An influx of coronavirus patients has overwhelmed the American health care infrastructure, leaving front-line medical providers to improvise creative solutions to the day-to-day pitfalls of treating those afflicted with the highly contagious disease.
The latest innovative solution found in hard-hit hospitals? Baby monitors.
"It’s a great example of nursing innovation with our front-line staff," Stacy Alves, a nurse at the Kaiser Permanente South Sacramento Medical Center, where workers have started using baby monitors to check in with patients, said. "Some of the biggest problems can have simple solutions."
From coast to coast, nurses have begun using two-way baby monitors to interact with isolated patients showing symptoms associated with COVID-19. Those who have used the baby monitors say it’s a practical solution for staying connected to patients -- a novel way to fight the novel virus.
"Clinicians have always been taught to examine the patient and to try to be as personal as possible," said Dr. Ben Scott, the vice chair of the Society for Critical Care Medicine’s (SCCM) committee on telemedicine. "But in the current situation it has become clear that one of the things we may need to do is actually limit our contact with patients in a way that can be uncomfortable for care providers."
The problem is simple and widespread. Front-line health workers want to limit risky interactions and preserve equipment already in short supply. But how can they do that without losing a personal connection with their patient? How do you have a bedside manner without actually being at the bedside?
"We started brainstorming: what’s the best way to get something to scale that’s easy to use and won’t require a whole lot of training?" Dr. Stephen Parodi, an executive vice president at Kaiser Permanente, said. "So when one of our team members suggested baby monitors -- she’s a mom herself -- we said, ‘Wow, that’s not a bad idea.’"
Kaiser Permanente began introducing the idea at its facilities in California’s Santa Clara County, where the hospital beds were already filling up with possible COVID-19 patients.
"In terms of our nursing staff, it gives us peace of mind because we can directly observe our patients at all times and as nurses we like constantly assessing," Alves said.
On the other side of the country, a nursing team in New Jersey, where the count of positive cases in the state approached 20,000 on Tuesday, struck up the same idea.
Inundated with patients, and already facing a limited supply of personal protective equipment, nurses began "thinking outside the box," said Philip Johnson, the nursing director at Virtua Our Lady of Lourdes Hospital in Camden.
"The staff immediately were uncomfortable with the idea of not being able to communicate at will with their patients," said Johnson. "We talked about pulling in a contractor to install permanent video cameras, but even that doesn’t allow the two-way communication."
Then, again, a brainstorming session provided the answer. Nurses and other frontline workers at the hospital began asking friends and family to donate their baby monitors. Within days, the system was up and running.
"We were able to implement the monitors and immediately establish a line of sight with our patients, as well as two-way communications so they could easily, say, ask for a blanket without having to open the door every time," Johnson said.
The emerging use of baby monitors can be useful in addressing two major concerns confronting health care workers, experts said. First, by limiting the number of times a nurse has to enter an isolation room, the obvious benefit is fewer high-risk interactions with the patient.
"Because you’re minimizing the in-and-out to the room, you’re reducing the amount of exposure to the health care workforce," Parodi said.
But as health care facilities face a dearth of personal protective equipment, or PPE -- masks, gowns and gloves -- communicating via baby monitors also offers a way to preserve those limited resources.
"If you had to open the door every single time a patient asked for something, you’d have to don [protective equipment], go in there, see what they wanted, come back out, go get what they wanted, then redo that process again," Johnson said. "So every single time you’d have to use a whole set of PPE."
The benefits are clear, and nurses using the baby monitors say patients like the system, too. Alves said, "It gives patients a sense of comfort."
But experts characterize the monitors as a Band-Aid -- not a solution. From concerns about network security to limitations in the technology, health care professionals recognize the drawbacks.
Even so, health care providers say those drawbacks are worth it, at least in the near term, to combat an unprecedented demand on front-line workers.
"This is one of those extraordinary times when you can’t let the ideal be the enemy of what you need to do in real-time," Parodi said. "But we’ve made the judgment that because of the size and scale of this pandemic this is the right thing to do right now … and the benefit really outweighs the potential risk."