Virtual Nursing Grand Rounds

Virtual Nursing Grand Rounds

Ha Noi, VietnamSan Francisco, United States
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
Established
Budget: 
$10,000 - $50,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

VNGR in the ICU at Thanh Nhan Hospital will improve nurse knowledge and practice, patient outcomes, and decrease complications and costs.

About Project

Problem: What problem is this project trying to address?

Closing the theory-to-practice gap is a serious pedagogical and practice issue facing nursing schools and hospitals worldwide, and is a particularly acute problem in Vietnam due to the limited educational resources. As part of a demonstration project (DP) to improve nursing practice in the intensive care unit at Thanh Nhan Hospital (TNH) in Hanoi, the Vietnam Nurse Project (VNP) needs to implement a low cost reliable and accessible means to provide face-to-face consults between US advanced practice nurses and their colleagues at TNH. The purpose of the real time interactive consults is to assist the ICU nurses to close the gap between the theoretical knowledge we provide them during our twice yearly visits, and its on-going direct application to their clinical role.

Solution: What is the proposed solution? Please be specific!

Sometimes using an old approach combined with currently available technology can create just the right solution for an existing problem. Using iPad technology, we will implement Virtual Nursing Grand Rounds (VNGR) in the intensive care unit at Thanh Nhan Hospital. VNGRs will facilitate the on-going collaboration between US nurses and nurses in Hanoi. This will result in a mobile low-cost economically sustainable infrastructure that will advance nursing practice and improve patient outcomes in the intensive care unit at Thanh Nhan Hospital, Hanoi, Viet Nam. The design of this innovative infrastructure will serve as a cost-effective model that can be deployed between two countries anywhere in the world.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Virtual Nursing Grand Rounds (VNGR) is an interactive teaching/learning strategy that uses actual patient cases to highlight best practices. Cases for presentation will be selected by TNH nurses. VNGR will be facilitated by USF/SONHP faculties and doctoral students, and U.S. nurse experts. The interactive, real-time presentation and consultation sessions (1-2 hours) will be scheduled 8-10 times during the year. Using a template designed by the VNP that reinforces the use of the nursing process, the ICU nurses will gather pertinent patient data to develop and guide the VNGR. Collected data will be translated into English, and planning and preparation meetings will be conducted via Skype. The interactive VNGR presentations will be conducted in English with real-time translation to Vietnamese. The sessions will also be videotaped and archived for future use. An example of VNGR: The lack of adequate nurse training and inconsistent practice contribute to the World-wide problem of pressure ulcers in hospitalized patients. Critically-ill patients are at higher risk for developing ulcers. The prevention of pressure ulcers is a nurse responsibility. The VNGR case study will highlight actions by the nurse to mitigate this risk. Research validates that when nurses use evidence-based practice protocols, the incidence of pressure ulcers is reduced, thereby decreasing the length of stay, infection rates, and the cost of care.
Sustainability

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

Volunteers from other nursing schools and healthcare agencies conduct episodic visits to Vietnam to present lectures and consultation. The Vietnam Nurse Project has been traveling to Hanoi for 7 years, visiting twice per year to provide ongoing educational workshops for students, faculty, and staff nurses; and consultation for faculties in interactive teaching strategies and curricular development. We believe the proposed Virtual Nursing Grand Rounds Model is unique in promoting ongoing, low-cost access for Vietnamese nurses to U.S. advanced practice nurse experts.
Team

Founding Story

Our “aha” moment came during a 2011 teaching visit in Hanoi. We were making presentations on nursing best practices for the treatment of pressure ulcers in patients with diabetes. During the question and answer session, one of our Vietnamese nurse colleagues wanted to know if we could come to Hanoi more frequently. Currently, we are funded for 2 visits per year and do not have funds to increase our physical presence in Hanoi. Since an unmet need is often the stimulus for innovation, we began a conversation to explore how we might increase our availability for consultations with our Vietnam partners. One of the nurses suggested using the Internet to connect us. We agreed that obtaining mobile technology (high-resolution video & audio, with recording capability) would enable us to collaborate in classrooms and clinical settings (at patients’ bedsides) to assist them in real-time assessment and treatment of their patients. We are seeking this grant to launch the inaugural program.
About You
Organization:
Vietnam Nurse Project
About You
First Name

Gregory

Last Name

Crow

About Your Organization
Organization Name

Vietnam Nurse Project

Organization Country

, CA, San Francisco, San Francisco County

Country where this project is creating social impact

, HI, Ha Noi

How long has your organization been operating?

More than 5 years

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Innovation
How long have you been in operation?

Operating for more than 5 years

Which of the following best describes the barrier(s) your innovation addresses? Choose up to two

Access, Cost.

Social Impact
Please describe the goal of your initiative; outline what you are trying to achieve

Our goal is to demonstrate, at the point-of-patient care delivery, that nurses educated to practice in expanded roles in the ICU at TNH will be more effective in meeting the needs of their patients. Systems barriers to delivery of safe, high-quality patient care in VN are similar to those in the U.S.; however, the scale of these issues, such as prolonged length of stay due to patient complications that result in increased costs and poor quality, plague their system. Research clearly supports that when nurses are allowed to practice in expanded roles, issues of cost and quality are positively impacted. Micro-level demonstration projects have the potential for enormous impact at the macro-level, and we strongly believe this will be the case with this initiative.

What has been the impact of your solution to date?

The innovation project(VNGR)at TNH has not begun. VNP has many important milestones. Of great importance to our partner schools, we introduced and trained faculty on the concepts and practices of evidence-based practice, advanced physical assessment, and use of the nursing process. We have assisted the Ministry of Education & Training to introduce the above concepts into the national nursing curriculum. At Bach Mai Hospital nurses in the neonatal ICU were not permitted to do physical assessments on neonates, develop a plan of care, or alter any aspect of care without physician approval. After this project, nurses in the NICU routinely conduct comprehensive assessments and develop and alter nursing care plans. Their physician colleagues have confidence in the nurse’s skills, and now rely on them to assess and make recommendations for treatment. In the past 3 years alone we have conducted more than 45 high-impact seminars with more than 4800 nurses, students, and faculties participating.

What is your projected impact over the next five years?

At the completion of this initiative, the following outcomes will be realized in the ICU at TNH: a) decreased infection rates, b) decreased medication errors, c) decreased hospital acquired pneumonia, d) decreased cost of care, and e) increased nurse job satisfaction. The former CEO of TNH, Dr. Chinh, with whom we have built a trusting and productive relationship, is now the Director of the Science and Education Department at the Ministry of Health. Through our close relationship with Dr. Chinh, we will have access to other hospitals in Hanoi to replicate this innovation project. Replication will enable refinement of the model to be universally applicable to any hospital in Viet Nam, with the potential to be used in other countries as well.

What barriers might hinder the success of your project? How do you plan to overcome them?

Limited English-speaking nurses in Hanoi. VNP has a pool of English translators in Hanoi with whom we have worked for 7 years. The physician director of the ICU at TNH is an English speaker. Lack of contemporary nursing practice knowledge. The physician director completed a residency in the U.S. and has first hand, in-depth knowledge of nursing practice and standards in the U.S. Time zone differences. The 15-hour time difference between San Francisco and Hanoi, requires all VNGR sessions be conducted between 1500 & 2400 hours California time. VNP leaders, USF faculty, and nurse volunteers have agreed to conduct VNGR during the day shift in Hanoi. Vietnam health care data are not readily shared with foreigners. Due to the unreliability of public data sources, we will collect baseline data.

Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact

VNGR leaders debrief via Skype after each session to evaluate process and outcomes of the session.

Identify three major tasks you will have to complete to reach your six-month milestone
Task 1

Purchase equipment and create the infrastructure (iPads, wireless Internet, hire translators) to facilitate VNGR

Task 2

Collect baseline data on identified outcome criteria

Task 3

Orient staff to VNGR process & conduct 4 VNGR sessions

Now think bigger! Identify your 12-month impact milestone

Measurable positive trend lines for outcome criteria with dissemination of findings to Vietnam leaders.

Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1

Design and use data collection tools specific to project, ensuring the integrity of data collection.

Task 2

Survey nursing staff and physicians to determine their satisfaction with VNGR.

Task 3

Identify appropriate, effective methods to disseminate outcomes to Vietnam leaders; published manuscripts to follow.

Sustainability
Tell us about your partnerships

The Vietnam Ministries of Education/Training and Health, and nurse and physician leaders, have identified the need for improved nurse education and expanded practice capacity to meet the health care needs of its citizens. Partners include: Bach Mai SON (focus: teacher & curriculum development, student & faculty exchanges); Vietnam University of Traditional Medicine SON (focus: establish masters & baccalaureate programs); An Khanh SON (focus: teacher & curriculum development); Thanh Nhan Medical Center (focus: improve standards & scope of nursing practice & nurse leadership).

Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?

At this time the innovation grant we are seeking will fund the pilot to develop, implement, and evaluate process and impact of Virtual Nursing Grand Rounds as an economically-sustainable, easily-accessible, point-of-care consultation and staff development model to enable collaboration among nurses providing direct patient care to improve patient outcomes. Through publications, the innovation will be disseminated to nursing communities worldwide.

What type of operating environment and internal organizational factors make your innovation successful?

The Project enjoys the ongoing contributions of an effective, well-established, productive team. Additionally, we have been diligent in learning the values, customs, and business approach of our Vietnam partners and are committed to advancing our shared agenda to improve the education of healthcare providers and subsequently improve the health of Vietnam’s citizens. At TNH, our chosen site to implement the innovation project, we have established trusting and enduring relationships with our nurse colleagues and physician leaders. This relationship is sustained because the VNP has continued to visit, provide consultations and educational programs, and we have delivered everything we have promised.

Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list

Internal grants at USF have now been exhausted. Funding of this innovation grant will enable us to involve additional nurse experts, students, and nurse leaders to create synergy in our efforts to improve nursing practice in Vietnam. Our volunteer participants represent California, Colorado, Washington, Maryland, Wisconsin, Georgia, and Arizona.