"COVID-19 Inspired Me to Improve Patient Care": How Two Nurses Devised New Ways to Help Kids and Fellow Nurses During the Pandemic
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hen you’re a healthcare provider faced with unimaginable circumstances—like the kind of once-in-a-lifetime situations experienced during a global pandemic—you learn quickly to think on your feet.
This has been especially true of nurses, who have been on the ground working with patients since COVID-19 first began spreading worldwide. To tap into their immense learnings throughout the past year, Johnson & Johnson—together with the American Organization for Nursing Leadership (AONL) and the Society of Nurse Scientists, Innovators, Entrepreneurs & Leaders (SONSIEL)—asked enterprising nurses to submit ideas for improving COVID-19 patient care through its Nurses Innovate QuickFire Challenge series.
The two just-announced awardees of the challenge will receive a combined total of $100,000 in grant funding, mentoring from experts across the Johnson & Johnson family of companies and access to the Johnson & Johnson Innovation–JLABS ecosystem to help bring their innovations to life during this time of crisis.
Nurse practitioner and clinician scientist Jennifer Stinson, who is codeveloping with the Stanford Chariot Program a high-tech way to help address children's pain management at home, and pediatric nurse Kathleen Malouf, whose innovation could help hospital workers be more efficient while administering care to COVID-19 patients, sat down with us to share their visions for helping transform healthcare today and into the future.
An Ingenious Way to Help Improve How Nurses Tend to COVID-19 Patients
Kathleen Malouf never imagined she’d be reassigned from her position as a pediatric nurse to taking care of adults with COVID-19 in an intensive care unit at Monmouth Medical Center in Long Branch, New Jersey. Yet in April 2020, at the height of the first wave of the pandemic, that’s exactly what happened.
“It was such a stark change going from taking care of kids to seeing so much suffering and death,” Malouf recalls. Not only that, a lack of PPE and the constant fear that it would run out presented a unique set of challenges.
“We started practicing ‘cluster care’ with our COVID-19 patients, which meant we would go into their rooms as few times as possible in an effort to disturb these very sick patients as little as possible,” she says.
Cluster care also meant that when Malouf and her colleagues entered a room to take care of patients, they had to carry everything they’d need—from medications and medical devices to bed sheets—in one trip, rather than in multiple visits.
One day, with stacks of linens tucked under her armpits and both hands full of medications and other equipment, Malouf kicked open the door to a patient room and realized she’d forgotten something. “As I pushed the door back open again with my hip, and yelled into the hallway for someone to run and get me what I needed from the supply closet, I thought to myself: There has to be a better way.”
I have 30 ideas in the Notes app on my phone. Nurses are constantly figuring out how to work with what we have—and anything that makes our job easier and safer is better for our patients and how well we can care for them.ShareDid you like reading this story? Click the heart to show your love.
Malouf started thinking about how much she missed the deep pockets on her scrubs; the isolation gown she was required to wear to treat COVID-19 patients made them completely inaccessible. So she started dreaming up ways to create an inexpensive disposable pouch that she could fill with all the supplies she needed to care for her patients and then throw away with her gown and other PPE.
One day, she opened the plastic packaging for a suction catheter and had an aha moment.
“I brought the packaging home and asked my husband—who’s the manager of a custom framing store—for some adhesive to stick on the back,” she says. "By that point, I was no longer working in the ICU. But I stuck the makeshift pouch to an isolation gown and showed it to colleagues who were still caring for COVID-19 patients to get their feedback."
They thought it was a genius idea and encouraged her to enter it in the Johnson & Johnson Nurses Innovate QuickFire Challenge. The concept resonated with the judges, who awarded Malouf a $25,000 grant to help make her early stage innovation a reality.
“This money is going to help me pursue a patent, manufacture the pouch"—which is now called the IsoPouch, short for Isolation Pouch—"and get it to practitioners who need it,” Malouf explains. What’s more, she says the incredible feedback she’s received has reminded her of the power of a simple idea—and has inspired a slew of new ones, too.
“I have 30 ideas in the Notes app on my phone,” she says. “Nurses are constantly figuring out how to work with what we have—and anything that makes our job easier and safer is ultimately better for our patients and how well we can care for them.”
An At-Home Way to Help Kids Handle Pain Via Virtual Reality Technology
For more than 20 years, Jennifer Stinson has worked with children who are in chronic pain—and who are often fearful of working with physical therapists whose job it is to get them moving and address their pain.
To help these young patients confront their fears, “I became interested in virtual reality [VR] as a way to make movement more fun,” says Stinson, who codeveloped a chronic pain services program at the Hospital for Sick Children (SickKids), Canada’s leading pediatric pain clinic in Toronto.
Prior to the pandemic, Stinson had already been using Pain Rehabilitation Virtual Reality (PR-VR) with children at the clinic's rehab department.
The PR-VR program, Fruity Feet, allows physical therapists to coach children through games that target specific areas of the body where their pain is focused. For example, if a practitioner wants to work on improving range of motion in a child’s right leg, she can run a program where a child is prompted to squash fruit or combat an alien invader with that leg. Range of motion is measured via sensors attached to the kids’ hands and feet, which helps practitioners see progress in real time and works as a kind of biofeedback for the patients, too.
“Once they see that they can move more than they originally thought, it helps them realize that movement isn’t as hard as they thought, and they’re often left feeling like they can do more, which can improve their quality of life,” Stinson explains.
Our goal is to continue to offer VR therapy in the home setting after the pandemic ends, because it will help us get the technology to more patients—especially children in lower income and rural areas around the world.ShareDid you like reading this story? Click the heart to show your love.
Unfortunately, as a result of the pandemic, in-person programs were paused and the SickKids staff had to pivot to seeing patients virtually. The chronic pain clinic's team of physical therapists quickly realized that while Zoom appointments allowed them to continue working with their patients, the virtual sessions weren’t as engaging as in-person appointments.
“It was tough to accurately assess things like range of motion or changes in mobility without being in the room,” Stinson explains. What’s more, there was a limited number of exercises the physical therapists could teach virtually because the kids didn’t have the necessary equipment at home.
“So many of our kids were dealing with increased anxiety and depression during the pandemic because they weren’t able to get their therapies,” Stinson says. "This inspired us to consider ways we might adapt our in-hospital VR protocol to the home setting, but we needed funding to help with the technology that would allow patients to use both the VR and motion sensors at home, and for PTs to be able to monitor their patients’ movements and progress remotely."
Enter the Johnson & Johnson Nurses Innovate QuickFire Challenge in COVID-19 Patient Care. As an awardee, Stinson was provided a $75,000 grant to help create the solutions she and her team needed to get PR-VR into the homes of their patients. For one, they needed to make software from the large virtual reality setups they used in the clinic compatible with smaller all-in-one VR headsets used at home. They also needed to procure device management tools that would allow providers in hospitals to remotely monitor patients, as well as create manuals and trainings to help both practitioners and patients alike learn how to use the new technology.
So far, Stinson says the physical therapists using this technology report that it has helped make their work more effective, engaging and fun. “The parents are also amazed to see how much their kids can move within the VR environment,” she adds. “Before this work, a lot of these children were in wheelchairs or using walkers. To see moms and dads shocked at how easily their kids move when using the VR has been quite gratifying.”
Based on these early results, Stinson sees nothing but potential for the in-home PR-VR technology she's helped champion in the years to come.
“Our ultimate goal is to continue to offer it after the pandemic ends, because it will help us get the technology to more patients—especially children in lower-income and rural areas around the world, where access to the kinds of hospitals that offer this technology may not be realistic,” Stinson says. “We also want to donate this technology to people in developing countries with the hopes that it will improve outcomes for kids in chronic pain around the world.”