients can use their remote control or an app on their smartphone to scroll through the prompts. One of the prompts on the welcome screen is an infection prevention prompt or tab. These prompts are customizable and offer customized views of things pertinent to each patient.

Digital Personalized Education

Patients with indwelling catheters will have a short prompt for education on preventing catheter-associated urinary tract infections. Short videos are around a minute long, each covering different areas of best practices for catheter care. Education is clear, non-medical, and uses easy-to-understand verbiage. Patients with central venous catheters (CVCs), such as peripherally inserted central catheter lines, will have videos explaining CVC care and infection prevention. Patients can scroll through multiple videos on their personalized care plan to better understand their role in infection prevention.

Point of Care Engagement

Patients often do not possess a form of engagement for activities such as catheter care and hand hygiene. This platform allows patients to weigh in on critical care items such as “Did your provider sanitize their hands on your last encounter?”. This prompt refreshes every 24 hours (or however frequently it is set) and compiles the data for review. This allows IPs to see what the patient sees from the actual patient’s bedside. Other care questions, such as “Did your care team member utilize the clean wipes for catheter care today?” are also available. These questions ensure patients get care behind closed doors according to established infection control best practices recommended. This is real-time data that is currently unavailable but will be compiled by the software to allow a better look at how the patient perceives their care.

Consistent Health Care Prompts

These prompts allow patients to sustain participation in managing and controlling the outcomes of their own health care. Patients also better understand their plan of care and the outcomes. Prompts across the health care disciplines intertwine and affect each other and can all be found on the platform right at the patient’s bedside. Short, informative infomercials on isolation precautions, visitor restrictions, vaccinations, antibiotics in use, antibiotic stewardship, and hand hygiene are all loaded for patients according to their care plan. The selections are complete, precise, and clear communication tools that allow patients to understand the complexities of different aspects of their care.

Communication

The nursing field has long been responsible for all the above patient engagement. Human factors such as stress, fatigue, and memory failure can prevent these critical areas from being addressed by nursing staff. Time pressures, workloads, shift changes, and other distractions can prevent essential aspects of care from being translated to the patient. Likewise, the patient may not be receptive to information when it’s being offered, resulting in barriers in the communication process. Patients may temporarily shut down when hearing told they have an infection or complication that may affect their outcome. They may not be ready to receive teaching when the nursing staff is ready to give it. Medications can cloud a patient’s ability to comprehend what is being discussed. For many reasons, presenting information as a part of the patient’s daily routine, at their prompt and when they are ready, is a better idea.

The CDC reports, “Research suggests that people with higher knowledge, skills, and confidence to become actively engaged in their health care have better health outcomes.” Lower hospital readmission, increased compliance with medication adherence, and higher patient/family satisfaction are a few of those outcomes. Improved patient safety and quality of care are also results of patient engagement. Key important points are repeated at different intervals to ensure retention of what is essential. It will be interesting to see what changes in patient outcomes occur because of point-of-care engagement.2