06Jun

Patient monitoring technology has proven both a boon and, in some ways, a burden to medical science.

Automatic sensors can detect heart fluctuations, sounding an alarm that will bring staff running. Other sensors monitor respiration, brain activity, temperature and multiple other critical factors, alerting professionals when help is needed.

However, these monitors can be so sensitive they send alerts for even minor departures from preset norms. A busy surgical unit can be a noisy place with alarms going off so frequently for little reason that they become part of the background ambiance, causing what medical professionals call “alarm fatigue.”

In one large study, nurses in a busy urban hospital were bombarded by an average of 187 alarms per bed each day. Of the 2,558,760 alarms recorded during the month-long study, most – up to 95% — were false or of little consequence.

So serious is alarm fatigue that in 2013 The Joint Commission issued a Sentinel Event Alert warned about the potential for desensitization. “In response to this constant barrage of noise, clinicians may turn down the volume of the alarm, turn it off, or adjust the alarm settings outside the limits that are safe and appropriate for the patient – all of which can have serious, often fatal, consequences.”

Still listed as one of the “Top 10 Health Technology Hazards” by the Emergency Care Research Institute, there is hope that yet another technological advance may hold the solution to too many alarms.

At Johns Hopkins, the health system’s alarms committee has been using and testing a number of techniques for quieting unnecessary alarms. Among these is the use of algorithms to decide when to sound an alarm, to whom and when and how to escalate the situation.

A more extensive use of artificial intelligence was discussed last fall in the Journal of Medical Internet Research. Researchers tested their AI algorithms against the recorded data from 32 surgical patients in Australia. Their technology reduced the total number of alarms by 99.3%.

Although it was not used in an actual clinical environment, “The experimental results strongly suggest that this reasoning algorithm is a useful strategy for avoiding alarm fatigue,” they wrote.

Using artificial intelligence to decide when and how to sound an alarm is still in the future. But, notes The Medical Futurist, “With time, AI solutions will be incorporated in patient monitors as a built-in “smart alarm system” throughout hospital units.”

Image by Bokskapet

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Jun 6, 2023

Abbott Begins Hiring to Produce Its New Rapid Covid Test

Abbott Laboratories has begun hiring for facilities in Illinois and Maine that will make the pharmaceutical firm’s new rapid COVID-19 test.

The Illinois site is expected to fill 2,000 new positions. The plant in Westbrook, Maine will hire 1,200 workers. Most of the jobs will be temporary, but are likely to extend well into next year based on the company’s announced production schedule.

Abbott was contracted by the federal government to produce 150 million tests at $5 each. Called BinaxNOW COVID-19 Ag Card, Abbott says the test delivers reliable results in just 15 minutes. The most commonly available current tests take two or more days for results, sometimes even up to a week, depending on where the test was done.

Like other tests, Abbott’s requires taking a nasal swab. Trained workers activate the test kit, inserting the swab into a “test well” in a credit card-sized cardboard test card. Results are ready in 15 minutes. The presence of a COVID infection shows up as two pink/purple lines.

Use of the test is intended for individuals “suspected of COVID-19 by their healthcare provider within the first seven days of symptom onset,” said the Food and Drug Administration.

The test was fast tracked by the FDA, getting emergency approval on August 26. The following day, the government announced the deal to acquire a supply of the tests for $750 million.

Abbott has also created Navica, an app allowing those who test negative to demonstrate their COVID status. Abbott says it will serve as a “digital ‘boarding pass’ that can be scanned to enter organizations and other places where people gather.”

Most of the new jobs don’t require any technical experience. Abbott said it will provide all the training production workers will need.

Photo provided by
United Nations COVID-19 Response

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Jun 6, 2023

The Unsung Heroes of the Pandemic

Nurses and doctors who treat patients with COVID-19 are rightfully celebrated as heroes of the pandemic. First responders, hospital orderlies, janitors, housekeepers and medical workers playing a support role in the fight against the virus are being cheered loudly and publicly and on social media posts worldwide.

Those are the ones we see and hear about daily. Yet there is another group of professionals laboring behind the scenes, often remotely, whose vital work goes unsung. These are the case managers — nurses or social workers in most cases — who, explains Wil Shelton, “coordinate with physicians, nurses, mental health and insurance companies, and family and friends of the patient, their client.”

His wife is one.

“Case managers are in a battle behind the scenes, huddling daily to plan for the next six months. But mostly these men and women are alone, hunched over computers in trenches of their bedrooms or living rooms, making frantic phone calls, staying focused on the needs of patients even when their families need them, too.”

In just one week, Shelton says, his wife helped cancer patients unable to see their oncologist because offices are closed. She worked with the family of a 2-year-old asthma patient discharged home because his doctor’s office, too, was closed. Then there were the terminally ill patients who contracted COVIC-19 and had to be isolated from family when, he notes sadly, “time with them matters most.”

That doesn’t even include the administrative tasks like finding an empty bed, handling records, tracking patients and hunting down busier-than-ever doctors and nurses.

“All of these situations bring tears, confusion, fear, and loss — all of which my wife, and case managers like her, are supposed to alleviate from a remote location with little support and in the middle of a system plagued by glitches and breakdowns,” says Shelton.

“Please,” he ends his post, speaking to all of us, “Be kind to your case worker. He or she is making a great sacrifice to ensure the best outcome for you.”

Photo by National Cancer Institute on Unsplash

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