As generally include a subcutaneous pulse generator placed

As professionals in the
healthcare field, one thing that remains constant in our profession is change.
From changing legislation and regulations to advancing technologies, each year
we see new trends emerge.  Nursing professionals are typically exposed to
the most change as they are navigating the front lines of patient care.  This
paper covers a few current trends that will impact nursing in 2018 and beyond.Traditional pacemakers Vs Leadless pacemakersHeart
disease is the leading cause of death in the United States surpassing cancer by
a margin. Each year, approximately 200,000 pacemakers are implanted in the
United States in bradycardic patients, who derive a clear benefit from pacing
therapy (Avanderzee,2016). The indication for a pacemaker is needed when the
heart begins to have abnormal heart rhythms which in turn helps control abnormal
heart rhythms. A
pacemaker is a small device that is inserted in the chest or abdomen to help
control arrhythmias (NHLBI,2018). During an arrhythmia, the heart can
beat too fast, too slow, or with an irregular rhythm, the heart may not be able
to pump enough blood to the body (NHLBI,2018). A pacemaker does what the heart can
no longer do and the device uses electrical pulses to prompt the heart to beat
at a normal rate. The benefit of a pacemaker is that it can relieve some
arrhythmia symptoms, such as fatigue and fainting. Traditional
cardiac pacemaker systems generally include a subcutaneous pulse generator
placed in the chest wall and transvenous pacing leads affixed to myocardial
tissue(Avanderzee,2016). Associated with traditional pacemakers are early and long-term
complications related to lead placement. According to Avanderzee (2016), the
majority of early complications are related to lead placement and include
pneumothorax, difficulty obtaining upper extremity venous access, hematoma
formation, cardiac perforation, and lead dislodgement. Long-term complications
that also contribute significantly to patient morbidity include fracture due to
mechanical lead stress, venous thrombosis, and infection of the pocket and
bloodstream. Miniature leadless pacemakers have the potential to minimize many
of the complications associated with transvenous pacing systems (Avanderzee, 2016).   Clinical Experience with Leadless Right Ventricle
(RV) PacemakersThe researchers of
this study found that patients with leadless pacemakers were 94% free of
complications. They investigated the leadless pacemakers in patients who
require single chamber ventricular pacing. In the LEADLESS
trial, 33 patients had a single-chamber leadless cardiac pacer attempted; 97%
had a successful implant. One patient developed RV perforation and another
cardiac tamponade during the implant (Avanderzee, 2016).
The overall complication free rate was 94%. Pacing performance was stable in
all implanted patients at three months and one year(Avanderzee, 2016).They
also found that there was no pacemaker related adverse events were reported
between 3 and 12 months of follow-up.Personalized
drug dosingA current
trend in the healthcare field is 3D printing medicine. Experts and researchers have
come up with an idea to produce personalized 3D printed oral tablets. A doctor or a pharmacist
would be able to use each patient’s individual information — such as age, race,
and gender — to produce their optimal medication dose, rather than relying on a
standard set of dosages(Govette,2018). 3D printing may also allow pills to be
printed in a complex construct of layers, using a combination of drugs to treat
multiple ailments at once. A benefit of 3D printing medicine is that it greatly
reduces the need of polypharmacy especially for elderly patients who take many
medications daily. The precision of 3D printing means pills can be designed to
house several drugs, all with different release times this rather than embedding a single
drug in a pill. A 3D printed “polypill” that contains three different drugs has
already been developed for patients with diabetes and hypertension (Trounson-Melbourne,2017).GPS
Tracking Have you ever found yourself wasting
valuable time in the unit tracking down a needed piece of equipment or staff member?
Real-time locating are local systems used for
the identification and tracking of the location of assets and/or persons in
real or near-real-time. According to Bulous, An RTLS receives wireless
signals from small ID badges or tags attached to objects of interest and/or
persons, to determine where the tagged entities are located within a building
or some other confined indoor or outdoor space (Bulous et al., 2012). Currently,
tracking chips are being embedded into these devices and integrated with an
“in-house” positioning system so they can be located instantly (Bulous et al.,
2012). RTLS are also used locate healthcare
staff in facilities when a client nor staff member requests assistance during a
medical emergency. I believe that this aspect makes the RTLS system unique and very
valuable.It has been preached to
those in the healthcare profession that safety is number one. Clients residing
in nursing homes and assisted living elderly care situations can also greatly
benefit from RTLS. Residents who agree to this will be equipped with wearable
technology that tracks them no matter where they are in the care facility. RTLS will help ensure elderly clients safety,
particularly in the case of Alzheimer’s and dementia patients (Bulous et
al., 2012). An
RTLS can also alert staff and pinpoint the location of a resident who wanders
away from a pre-defined area or tries to leave the building or in the proximity
of an exit (Bulous et al., 2012).. On any hospital unit, it is
common for a nurse or a UAP scramble around looking for devices such as IV
pumps or the vital sign machine. Many staff members use these devices and often
the devices become non-operable, malfunctions or lost and this delays patient
care unnecessarily. I believe that tracking equipment saves valuable time and
effort and reduces the healthcare staff workload. According to Bulous (2012), Tracking
expensive or shared equipment, such as ICU ventilators and intravenous (IV) pumps,
can save time and money, and reduce equipment theft and accidental loss (Bulous et al., 2012). Hospitals are often large institutions, and personnel
often find it difficult to locate portable equipment when it is required
(Bulous et al., 2012). Personnel often find it
difficult to locate portable equipment when they need it, they sometimes hide
or hoard it, so that they may find it when required; this practice exacerbates
the problem (Bulous et al., 2012).As an extra universal standard precaution, RTLS can help with infection
control in the hospital. Hand hygiene is the corner stone of preventing and
transmitting nosocomial infections and should be taken very seriously. How well
does one know if their nurse, physician or tech actually performed hand
hygiene? If I were a patient, I would love to be assured that the healthcare
professional taking care of me is compliant with hand hygiene. RTLS should be considered
as a low-cost method for recording when members of staff use hand sanitation
stations before and after they enter and leave rooms and wards (Bulous et al., 2012). When a member of staff uses a hand washing station, a nearby
electromagnetic field emitter triggers the personal badge tag worn by the
caregiver to transmit a ‘hand washing event’ message that identifies the
caregiver and the time that the specific dispenser was used (Bulous et al., 2012). Exercising the RTLS system would be a great tool used as a hospital
infection control measure to identify individuals and groups who may need
additional training or education.Improving the productivity and efficiency of nurses and caregivers is a
trend one should strive for in the healthcare field.  RTLS has the potential reducing many mundane
and repetitive tasks that staff encounters on a daily basis. For example, a
nurse or a caregiver typically has to manually cancel a call (register that it
has been answered), but an RTLS can perform the same task automatically by recognizing
the nurse’s presence in the room(Bulous et al., 2012). RTLS can also cut the time staff has
to spend to check the status of rooms and beds and also improve a patient’s
family/visitors’ satisfaction by increasing their awareness of patient location (Bulous et al., 2012).Wireless Patient MonitoringIn the intensive care unit or any other unit
where a patient is in critical care, a monitoring system is essential to
constantly monitor the patient’s physiological parameters. Wireless patient monitoring
system that has the capability to monitor physiological parameters from
multiple patient bodies(Aminian,2013). The attached sensors on patient’s body form a wireless
body sensor network and they are able to sense the heart rate, blood pressure
and so on. This system can detect the abnormal conditions, issue an alarm to the
patient and send a SMS/E-mail to the physician(Aminian,2013). Body sensor network systems can help people
by providing healthcare services such as medical monitoring, memory
enhancement, medical data access, and communication with the healthcare
provider in emergency situations (Aminian,2013). Therefore, the patient and their loved ones will greatly
benefit from these and it will improve patient outcomes. Monitoring systems like the ECG allow
continuous monitoring of patient vital signs but the downfall is that these
systems require the sensors to be placed bedside monitors or PCs, and limit the
client to their bed. The upside to this that with wireless devices and networks
don’t require the client to be limited to their bed and allows freedom. LobbyingMy plan is to meet the legislators either in Washington, DC, or in their
local office by contacting the scheduler through the U.S. Capitol Switchboard
and asking for the senator’s and/or representative’s office. My goal is to
increase funding for some of these wonderful new technologies and I will go
over 3 of the best equipment’s that I want for the hospitals in my location. I
will go with other nurses who feel the same about advancing our technology with
a printed fact sheet for the legislator.                                                                    



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