Nurse-Engineer Teams: Creating the Next Generation of Health Care Innovation Leaders

Karen Giuliano, PhD, RN, MBA, FAAN

Throughout my career, I have had many opportunities to participate in interdisciplinary clinical outcomes research and medical product development as a staff nurse, clinical nurse specialist, and project lead from the clinical, industry, and academic perspectives. Early in my career, I realized how vitally important a nursing perspective is in the design of technology for meeting the needs of patients, nurses, and other professionals who provide this care. I had my first experience in technology innovation in the 1990s, when I worked with Dr. William Kaye and Laerdal to help develop the first automated defibrillator and the first computerized training mannequin for Advanced Cardiac Life Support (ACLS). It was from that experience that I understood the fundamental importance of including the end-user perspective throughout the product development process, from idea to commercial release. 

As the nation’s largest group of health care professionals, nurses use more products than any other health care professional, and thus have a uniquely practical and care-sensitive perspective on the development and design of medical products. Nurses are in a position to identify and address everyday health care issues, challenge assumptions and the status quo, address unrecognized needs, and ensure that clinical outcomes research serves as the foundation for validating the effectiveness of innovation.

I have had the opportunity to work on numerous projects that address practical clinical questions. For example:

• “How can we improve accuracy in medication infusion calculations?”
• “What is the best practice for central venous pressure measurement accuracy?”
• “Can we use oral thermometry with intubated patients?”
• “Can point-of-care blood analyses improve patient care and be cost effective?”
• “Can continuous cardiac output measurement be done accurately without placing the patient flat in bed?”
• “Can a program of continuous venovenous hemofiltration be safely developed and implemented by critical care nurses?”
• What are best practices for 12-lead electrocardiography (ECG) and cardiac monitoring in critical care?”
• “Do clinical differences exist among different pulse oximetry (SpO2) technologies?”
• What is the best method for early detection of sepsis?
• “Can the use of improved oral care reduce the incidence of non-ventilator hospital-acquired pneumonia?”
• “Can we improve the safety of IV medication infusion with IV smart pumps?”

By using the practical aspects of everyday clinical practice as the basis for technology innovation and clinical outcomes research, we can narrow the research to practice gap and continually improve patient care.

In 2021, with engineering co-Director Dr. Frank Sup, we started the Elaine Marieb Center for Nursing and Engineering Innovation at the University of Massachusetts Amherst. Our mission is to untap the unique insights of nurses and engineers to address healthcare challenges at the forefront of patient care; forge new pathways in interdisciplinary research and education, and to empower nurses and engineers to be health care innovation leaders. The Center connects students and faculty through hands-on experiences to foster interdisciplinary partnerships. Examples of nurse-engineer student and faculty team projects include IV smart pump flow rate accuracy, a more patient-friendly bedpan, health care robotics, a wearable pain monitoring device, cloud-based home health care, digital health, and a video application to support behavior modifications to aid Chinese adults with osteoarthritis. Providing hands-on experiential learning is essential for supporting the next generation of students to be leaders in health care innovation.

In 2022 we established an interdisciplinary collaboration with Baystate Medical Center (BMC). This collaboration will be impactful because it will help our Center bring health care innovation from our laboratories at the University of Massachusetts Amherst to the point of patient care. We work closely with BMC Nurse Scientist Dr. Cidalia Vital, CNO, Dr. Joanne Miller, and additional staff on several active research projects. Examples include a survey of practicing nurses on their perceptions of health care robotics funded by UMass, a study on flow rate accuracy of IV smart pumps during actual clinical use funded by BMC, and a group of UMass engineering Capstone students working with BMC and using a systems approach to study the problem of patient falls. BMC human resources Vice President of Operations Patty Samra and UMass engineering faculty Dr. Hari Balasubramanian are working on a big data project to optimize staff nurse satisfaction and retention. In the summer of 2023, undergraduate nurse-engineer student teams will work at BMC on real-world clinical issues, including safe patient handling, medication dispensing safety and efficiency, pressure injury in critical care, patient mobility, and additional work on IV smart pump flow rate accuracy.

We are excited to bring together the knowledge and skills of our Center and BMC. We believe that the most effective and affordable healthcare innovations should be created with input from nurses and other clinicians who work closely with patients. We hope that our partnership can serve as an example for other academic institutions and healthcare systems to realize the value of collaborative innovation with nursing.

Nurses and Engineers Join Forces to Revolutionize Health Care: UMass Amherst