When you think about the job scope for nurses, it is likely that ‘innovation’ will not be the first thing to pop up in your mind, if at all. However, for Taiwan Adventist Hospital (TAH), building a culture of innovation among their nurses is a key priority.
“In the process of fostering an innovative culture, the nurses are given full professional autonomy. This builds self-confidence, which in turn further strengthens their passion for the nursing profession,” explained Ms Tzu-Chuan Hsu, Vice President and Chief Nursing Officer of TAH.
“With the innovation and improvement of nursing technology, supplies, care model and so on, we can provide safer and better nursing care. This then leads to an improvement in the quality of patient care.”
Building innovative nursing culture
Ms Hsu and Hospital President Hui-Ting Huang were instrumental in growing the innovative culture at TAH. The nursing department had set up an innovative team back in 2016, to look into methods of improving nursing care tools and their practicality, as well as redesign workflows for higher efficiency. Several rounds of discussions and amendments were held, but bottlenecks slowed down the process.
Ms Hsu then initiated an industry-academia collaboration with Tzu Chi University of Science and Technology (TCUST), and launched the “Nursing Creative Invention Seed Training Program” to train the first batch of innovation team members.
Nurses in the programme receive guidance from professors who possess rich innovative experience in nursing, as well as advice from Patent Attorneys. They were thus able to experience the full process of innovation – from the forming of concepts, to the production of prototypes based on their ideas, to the application for patents, and finally, the publication of their works.
“We hoped that the guidance from TCUST would stimulate the creativity of our nursing staff,” said Ms Hsu. “Although it’s a lot of hard work along the way, the clinical nurses gained a sense of accomplishment in creating works and enhancing their expertise.”
Since then, whenever new nurses join the team, they are scheduled for an initial training session on nursing creativity and invention, to seed and cultivate innovative thinking across the team.
For example, the team adopts the ATDE creative thinking structure in their day-to-day work. This refers to:
Asking – raising questions about issues;
Thinking – exploring and comparing for solutions;
Doing – implementing and verifying, including learning through the process; and
Evaluating – drafting evaluation standards, and adjusting the solution accordingly.
With this structure in place, team members hold regular group meetings to discuss clinical problems encountered in their nursing experience, and brainstorm about what can be improved. This ensures that innovation is an ongoing process at the hospital.
Ongoing efforts to further innovation
The hospital’s commitment to innovation has grown stronger over the years.
Its Unit Governance Councils promote the innovative work of each unit, and encourage nurses to participate in the discussion of care issues, as well as to develop innovative and improvement strategies.
Another initiative was the installation of a bulletin board to feature in-house innovations that are being used in clinical care. The hospital’s President and Vice Presidents were invited to give scores on the board, which showed their affirmation for the nurses’ work. The aim of this initiative was to encourage idea exchanging and learning among nurses.
“Nursing innovation focuses on starting small,” said Head Nurse Hsiu-Yen Huang. “Engaging in the research and development of quality-improving innovations will successfully reduce nursing costs and manpower. The innovative R&D process also creates a positive working environment. With a strong sense of participation and professional development built amongst the nurses, the goal of retaining nursing staff can be achieved.”
The hospital also provides funding support for patent applications for innovations created by the team. From 2016 to 2020, the team jointly invented a total of five works which obtained national patents.
One of these was the “all-in-one composite tube fixation device”, which won the Honourable Mention Award at the Taiwan Union of Nurses Association in 2016, and the Silver Award at the 2018 Seoul International Invention Fair.
This device was invented by the ICU nurses at TAH. When ICU patients would need tubes – such as the endotracheal tube or nasogastric tube – inserted in them, nurses would usually use tape or cotton trips to wrap and fix these tubes to the patient’s skin, to prevent the tube from slippage. This, however, could cause the patient to suffer from impaired skin and ulcers.
The team thus developed a device that could set and fix the position of the three tubes, which helped to reduce the pressure applied to the skin by the tubes. The device also prevented tube biting, while at the same time helping with oral care, thus successfully enhancing patient safety and the quality of nursing care.
Another invention was a lactation aid for new mothers. The postpartum nurses at TAH noticed that new mothers often faced the challenge of inadequate breastmilk production. However, relying on bottle feeding may mean that babies have a hard time breastfeeding later on. The team came up with a new device that connects a nasogastric tube from the milk bottle to the nipple, mimicking the breastfeeding process. This helped reduce the novice mothers’ frustration, and prolonged mother-baby time. With the device, mothers reported an increase in confidence in breastfeeding, which led to a higher breastfeeding rate during hospitalisation.
Granting nurses autonomy for innovation
With affirmation from patients on its nursing care quality, as well as the successes they have enjoyed so far, the hospital intends to press forward on its innovation journey.
“In the future, all creative ideas aimed at improving clinical care quality will gain full support from the hospital. We do not limit certain areas for innovation because our nurses are encouraged to give their creativity and imagination free reign,” said Head Nurse Shu-Min Yeh.
“The innovation team will also continue to uphold the spirit of nursing innovation, research, and development, recruiting nurses with creative minds to join the team, and also constantly strive for patient care improvement – turning creativity into innovation, and turning ideas into concrete actions.”