Electronic link helps keep eyes on patients

By Wayne Bryan Published July 3, 2014 at 12:00 a.m.
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PHOTO BY: Rusty Hubbard

Billie Schnebly, a veteran critical-care nurse, answers an eICU call from Baptist Health Center-Hot Spring County in Malvern.

MALVERN — Patients in the intensive-care unit are there because of severe and life-threatening illness or injuries. They require close, constant monitoring and care from specially trained doctors and nurses.

Physicians and nurses at Baptist Health Medical Center-Hot Spring County in Malvern are using high-definition cameras and computerized communication links for assistance in the monitoring of patients in the intensive-care units of the hospital. The program is called eICU.

“This is a great step forward,” said Billie Schnebly, a veteran critical-care nurse at the eICU monitoring office in Little Rock. Commenting via a monitor in an eICU room, Shnebly added, “We can interact with patients, doctors and nurses on a daily basis. We are not only another set of eyes, but eyes that never close.”

Located on an upper floor of the Baptist Health Eye Clinic in Little Rock, experienced nurses like Schnebly work a shift monitoring critical-care patients in 20 Baptist hospitals, 19 of which are in Arkansas.

Speaking to a patientless room of the ICU unit in the Malvern hospital, Schnebly explained that the technology used in the program allows eICU nurses to monitor a patient just as effectively as a nurse standing at the patient’s bedside.

The nurse at the central location can zoom in the high-definition cameras to check the IV pumps, blood pressure and heart-rate monitors, and can observe the patient up close.

“I can zoom in and even count the number of eyelashes on the patient,” Schnebly said. “I can check their skin and watch their movements.”

Paul Green, ICU supervisor from BHMC-HSC, said the camera’s picture quality and range are more than enough to take a good look at a patient.

“If a man was standing on the roof back there,” he said, pointing from the window in the ICU room to a building behind the hospital’s main building, “we could train this camera on him and read his identity card.”

While the nurse can quietly observe the patient, Schnebly said, the eICU program guards the privacy of the patient.

“When the camera goes live, it has the sound of a doorbell ringing,” she said. “I introduce myself to the patient, as well as to staff and any family that are in the room. Then I explain that I am checking vital signs and making sure the patient is OK.”

Dr. Jack Griebel, medical director of eICU for Baptist Health System, said the program allows patients to receive care from specialists who are not part of the regular hospital staff.

“I am a pulmonary-care specialist,” he said. “I can observe a patient and talk with the doctor at the hospital and make sure we are all working on the same plan. We’re a team. We usually have the same answers, but they can check with me without me being there.”

Griebel said that when families know a specialist is looking in and is involved with patient care, it gives them peace of mind.

“In addition to being able to connect with the 223 monitored beds through eICU, it means a patient can stay in the local facility and receive the care and attention they would receive in Little Rock,” he said. “The patient does not have to be transferred to another hospital, and families can stay in their community and do what they have to do.”

So sicker patients don’t have to go through the trouble of being transported, and Green said that often helps patients recover faster.

The command center in Little Rock has a team of 24 nurses experienced in critical care at the work stations to monitor patients, said Vicki Norman, system director of operations for eICU. They can be called in by the nurses at the local hospitals with the push of a button in a patient’s room.

The monitoring equipment in a patient’s room is also linked to the command center, Norman said. Any change in a patient’s vital signs signals one of the eICU nurses. The command-center nurses can, if needed, notify the local staff about a problem. Griebel said command-center nurses are called upon to consult or intervene three to four times a day during a day shift, while at night, when fewer nurses are on staff, it happens six to eight times during a shift.

Schnebly said her last intervention had been just minutes before she was called for the interview.

She said the monitors had detected that a patient’s heartbeat and respiration were declining.

“The patient has signed a DNR (do not resuscitate) order, so I alerted the nurses what was coming up,” she said.

In a ribbon-cutting ceremony heralding the official opening of eICU care at Baptist Health Medical Center-Hot Spring County, Russell Harrington, president and CEO of Baptist Health System, said the new program has improved health care and helped patients.

“We are not reimbursed for this service, but we still have to have it,” he said. “It saves lives, extends life and helps with recovery.”

Staff writer Wayne Bryan can be reached at (501) 244-4460 or wbryan@arkansasonline.com.

Tri-Lakes Edition Writer Wayne Bryan can be reached at 501-244-4460 or wbryan@arkansasonline.com.

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