Using videoconferencing to discuss themes of nursing management in university hospitals

EXPERIENCE REPORT

Using videoconferencing to discuss themes of nursing management in university hospitals

Uso de videoconferência para discussão de temas sobre gestão de enfermagem em hospitais universitários

Uso de videoconferencia para discusión de temas sobre la gestión de enfermería en hospitales universitarios

Maria Elisabete Salvador^I; Rita Simone Moreira^II; Luisa Tanaka Hiromi^III; Sonia Regina Pereira^IV; Maria Isabel Sampaio Carmagnani^V

^INursing Ph.D. Health IT Assistant of the Superintendence at Hospital São Paulo (HSP), Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brazil

^IIMaster in Nursing of the Teaching and Research Department of the Nursing Board at Hospital São Paulo (HSP), Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brazil

^IIINursing Ph.D. Care Coordinator from the Nursing Board at Hospital São Paulo (HSP), Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brazil

^IVNursing Ph.D. Coordinator of the Teaching and Research Department of the Nursing Board at Hospital São Paulo (HSP), Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brazil

^VNursing Ph.D. Nursing Director at Hospital São Paulo (HSP), Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brazil

^{Corresponding Author}

ABSTRACT

This study reports the experience of creating a project based on videoconferencing technology to discuss topics related to nursing management in university hospitals in the country. The study describes the Telemedicine University Network of the Science and Technology Ministry in partnership with the Ministry of Education, authors of projects that subsidize the infrastructure for videoconferencing, aiming at offering relevant experiences among teaching hospitals. The nursing professionals in the Sao Paulo Hospital have used the telemedicine resources in the last 2 years, to discuss administrative issues and human and technical aspects of nursing in the hospital. This initiative has been showing good results regarding the regular involvement and assiduity of nurses and users.

Keywords: Health management; Hospitals, university; Telemedicine; Videoconferencing

RESUMO

O presente estudo relata a experiência da criação de um projeto baseado em tecnologia de videoconferência para discussão de temas relacionados à gestão de enfermagem em hospitais universitários do País. Descreve a Rede Universitária de Telemedicina do Ministério da Ciência e Tecnologia em parceria com o Ministério da Educação, como autores de projetos que subsidiam infraestrutura para a realização de videoconferências, com vistas a oferecer intercâmbio de experiências relevantes entre os hospitais de ensino. Profissionais da Diretoria de Enfermagem do Hospital São Paulo vêm utilizando recursos de telemedicina a cerca de 2 anos, a fim de discutir aspectos administrativos, humanos e técnicos da enfermagem hospitalar. Esta iniciativa vem apresentando bons resultados em relação à participação e assiduidade dos enfermeiros usuários.

Descritores: Gestão em saúde; Hospitais universitários; Telemedicina; Videoconferência

RESUMEN

O presente estudio relata la experiencia de la creación de un proyecto basado en tecnología de videoconferencia, con la finalidad posibilitar la discusión de temas relacionados con la gestión de enfermería en hospitales universitarios del país. El estudio describe la Red Universitaria de Telemedicina del Ministerio de Ciencia y Tecnología en sociedad con el Ministerio de la Educación, que son los autores de proyectos que subsidian la infraestructura para la realización de videoconferencias, con el objetivo de ofrecer intercambio de experiencias relevantes entre los hospitales de enseñanza. Los profesionales de la Dirección de Enfermería del Hospital Sao Paulo vienen utilizando recursos de telemedicina desde hace 2 años, con la finalidad de discutir aspectos administrativos, humanos y técnicos de la enfermería hospitalaria. Esta iniciativa viene presentando buenos resultados en relación a la participación y asiduidad de los enfermeros usuarios.

Descritores: Gestión en salud; Hospitales universitarios; Telemedicina; Videoconferencia

INTRODUCTION

The first decade of the present century has been marked by the advance of videoconferencing in the health area, which has demonstrated its value, especially in hospitals. With a great applicability in teaching, research and care, videoconferencing has successfully enabled different ways to transfer, obtain and discuss scientific information using an expressive collection of medias as well as the exchange of experiences of users^(1-3).

Videoconferencing is defined as sending and receiving quality audio and video transmissions among one or more points of connection in real time, with simultaneous integration to communicate. The contact can be through audio, texts, images, animation and videos; the simplest form is the static transmission between two positions. The most sophisticated format provides full-motion video image transmission and high definition audio among multiple positions⁽⁴⁾.

Videoconferencing started in the United States in the 60's, with the purpose of diagnosing and monitoring the vital functions and it is now a complex network connecting distant places to reference medical centers⁽⁵⁾.

In Brazil, since the 90's, the advantage of videoconferencing has been unquestionable because of the distant places and the unequal distribution of the scientific production and medical hospital resources in the country.

Currently, professionals have intensively exchanged protocols, classes, lectures, images and videos; multicenter studies; case studies; second diagnoses and inter-appointments, in real time with the active participation of those interested. Furthermore, users increase their power of professional action, optimizing time and costs involved with trips and transport, justifying the investment in technology⁽⁵⁾.

In this sense, the Telemedicine University Network (RUTE) has provided infrastructure and telemedicine projects to university hospitals, as well as the promotion of the integration of knowledge among the participant institutions. It is an initiative of the Ministry of Science and Technology, supported by the Financiadora de Estudos e Projetos (Funding of Projects and Studies) and by the Brazilian Association of University Hospitals, coordinated by the National Network of Teaching and Research⁽⁶⁾.

Because of the growing interest of teaching hospital institutions in performing video conferencing in specific health areas with the coordination of RUTE, the Special Interest Group (SIG) was created with the objective of carrying out periodical meetings through videoconferencing. This initiative integrates 140 institutions, distributed in 27 States of the country, making this excellence centers that are geographically far, virtually closer, to discuss important issues to each specialty of the health area⁽⁶⁾.

The SIGs from RUTE form a network of specific interest, linking professionals working with teaching, research and health care. After a SIG is formed, the work agenda with video conferences is defined. In this way, health professionals from different parts of Brazil and of the world can get in touch with each other in real time to reflect on issues related to their fields^(7-8).

To establish a new form of communication between manager nurses and nursing researchers of the hospital context, professionals from the Nursing Board at Hospital São Paulo (HSP), Universidade Federal de São Paulo (UNIFESP) have created the SIG: "Nursing Management in University Hospitals".

Development and introduction

With the challenge to propose and discuss solutions to train manager professionals timely, minimizing institutional costs and optimizing the time of each participant, the contact with other nursing services can meet a need for exchanging successful experiences among university hospitals. Thus, nurses, advisors, and professionals of the Teaching and Research Sector of the Nursing Board at HSP proposed the use of a modern, fast and efficient communication strategy: video conferencing.

In this context, the creation of the SIG "Nursing Management in University Hospitals", has been demonstrated as the faster path to make this experience feasible since UNIFESP, through its Telemedicine Laboratory (LAT) of the Department of Health IT, has state of the art equipment, trained professionals, and broad access to RUTE projects.

After the creation of this SIG, the priority was to select the nursing services in university hospitals that should take part in programmed sessions of video conferencing. Although the Nursing Board at HSP wanted to invite all institutions, especially those that were far from excellence centers, the telemedicine technology of RUTE, introduced and working in the institutions was a relevant factor for inclusion. Thus, the following institutions have been selected: Hospital Universitário Prof. Polydoro Ernani de São Thiago, Universidade Federal de Santa Catarina; Hospital das Clínicas, Universidade Federal de Minas Gerais; Hospital Walter Cantídio, Universidade Federal do Ceará; Hospital Universitário, Universidade Federal do Maranhão; Hospital das Clínicas, Universidade Federal de Pernambuco; Hospital de Clínicas de Porto Alegre - UFRGS, and the coordinator of the above mentioned SIG, is the Nursing Board at HSP/UNIFESP.

With this list, the Nursing Board of the HSP sent an invitation-letter through e-mail. In this message, in addition to the formal invitation and the date of the opening session, we have asked telemedicine professionals of each institution to get in touch with LAT of UNIFESP to perform tests and to know about technical data to make video conference calls via RUTE feasible.

As for the program, first we had to get to know the nursing centers and later analyze the issues that encompassed situations experienced by each center.

Sessions had been programmed to last one hour and a half, with classes for about 10 minutes for each participant and then a free discussion on the issue being discussed.

RESULTS

After analysis and approval of the RUTE Coordinator to create the SIG proposed, the first video conference on "Nursing Management in University Hospitals" occurred with the participation of 100% of those invited on November 17th, 2008. The activity was marked by the introduction of the participating nursing centers which demonstrated, through a Microsoft Power Point® class, their organizational structure, human and management aspects, as well as the characteristics of the practical work of each institution, such as: nursing protocols, humanization projects, internship programs, and in which stage they were (development, introduction, or obtaining results). It is worth mentioning that the management model was also presented according to institution.

Next, the issues of the following session were assessed and discussed by the participants in this first meeting, and the following issues have been chosen: Nursing personnel sizing and absences; Care Systematization; Nursing Diagnoses; Single Health System Contracting; System of Referral and counter-referral / H1N1; Additional Payment for Hospital Duty; Introduction of the protocol Risk Classification of HSP/UNIFESP; Professionalizing Master Degree; University Hospital Management Applications; Electronic Nursing Prescription, among others.

Relevant issues, approached by the media or being introduced in the participant institutions were also included in the issue planning, so that all could give opinions and contribute to the development and solution of the problems. Some examples are the issues related to H1N1 protocols, the introduction stages of the Risk Classification in the Emergency Unit at HSP/UNIFESP, the laws on duty systems that went in force in the middle of 2009 and the introduction of multiprofessional internship in a university hospital.

The nursing centers have participated in the videoconferencing sessions with the presence of nurses from permanent education, managers, unit heads, and professionals working in these fields.

Video conferences are taking place every month since the opening session in 2008, and the participation of the directors of the centers as well as invited professionals of each institution has been assiduous with no important absences up to the present.

CONCLUSION

National and international experiences in the use of telemedicine, according to hospital context are real, representing a fast and efficient form of communication. Video conferences are excellent tools to train and update health professionals; they also present a great impact on the costs of permanent education, especially in university hospitals.

Making participants closer to the place of work of each center, being able to observe the reality and the features of each center, give the opportunity for current experiences to take place, which match the care and management needs of the participating institutions.

The participation with rich technical-scientific information and, especially, with experiences of the practice of each nursing center in the videoconferences at SIG-RUTE may be a great encouragement for other institutions to invest in telemedicine technologies, taking advantage of the network infrastructure and the projects offered by RUTE.

REFERENCES

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2. Duarte PS, Matsumoto CA, Martins LRF, Alonso G. Análise do potencial de impacto da utilização de telemedicina em um serviço de medicina nuclear. Rev Imagem. 2004;26(2):141-7.

3. Viñals F, Mandujano L, Vargas G, Giuliano A. Prenatal diagnosis of congenital heart disease using four-dimensional spatio-temporal image correlation (STIC) telemedicine via an Internet link: a pilot study. Ultrasound Obstet Gynecol. 2004;25(1):25-31.

4. Videoconferência: equipamentos e recursos tecnológicos. [citado 2009 Mar 3]. Disponível em: http://www.ccuec.unicamp.br/ead/index_html?foco2=Publicacoes/78095/371123&focomenu=Publicacoes

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7. Nichiata LYI, Takahashi RF, Fracolli LA, Gryschek ALFPL. Relato de uma experiência de ensino de enfermagem em saúde coletiva: a informática no ensino de vigilância epidemiológica. Rev Esc Enferm USP. 2003;37(3):36-43.

8. Seixas CA, Mendes IAC, Godoy S, Costa AL. Implantação de sistema de videoconferência aplicado a ambientes de pesquisa e de ensino de enfermagem. Rev Bras Enferm. 2004;57(5):620-4.

Received article 04/12/2009 and accepted 09/06/2010

Publication Dates

• Publication in this collection
  11 Nov 2010
• Date of issue
  Oct 2010

History

• Received
  04 Dec 2009
• Accepted
  09 June 2010