Why did 21st Century Hospital monitor kidney function through technology from the 1930s?

“What to measure?”

This is a clarification question. As I stand next to the nurse manager of the hospital, I am ready to explore any requirement that will make a nurse’s life easier. I am the head of corporate innovation in the hospital system and know that the clinical team is overwhelmed by their growing daily work, documentation and demand. Nationwide, the nurse-to-patient ratio is increasing, leading to burnout and concerns about patient safety. Nevertheless, the request was an unexpected request.

“Pure.” She signaled in the direction of the patient's catheter. “There has to be an easier way to monitor, measure and manage urine volume and kidneys.”

I heard and understood the question. Catheters aren't the most important thing in my mind, but I know how they work. Although patients use 15-25% of patients during hospitalization, the technology is not automatic and the workflow is not easy. Innovative nursing aspects are needed.

Urine volume is an important sign of overall renal function, so promoting fluid management and maintaining kidney health is crucial for hospital patients and their care teams. But despite progress has been made to monitor our heart, brain, and lungs for better preventive care, the kidneys are manually and time-consuming processes – originally patented in 1936. Our hospitals, and each of the old racing cars are not suitable for patients and nurses. The stubborn incidence of acute kidney injury (AKI) in patients with postoperative hospitals, which causes 300,000 deaths each year, partly due to the prevalence of old technology.

The 1936 Foley catheter was the most widely used technology to drain patients' bladder after surgery or intensive care unit (ICU) procedures, and sold more than 30 million times a year in the United States. Because its design relies on gravity to collect fluid, Foley catheters can cause inconsistent tracking for nurses, who need to solve up to 125 tasks per hour. Apart from that, the traditional catheter does not show the entire picture, and does not even show the correct picture.

The catheter is inserted into the patient before surgery, such as cardiac surgery, and stay there when the ICU is restored in the patient. Even though nurses can always manually remove urine from tubes and measure urine volumes every hour in the world, the data obtained from catheters are still not guaranteed to be accurate due to their limited technology. When a clog occurs, the doctor does not have a complete picture of the data due to contamination of the twisted tube or urine sample. The patient's heart surgery was successful, and he might leave the hospital without even realizing that he was compromised due to an infection obtained by the hospital, which could take up to 7 days to develop

AKI is a common hospital injury that affects 42% of ICU patients, which increases the risk of hospital stays – the associated costs are as high as $69,000 per patient and can lead to chronic illness.

All of this goes back to the hospital floor, stands with the nurse manager and wonders if there is a technology to modernize kidney monitoring and improve the health of patients. I'm not sure – but it's clear that a transformational solution is needed to help clinical teams monitor, manage and measure kidney performance more easily. After spending hours in ORS and ICU, I knew I needed a solution:

1. Automated urine volume: Infection and obstruction may result from improper drainage from the catheter. By automating drainage systems, the risk of problems will plummet.
2. Real-time monitoring: inThe same tools we have to measure patients' heart rate or blood pressure more accurately, reliable and improved methods, do the same for the kidneys.
3. Workflow: First, we need design to support nurses. If innovation is not suitable for their workflow or makes their work easier, it will not be innovation. The catheter needs to provide standard driven, objective, reliable and accurate information about renal performance.

Years later, after discovering the technology they wanted, I returned to the hospital and saw the nurse nailing a new, automated smart catheter that read: “Don't remove it from the CTICU.” It's obvious that this innovation improves the nurse's ability to get the job done. The United States has used more than 110,000 new catheter and sensor systems, a small part of the established approach, but it represents the country’s potential to transform kidney health.

My conversation with the nurse manager was about making a better call. Hospitals are flooded with thousands of competitive priorities and staff shortages. When technology has a direct impact on things as important as kidney health, we need to take action.

Photo: Urupong, Getty Images

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