For the many advancements in technology and innovation within the surgical sector, University of Iowa operating room nurse Jill Droste said there still isn’t an efficient way to keep the base of surgical beds tidy during operations.
Until recently, the method has been to wrap linens around the base, which has only been partially effective, she said. Nurses find themselves spending precious moments between cases scrubbing dried fluids from between cracks and crevices that could be spent preparing for the next patient.
“The nurses in the room are spending extra time deep cleaning these beds after long cases and throwing linens on the bottom of the bed has always just been the way that we’ve done it, and I’m tired of that being the solution,” she said.
Ms. Droste, a 13-year OR veteran, had a solution — the Droste Drape, a plastic cover that fits snugly around the base of the bed like a Christmas tree skirt and uses fabric fasteners in the back to accommodate different sizes. An underpad on top can absorb about a liter of fluid, making clean up easy and offering more protection for the expensive beds, which cost up to $41,000.
The Droste Drape represents more than a practical solution, however — it highlights the transformative power of frontline nurses in shaping health care innovation. To harness this potential, the University of Iowa (UI) has launched the Nurse Innovators program, designed to turn creative concepts into impactful realities.
‘Inherently innovative’
“(Nurses are) inherently innovative,” said Allie Hurt, nurse innovator liaison with UI Ventures and MICU staff nurse with UI’s Intensive and Specialty Services Division.
The five-year-old program is a collaborative partnership with medical prototyping company MakerHealth and UI’s Office of Innovation, with the goal of empowering nurses.
“Our goal is to allow these nurses to solve their own challenges and to not feel burdened by these workarounds that they’ve been doing for years and years,” said Ms. Hurt. “We thought, ‘if we put a little bit of money behind these nurses, will they turn these workarounds into a real solution?’ And turns out they will.”
Nurses interested in the program are connected to Ms. Hurt, who helps them identify the challenges they want to solve and walks them through the steps in finding a solution, which includes a virtual meeting with MakerHealth staff.
The company sends a customized kit of materials to the nurse, who launches an iterative process of design and testing. With each cycle, the nurse experiments with the provided tools, collects data, and tweaks the design. Follow-up video calls with MakerHealth guide the process, leading to updated kits that further refine the solution.
The length of the program varies by nurse, since prototyping is worked around their daily schedule, but typically takes a year.
“The nurse is very much working from the ground level up to that real prototype, and once they get essentially a functional prototype that they can hold in their hand, we’re typically ready to graduate them at that point,” said Ms. Hurt, adding that the next step is prototyping resources with the Office of Innovation.
Following the creation of a successful prototype is the issue of intellectual property rights, which can be tricky to navigate.
The process often begins with the submission of an invention disclosure form to the university’s tech transfer office, UI Research Foundation (UIRF), which assesses the invention to determine if pursuing a patent is warranted.
Should the decision be made to move forward, the office collaborates closely with the nurse innovator to draft and file the patent. Once the patent is secured, the university works to identify external companies interested in licensing and commercializing the technology.
“It will go into the normal tech transfer process at that point for licensing and commercialization, but we will also be keeping an eye on these projects as they come through as well. They’re all very important to us, and we want to see them succeed, and we want to support these nurses as well,” said Jordan Kaufmann, senior director of UI Ventures.
Program open to other medical sectors
Although the program was originally geared toward nurses, it’s open to other medical professionals as well.
“We discovered through the early stages of this program that it’s not just those nurses that have ideas, and we have found that nursing leadership, nursing assistants, physical therapy, respiratory therapy, and so many other clinicians are also facing challenges as well,” said Ms. Hurt. “So our initial target was those frontline nurses, and we discovered that really all staff are capable of solving these challenges.”
Eventually, nurses within the program can pitch their ideas and compete for funding at the Nurse Innovator seminar and pitch competition, held this year on Nov. 14 at the UI Health Care Medical Center.
Ostomy bag spurred quest for solutions
Pediatric skin, wound, and ostomy nurse clinician at UIHC Stead Family Children’s Hospital Kayla Piplani’s experience with a premature infant set her on the path to solutions with the Nurse Innovators program. An ostomy bag — an exterior pouch which collects human waste — was causing issues for the infant.
The ostomy bag needed changing every two hours, she told the audience at the Nurse Innovators pitch competition Nov. 14. Poorly-fitted ostomy bags can cause skin irritation, pain and increased risk of infection, and the frequent handling of a fragile newborn added to the complexity of the case.
With the use of a 3D printer and medical imaging, Ms. Piplani hopes to scan a patient’s abdominal contours and create a customized wafer, the piece of the pouching system that adheres to the skin and fits snugly around the stoma, preventing leakage.
Frequent wafer changes can be “a source of infection for these patients. It keeps them here much longer,” she said.
“Changing a pouch every two hours is expensive, and insurance only covers so many bags a month, so let’s say (patients are) at home and they’re having trouble, then they’re going through their supply much faster. So let’s get them something that works,” she said.
Her idea, StomaCoach, ultimately won third place and $10,000 at the pitch competition.
“Really from the beginning of our profession, nurses have been innovators, and I think COVID-19 really brought out this critical role of nurses and innovation,” said clinical researcher and intrapreneur Abby Hess, a nurse practitioner at Cincinnati Children’s Hospital and a keynote speaker at the pitch competition.
“It brought that to the forefront, because we had so many challenges we had to fix quickly, and so I think it really helped accelerate sort of everything. A lot of nurses have been working to grow our role in innovation. COVID-19, even though there were so many challenges, it also really helped to bring to the forefront this need: We can’t do this without nurses. And really our ideas from the bedside and these workarounds that we see all the time, these are the important first steps to recognizing what the opportunities for innovation can be when we look at our profession,” she continued.
Empowering nurses to drive innovation statewide
According to the World Health Organization, nurses are the largest group of health care professionals globally, with an estimated 29 million worldwide and five million in the U.S.
“We have both the largest numbers, but also we have such diverse skill sets,” said Ms. Hess. “We have so many different types of degrees that are able to specifically transform health care. And so as we build innovation into our education, both at the bedside, graduate education and even our initial programs, we really have the ability to impact health care in a really profound way.”
University of Pennsylvania School of Nursing collaborated on a 2019 study with accounting firm BDO USA, P.C. and found only 31% of clinical leaders have designated a nursing leader whose primary responsibility is innovation. Additionally, only 46% of other industry business leaders say their C-suite includes someone with a nursing background, the report stated.
“To really be able to create that ideal system that can address these complex challenges, the roadblocks need to be removed so that our systems can embrace nurse leaders and innovation,” said Ms. Hess.
Part of removing those barriers means making the Nurse Innovators program available to nurses across the state of Iowa, said Jon Darsee, UI chief innovation officer.
“The mission was to be able to support nurses across the state, recognizing that rural health care is really struggling with nurses,” he said.
The idea to open the program statewide originated with the Ewing Marion Kauffman Foundation in Kansas City, which provided a grant to the program and whose mission is to impact rural communities with economic development opportunities.
There are currently 83 critical access hospitals in the state with 25 beds or less, said Mr. Darsee, and for a rural community to remain sustainable, it needs access to health care.
“Those nurses in those rural communities are just as central to the fabric of that community, and if they leave to take a different opportunity, (or) get pulled away for something else, it’s just so hard to bring them back into the fold,” he said.
Fostering innovation and creativity can also improve job satisfaction, he said.
“After the pandemic, when the nursing charge is so acute and the pressures on nurses are so intense, we realized that giving them a creative outlet (with) these instincts they had, was a way to really improve their quality of life and their satisfaction with their job,” he added.
“We’ve seen nurses that have really been ready to leave the bedside start to feel agency and pride in their work again and are happy, and staff satisfaction is going up,” said Ms. Hurt, adding that the university has been able to leverage the program’s success in recruiting new talent. “Nurses really are loving the fact that they get the opportunity to solve a challenge and gain some professional development out of it.”
Julie Boothby, a nursing practice leader at University of Iowa Hospitals & Clinics who invented a hygiene tracker through the program, said the process has inspired her to be vocal in solving challenges in her field.
“I think that what I’ve learned through this program is just speak up, because if you’re having the problem, everybody else is too,” she said. “Before this program existed, there wasn’t a pathway for those workarounds to turn into solutions, and now that there is, of course, I’m the strongest proponent, but speak up. Let’s get to work. Let’s solve those challenges. Those workarounds don’t really have to be workarounds anymore.”