Guest Writer: Donna Elrod, PhD, RN, Associate Chief Nursing Officer, Executive Director of Clinical Programs, Institute for Digital Health and Innovation
What if your patient complained of pain, you brought the pain medication to the patient and as you administered it, documenting their current pain score, you said to them, “In about 30 minutes, you will be prompted by an automated video through your television to rate your pain. You just need to answer the question with a number so we can make sure the medication helped you.”
This year, you’ve likely heard and read about our emphasis on back to basics when it comes to nursing care. By the time you are reading this, UAMS will have completed a mock TJC (The Joint Commission) survey to help us prepare for a real survey visit in 2026. As you likely know, both our mock and real TJC surveyors almost always find a deficiency in documentation of reassessment of pain after a PRN medication. There are many reasons – legitimate variables in workflows – that make actually documenting a pain score reassessment difficult.
What if technology actually made this basic nursing practice expectation easier? What if almost all the variables were taken away and the information was documented for you? What if the technology were smart enough to alert you that the pain score had not improved? Or you received an alert that the patient failed to answer – potentially indicating a problem?
Specific applications of technology and AI focused on nursing practice and workflows have lagged behind other healthcare disciplines, but that is changing rapidly. While there are many new applications emerging, I want to highlight some that you are already practicing with and/or will likely be helping evaluate in the near future.
Applications of AI:
Epic Falls Scoring Tool. We will continue the rollout of the Epic Falls scoring tool. This tool pulls nursing documentation and other areas of the medical record into a validated algorithm to compile a falls risk score. This saves nursing time AND eliminates interrater reliability issues. As we continue to work to decrease falls and falls with injury, we can move away from discussing and intervening on scoring issues/debates and focus more on specific interventions in patient care of those identified at high risk by AI.
Nursing Workload Scoring. This is a tool we have had in place for a few years now. We validated it against our nurses’ lived experience of their assignments and found it to be very accurate at predicting the nursing workload needs of the patient in a numeric form. Several of our Charge Nurses already use it as they are making decisions about assignments, but it has not been easily available for this activity. Until now. Introducing…..
Assignment Wizard. This is our newest AI tool. Many of you were introduced to it at the recent Med/Surg skills fair. Assignment Wizard is live in Epic now, and you can test it out in the Epic playground. At its basic use, it pulls patients and their workload information into one place, and integrates with UKG to pull staff assigned to the unit for that shift. It enables AI to directly help with Charge Nurse decisions related to staffing. We will be working together over the next few months to fully implement this change in our inpatient care areas and look forward to feedback and optimization ideas you will have. In its more advanced applications, it will be able to help predict upcoming potential staffing shortages and help us understand nursing workload patterns at individual and unit levels.
Applications of Technology:
I’ll save this heading to talk about Virtual Nursing. Many of you have used our telesitter technology (Avasure). When we first explored this technology a few years ago, it was to determine use cases that made sense at UAMS. Our F4 unit took on a lot of responsibility with the technology and helped us try it out in various ways. We found it very useful for patients who needed to be watched but not necessarily by a sitter in the room. We are using it that way today, and are able to increase the safety of our patients without pulling individual PCTs to sit. We average about 6-10 patients daily who benefit from this technology. We also tested it out by placing the mobile units in rooms of patients who were newly admitted or about to discharge home. An RN on F4 would use it to speak to a patient somewhere else in the hospital in order to do the history portion of the admission navigator, or to go over discharge instructions prior to the patient leaving. This use enabled the physically present RN on the unit to complete other tasks. While all participants were very satisfied with these functions, the piece of the workflow that was the biggest barrier was having to move the mobile unit to where it was needed. We have known for a few years now that we need fixed screens in each room integrated with virtual nursing software in order to fully maximize return on investment.
This fall and into next year, we are looking at ways to bring fixed technology into rooms in order to grow our virtual nursing footprint. This would enable us to greatly expand support of patients and nurses in our inpatient areas. Tasks and workflows like completing an admission navigator, double-checking high-risk drugs, patient teaching, quality checks, monitoring during infusions of blood products, and many, many other tasks can be completed by a virtual nurse. This addition to our nursing care model will multiply the level of nursing care provided to our patients. Many of you have practiced in facilities with some level of virtual nursing and have valuable knowledge of the most optimal use cases. We will be relying on you to help us bring this technology to life at UAMS.
I’ve touched on just a few of the nursing-specific applications of AI and technology in current use, or you can look forward to in the near future. If you have five, ten, twenty-five, or more years left in your nursing career, you can count on many, many more ways you will grow into its use in your nursing practice. If you practice long enough, you may one day administer a PRN pain medication and know that technology will be helping you assess the response to the medication – AND WILL DOCUMENT IT FOR YOU!
Want to learn more about AI in Healthcare? UAMS just held the 2nd Annual Innovations in Artificial Intelligence Conference. Hear some of the conference proceedings here.
