Monthly Archives: October 2016

Enhancement in Education, Part Three: Enter MedAffinity

This story is part of an ongoing series about the BYU College of Nursing’s Mary Jane Rawlinson Geertsen Nursing Learning Center and the College’s constant efforts to update it.

In the basement of the Spencer W. Kimball Tower, students are training to be observers. All their subjects are kept under intensive watch, with any changes in behavior or well-being quickly typed into computer files. Nothing escapes their notice, or more importantly, their notes.

No, this is not NSA training; these are nursing students using new software, MedAffinity EHR, that helps them practice documenting patient treatment. It’s a system that hopefully will allow students to adjust better to working in a hospital environment where recording patient data on a computer is the norm.

“MedAffinity is electronic documentation, and the way the real world is going is to have an electronic health record,” says Colleen Tingey, supervisor of the Mary Jane Rawlinson Geertsen Nursing Learning Center (NLC). “The world that [students will be] working in is using electronic documentation, and [they] need to figure out how to do it.”

Documentation in nursing is everything, says Tingey. She teaches students that if they don’t document what they did for a patient, then they effectively didn’t do it, leaving them legally vulnerable if there are questions about what they have done to treat patients.

This documentation used to be mainly by hand, but in recent years the trend has been to do it electronically, including in the hospitals where students do their clinicals. That made it necessary to search out a program that could imitate standard documentation software.

After examining many programs over the years, it was decided that MedAffinity was the way to go, but not without some changes.

The program looks just like a typical electronic documentation software that you would find in hospitals. As students complete their labs in the NLC, afterwards (or during) they record what they did on the program. The “patients” they treat and their background information are preloaded by NLC assistant supervisor Kristen Whipple, so students can write about all the different actions they take to treat them.

“Our goal is to make it as real as possible,” Whipple says. In an effort to resemble a typical hospital environment, the NLC now has computers next to patient beds.

MedAffinity is extremely meticulous, in large part thanks to BYU nursing faculty as well as Tingey and Whipple who helped redesign the software to make it more compatible with the nursing program’s requirements. It now covers many more aspects of documentation, with very specific descriptions of treatment and patient reaction.

Another benefit is that this program helps train not only students in the undergraduate registered nurse program, but also those in the graduate nurse practitioner program.

However, Tingey and Whipple stress that the idea of MedAffinity, which is currently employed mainly in the skills labs, is not meant to show students how to use all documentation software, since it can vary throughout the country. “We’re not trying to teach a certain program; we’re teaching principles of documentation,” Tingey says.

Assistant professor Dr. Deborah Himes, who teaches courses involving MedAffinity, sees other benefits in teaching students how to document their work beyond just their legal protection.

“In a sense, learning how to chart well makes you a better nurse because you think about the outcomes you have to chart when you get to the end,” Himes says. “You do a care for a patient, and you go back to chart it, and you can evaluate how it went based on how the patient reacts.”

Implementation has been an intensive labor, but is now moving along relatively smoothly. It requires constant fine-tuning, and always will due to the dynamic nature of the industry. For students, the adaptation from paper to electronic is not always easy, but Tingey believes that it’s a key training for students.

“They’ll be much more prepared to function in the real world,” she says.

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Enhancement in Education, Part Two: Why The Sound Your Alarm Clock Makes Could Save Your Life

This story is part of an ongoing series about the BYU College of Nursing’s Mary Jane Rawlinson Geertsen Nursing Learning Center and the College’s constant efforts to update it.

Beep! Beep! Beep! The infusion pump has little tolerance for delay, and so when its user stalls in making a decision, a high pitched beep illustrates its displeasure. It continues to beep at other moments when the user attempts to get an intravenous line ready.

Some may get annoyed by the noise; however, that is one of the benefits of the new brand of IV pumps used by the Mary Jane Rawlinson Geertsen Nursing Learning Center (NLC).

Rebecca Edmunds, a student employee at the NLC, thinks that these pumps are much better than the old ones, mainly due to their being much more user-friendly, as well as safer for patients. “They’re easy to train on,” she says.

Part of that may be because any time that a nurse might mess up the IV administration, the beeping begins.

“There’s a lot of safeties built into this that were not in the previous pump,” Edmunds says. This includes a light system that indicates if an IV delivery is going smoothly, as well as the ability to automatically cut off an IV if something goes wrong.

Another plus for the new machines is that they are preprogrammed with information about usual drug dosages for patients—it will ask multiple times if a nurse is certain he or she wants to administer certain quantities of the drug, thus reducing the chance of medical error.

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NLC supervisor Colleen Tingey works to set up one of the new IV infusion pumps.

“The coolest thing about these is that they can associate to charting,” Edmunds says. This means that when an IV is running, the information can be given real-time to the patient’s hospital file, and others can remotely see what treatment is being administered.

NLC supervisor Colleen Tingey explains that the pumps were changed from their previous brand when Intermountain Healthcare switched its main brand to Alaris earlier this year, as many students do their clinicals at their hospitals. However, she says, the idea is to help students get used to using IV pumps in general since there are so many different brands in use in the medical world.

“To have lots of different kinds and to try and teach lots of different kinds is just cumbersome,” she says. “We can’t do that, so we tried to do what the majority of students will see.”

 

BYU Professors Use Pokémon-themed Race to Help Students Evolve in Fitness

On Saturday, October 22, the BYU College of Nursing and the campus chapter of Sigma Theta Tau (an international nursing honor society) will host the Pokéthon, a 3K run/walk event centered on Pokémon Go. Participants can dress up as characters from the game or wear their team colors, all while going to lures set up on the course.

To some, this seems like a fun way to spend a Saturday morning. For nursing professors Dr. Neil Peterson and Craig Nuttall, the Pokéthon is the beginning of a campus-wide health initiative to help students enjoy being active.

Peterson and Nuttall—both members of the American College of Sports Medicine, a fitness organization—recently found out that a program offered by the ACSM, Exercise is Medicine, has a college subcategory. Within the past month, the two have collaborated with others on campus to start a branch of the Exercise is Medicine at BYU to promote college fitness.

“Exercise is something that frankly is probably one of the most important things in medicine right now, because it can treat most diseases that are out there,” Nuttall says. “You exercise, your diabetes risk goes down. You exercise, your hypertension risk goes down. You exercise, your cancer risk goes down.”

With a PhD in nursing and a focus on physical activity and sedentary activity (sitting around), Peterson is well versed in student health affairs. He has noticed in his studies that college students spend a lot of time moving around, but then also spend a lot of time sitting around, especially with electronic devices.

“My concern then is once you get beyond the university atmosphere, when you get a real job, what’s the first thing that’s going to drop off? Probably the physical activity time and not the sedentary time, so I want to try to help find what’s motivating (to help people stay active even once they leave the student setting),” Peterson says.

Exercise is Medicine for college campuses comprises hosting physical fitness events (such as the Pokéthon), educating students, and working to promote measures that increase physical activity levels on campus. The program is still in its infancy, but the professors have managed to organize a leadership team which includes themselves, associate professor of Exercise Science James LeCheminant, and Peterson’s two research assistants. The team is now striving to meet requirements set by the ACSM.

“We’re working together to make our campus certified as an exercise medicine-friendly type of environment,” Nuttall says.

“It’s not necessarily about battling obesity per se,” Peterson says. “Unless you’re an Olympic athlete, everybody could be improving their physical activity.”

The plan right now is to organize more events like the Pokéthon and also to begin holding educational events to promote fitness awareness. Peterson is confident that the student body will be receptive.

“I think there are a lot of people interested in trying to improve their health and realize that maybe they sit too much or have too much screen time, so hopefully we will find a lot of people who are very interested in participating and advocating for us and helping to make this a success,” he says.

For students, Peterson and Nuttall say, improved fitness can have major benefits, including better sleep, increased test-taking ability, and deeper satisfaction with life.

“It doesn’t matter what the disease is, exercise can help it, either treating it or preventing it,” Nuttall says.

All students interested in the Pokéthon should visit the event website (http://tinyurl.com/byupokethon2016) and register. The race will begin at 9 am with check-in starting at 8:30 am.

See related story on the event: https://byunursing.wordpress.com/2016/10/05/upcoming-event-lets-pokemon-go-players-get-a-fun-workout/

Enhancement in Education, Part One: The Manikins Among Us

This story is part of an ongoing series about the BYU College of Nursing’s Mary Jane Rawlinson Geertsen Nursing Learning Center and the College’s constant efforts to update it.

Eight new patients in the Mary Jane Rawlinson Geertsen Nursing Learning Center (NLC) just got the doctor’s orders: eight years of bed rest and weekly IVs. It may seem like an intense recommendation, but given that the patients are newly acquired manikins designed to help increase nursing proficiency, the tall order makes sense.

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The BYU College of Nursing recently obtained eight mid-fidelity nursing manikins, four of which are the Nursing Anne type, pictured above.

The manikins, four “males” named Kelly and four “females” named Anne, are created specifically for nursing programs. They replace eight older models, which were donated to BYU-Idaho, and come with many features that allow students to train in a variety of situations.

“You can set them to run scenarios,” says Kristen Whipple, NLC assistant supervisor. “It changes every day to a different lab. It’s something on Monday, and then it’s a different lab on Tuesday.”

The Anne and Kelly manikins are considered low to mid-fidelity, which means that they can represent a human to a reasonable extent. When purchased with digital equipment, including a device known as a SimPad, they create a more lifelike patient.

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NLC supervisor Colleen Tingey and student employee Brian Wing work to unload the new manikins, which have weights comparable to normal people.

“They serve a great purpose just as they are. If you add the SimPad to them, then you can hear heart sounds, lung sounds, belly sounds, GI tract sounds,” Whipple says. “The manikins give us a great opportunity to let you hear what the not-normal sounds like.”

BYU nursing students work with manikins, including four high-fidelity ones, throughout their time in the nursing school. During their first three semesters, students use Anne and Kelly to run through the basics of inserting an IV, dressing wounds, and communicating with a patient. Often students will pair up, with one treating the manikin and the other vocalizing potential responses from the patient.

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Appendages to the nursing manikins wait to be unwrapped.

Each one represents a significant investment in student education; according to Colleen Tingey, NLC supervisor, one Anne or Kelly and the accompanying equipment costs around $11,000 and lasts eight years. The high-fidelity manikins cost around $65,000 each and last only five.  Accordingly, the college makes use of high- and low-fidelity in order to maximize the investment for the students.

“It’s having the different ones that make the real success of the program,” Whipple says. “You really need both to do it well. The big ones seem like they’re better, but they’re good for certain things and [the mid-fidelity manikins] are better for some things.”

Whipple and Tingey, both nurses themselves, appreciate just how much manikins have changed how students are taught.

“I like the fact that it integrates more than just learning the skill. You’re practicing the communication and you’re bringing things together,” Whipple says. “I did go to nursing school, and I think, ‘Wow, I wish that I’d learned it this way.’”

Upcoming Event Lets Pokémon Go Players Get a Fun Workout

Attention all students who like to wander around at five in the morning to pursue Pokémon—on Saturday, October 22, the College of Nursing and the campus chapter of Sigma Theta Tau (a nursing honor society) are hosting a 3K walk/run event that will help bring your hunting habits to the daytime hours.

The free event, called the Pokéthon, is designed to help students increase their fitness while also having a good time. Participants are encouraged to dress up in costumes or team colors, and the cherry on top is that the course will feature Pokémon Go lures.

Normally, Pokémon wouldn’t top anyone’s list of exercise inducers, but since the release of Pokémon Go, things have changed.

Nursing assistant professor Gaye Ray is an avid fan of the game (her favorite creature is Bulbasaur and she is on the red team), not just for its ability to entertain, but also for its health benefits to players.

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“I love Pokémon Go for a couple of reasons, but my favorite reason is that I think it’s a huge motivator for people to get up and move, and that’s what staying healthy is all about,” she says.

Ray points out that the game requires you to seek out Pokémon, which is why it adds extra incentive for her to do her exercise walks. Added on to that is the requirement to walk certain distances before Pokémon eggs will hatch in the game. Her level is full of eggs that require between two to five kilometers (roughly 1.2-3.1 miles) of walking to unlock.

“Some of the best guidance for us is to have cardiovascular exercise—or exercise enough to make us sweat—so you have to put some ‘oomph’ into it, forty minutes four or more days a week, so I think that people who play Pokémon Go really do get out,” she says. One of her students, who before did not get that much exercise, now runs a couple of miles each day to advance in the game.hand

Craig Nuttall, one of the professors who is helping to plan the Pokéthon, believes that getting students active in a fun way will have a stronger impact than students trying to force themselves to work out.

“I think having fun and feeling good is the most important part,” he says. “If they’re having fun while they’re exercising, they’re going to be more inclined to doing it.”

All students interested in the Pokéthon should register on the event website (http://tinyurl.com/byupokethon2016). The race will begin at 9 am, with check-in starting at 8:30 am. All members of the community are invited to attend.