Telestork: Delivering Telemedicine to Labor and Delivery Units Mary Kay Ford, RNC-OB,BSN, Jeni Ducoing , RNC-OB, Karin Lookingbilll, RNC-OB,BSN, Toni Wood, RN,MSN, Robin Winebar, RN, MSN,CNL Development of Telestork Improved Outcomes Future Plans • Use of telemedicine in Intensive Care Units (ICU) has shown Uterine Tachysystole YTD 2017 • Launching to rural hospitals improved outcomes in patient monitoring and safety (4) 4% • Telestork bunker will be partnering with rural hospitals in • Tele-ICUs in collaboration with the bedside team can be a valuable Louisiana and Mississippi to assist in monitoring high risk tool for enhancing quality goals and patient safety (2,3) 3% patients • Creation of Telestork was conceived from a collaboration of nurses • Integrating bunker observation into new nursing orientation and physicians who recognized a need for additional observation in 2% • Our new graduate nurses orienting to Labor & Delivery across Labor and Delivery (L&D) units the Ochsner System will observe 12 hours of telemonitoring • The initial success of Telestork prompted its launch into Ochsner's 1% with Telestork RN within the first year of hire four local community and rural hospitals in 2016 • Improving communication for nursing and providers 0% • Telestork nurses have collaborated with other campuses to ’ Jan Feb Mar April May June July Aug Sept Oct Nov Dec further improve communication with remote facilities including Nursing s Role Numerator= Number of monitored pa1ents with uterine tachysystole ( > 5 contrac1ons in 10 minutes over a 30 minute period) Denominator= Number of monitored pa1ents a future project with integrating video conferencing for • Telestork incorporates live streaming of fetal tracings with up-to- neonates in distress date pertinent patient information to the Telestork registered nurse (RN) who is located on a separate remote bunker. • The Telestork RN communicates via phone with bedside nursing to assist with fetal strip interpretation, recommending patient care interventions and calling physician to bedside. • Telestork RN helps the bedside RN to quickly identify labor distress and alarming fetal trends thus allowing for rapid intervention • At any time throughout continuous monitoring or at the request of the bedside team, interactions can be initiated via video to address emergent patient situations Good Catches References 1) Goran, S. (2010). A Second Set of Eyes: An Introduction to Tele-ICU. Critical Care Nurse, 30, 46-55 • Telestork RN notified bedside RN of prolonged deceleration. Bedside RN informed Telestork RN 2) Williams, L.M., Hubbard, K.E., Daye, O., Barden, C. (2012). Telenursing in the intensive care unit: that another emergency had occurred on unit and was relieved the bunker was watching transforming nursing practice. Critical Care Nurses, 32 (6), 62-69. • Telestork RN notified bedside RN via telephone of elevated blood pressure. Elevated blood 3) Goran. S.F, (2012). Measuring tele-ICU impact: does it optimize quality outcomes for the critically ill patient? Journal of Nursing Management, 20(3), 414-428. pressure was confirmed with next reading and hypertensive medication was administered and 4) Kleinpell, R., Barden, C., Rincon, T., McCarthy, M., Zapatochny, R.J. (2016). Assessing the Impact of patient closely monitored Telemedicine on Nursing Care in Intensive Care Units. American Journal of Critical Care, 25 (1), 14-20. • Uterine tachysystole was recognized by Telestork RN and bedside RN notified. Bedside RN 5) Ruesch, C., Mossakowski, J., Forrest, J., Hayes, M., Jahrsdoerfer, M., Comeau, E., Singleton, M. (2012). Using nursing expertise and telemedicine to increase nursing collaboration and improve patient outcomes. was unaware of tachysystole and decreased pitocin. Patient had an uncomplicated delivery Telemedicine and e-Health, 18 (8) 591-595. .