“Measure what?”
It was a clarifying query. As I stood by the hospital nurse supervisor, I used to be ready to discover any request that will make nurses’ lives simpler. I used to be the hospital system’s head of enterprise innovation and knew that scientific groups had been overburdened with their on a regular basis workload, documentation, and growing calls for. Nationwide, the nurse-to-patient ratio was growing, contributing to burnout and issues for affected person security. Nonetheless, the request was an surprising one.
“Urine.” She motioned within the course of a affected person’s hanging catheter. “There must be a better technique to monitor, measure, and handle urine output and the kidneys.”
I heard, and understood, the issue. Catheters weren’t foremost in my thoughts, however I knew how they labored. Although utilized by 15-25% sufferers throughout their hospital keep, the expertise wasn’t computerized and the workflow wasn’t straightforward. It was a facet of care that demanded innovation.
Urine output is an important signal of total kidney operate, so facilitating fluid administration and holding kidneys wholesome is significant for hospital sufferers and their care groups. However whereas advances had been made to watch our hearts, brains, and lungs for higher preventative care, kidneys had been left to a handbook and time-consuming course of – one which was initially patented in 1936. You can also make your personal analogies, however how about attempting to race a 1936 Maserati in opposition to a 2025 mannequin? Our hospital’s – and each hospital’s – antiquated race automobile wasn’t serving sufferers and nurses effectively. The cussed incidence of acute kidney harm (AKI) in post-operative hospital sufferers, a situation that contributes to 300,000 deaths yearly, ends in half from the prevalence of previous expertise.
The 1936 Foley catheter is probably the most broadly used expertise for draining a affected person’s bladder following surgical procedure or intensive care unit (ICU) procedures, with greater than 30 million offered within the U.S. yearly. On account of its design that depends on gravity to gather fluid, the Foley catheter can result in inconsistent monitoring for nurses, who have to sort out as much as 125 duties per hour. Past that, the standard catheter doesn’t present the entire image – and even the fitting one.
A catheter is inserted in a affected person earlier than surgical procedure, resembling a cardiac process, and stays there because the affected person recovers within the ICU. Even when nurses had on a regular basis on the planet to manually clear urine from tubes and measure the urine output each hour, the information gained from the catheter nonetheless couldn’t be assured to be correct attributable to its restricted expertise. When blockages happen, attributable to twisted tubes or urine samples turning into contaminated, medical doctors don’t have a full information image. The affected person, whose coronary heart process was profitable, may depart the hospital with out even realizing their kidneys have been compromised attributable to a hospital-acquired an infection that might take as much as seven days to develop
AKI is a standard hospital acquired harm, affecting 42% of sufferers admitted to the ICU which will increase the chance for size of hospital keep – with related prices as much as $69,000 per affected person – and may trigger persistent situations.
All of this goes again to the hospital flooring, standing with the nurse supervisor and questioning if a expertise even existed to modernize kidney monitoring and enhance sufferers’ well being. I wasn’t certain – however what was clear was the necessity for a transformational resolution to assist scientific groups extra simply monitor, handle, and measure kidney efficiency. After spending many hours within the ORs and ICUs, I knew an answer wanted to:
- Automating urine output: Infections and blockages can come from improper draining of catheters. By automating the drainage system, the chance of points would plummet.
- Actual-time monitoring: In the identical means we’ve instruments to extra precisely measure a affected person’s coronary heart charge or blood strain, dependable and improved strategies would do the identical for the kidneys.
- Workflow: At the beginning, we would have liked a design to help nurses. If innovation didn’t match into their workflow or make their job simpler, it wouldn’t be innovation. Catheters want to supply standard-driven, goal, dependable, and correct info concerning kidney efficiency.
A few years later, after discovering the expertise they had been searching for, I returned to the hospital and noticed nurses had pinned a notice to one of many new, automated sensible catheters that learn: “Do Not Take away from the CTICU.” It was clear this innovation had improved nurses’ means to do their jobs. Greater than 110,000 of the brand new catheter-and-sensor methods have been used throughout the U.S. It’s a fraction of the established technique, nevertheless it represents the potential for remodeling kidney well being on this nation.
My dialog with the nurse supervisor was a name to do higher. Hospitals are inundated with 1000’s of competing priorities and staffing shortages. When expertise could make a direct distinction for one thing as essential as kidney well being, we have to act.
Photograph: Urupong, Getty Photos
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