How nurses are improving healthcare through innovation: A Q&A with Children’s Hospital of Philadelphia

In my 30-plus years of nursing experience, I’ve had the pleasure of helping patients across the continuum of care.

Disposable IV pressure bags were not available to us in the field when I was a pediatric nurse. Holding the IV bag with one hand and caring for the patient with my other hand was not an effective strategy for resuscitation. To ensure my patients received necessary fluids, I re-engineered the bags by taking tape and cinching it around the top of the IV bag like a corset. This caused a rush of fluids to stream down to the patient.

I am a big believer that products must support practice, but there is a general misconception that many products are utilitarian. Nurses are MacGyvers by nature. If a product does not fit into their workflow, they figure out a way to create a more effective solution.

An example of this is certainly alive and thriving at the Children’s Hospital of Philadelphia (CHOP). Nurses there recognized a problem with IV infiltration in pediatric patients – they couldn’t see what was happening with the IV site in real time. Knowing there had to be a better way, they collaborated with CHOP’s Office of Entrepreneurship and Innovation to create a tangible solution for protecting patients called the SeeIV™. At the beginning of 2017, the team partnered with Medline to bring the product to market. I recently had the opportunity to speak with the clinical innovation team behind SeeIV – Registered Nurse Michele Davey, ICU Clinical Nurse Supervisor Jackie Anzalone, Manager of Enterprise Improvement Cheryl Gebeline-Myers and Venture and Innovation Manager Paul Dehel about their experience and their advice to nurses who are thinking about bringing bedside innovation to the masses.

Question: What motivated you to tackle the issue of IV infiltration?

Jackie Anzalone: Each year, more than 25 million peripheral IV lines are placed in hospital patients across the United States. If you break it down further, PIVs are placed in at least 44 percent of pediatric patients. In pediatric patients, the line is sometimes placed in their lower extremities so it’s really on us, the nursing staff, to make sure that the IV stays and to keep the patient safe.

Many hospitals have historically used an elbow brace to help avoid any tinkering of the line, but in order to assess the IV site, nurses have to remove the cover, which can be noisy and disruptive to the patient’s rest. It also decreases visibility of the IV site, which can prevent early detection of fluids leaking into surrounding tissue causing significant pain and damage known as an infiltration. Often times, infiltrations happen overnight between 3 a.m. -7 a.m. when patients’ rest presents barriers to assessment.

Question: Once you identified the challenge, what was the journey like to create a new solution?

Michele Davey: The most exciting part of our journey during development of the SeeIV was having the opportunity to take off our nursing shoes and, if only for a short time, become engineers, textile designers, lawyers and marketing professionals. It was an unreal experience that made us acutely aware of what is required to bring an idea to life to improve quality of care for our pediatric patients. We realized that our nursing experiences and knowledge were instrumental in product development. The partnership between CHOP and Medline was essential in supporting our journey in achieving a better outcome for our patients. At CHOP we strive to make the ideal patient experience. That is what we do!

Cheryl Gebeline-Myers: We felt strongly that being able to see the site directly through a little window would be less intrusive and also allow parents and patients to partner with the nursing staff in keeping an eye on the IV site.

CHOP is very fortunate to have an Office of Entrepreneurship and Innovation that is dedicated to supporting bedside innovation by providing employees with an outlet to create and share new ideas and the vehicle to bring their ideas to action. Jackie, Michele and I all happened to propose similar ideas for a new IV site cover. This is when the collaboration began.

Jackie Anzalone: To make a better product, the team started from scratch by assessing everything that can go through an IV. Sitting around tables full of different fabrics, shapes and closures, we analyzed how patients would feel with the product and created multiple iterations before narrowing it down to one product that we have named the SeeIV. It allows nurses to constantly see the IV site through a clear window and is quiet to remove in order to assess the site.

Question: What is CHOP doing to create awareness of the SeeIV with hospitals around the country?

Paul Dehel: This fall, the team presented a session at one of the largest clinician gatherings in the country, the ANCC Magnet Conference in Houston. The topic of innovation sparked lots of discussion and curiosity which drives home even further how clinicians are the ultimate problem solvers at facilities across the country.

Question: How can nurses start an innovation hub at their facility if they don’t currently have one?

Paul Dehel: Nurses or any providers that do not have access to innovation hubs in their own organization still have the ability innovate through meaningful collaboration. Before the Office of Entrepreneurship and Innovation ever commits funding or resources to ideas, we encourage innovators to talk to their colleagues both inside and outside of the organization. These conversations are not supposed to lead to our innovators giving away their new idea, but instead should serve as market research and analysis. We encourage CHOP innovators to verify the problem exists outside of their locus of control, obtain feedback on the proposed solution to the problem, and ask for recommendations for other individuals that could provide feedback. Practice at your organization with colleagues, managers and executive leaders, you will be surprised how often these conversations lead to potential development opportunities to spur your innovation onward.

In closing, it is crucial for facility leaders to support nurses by encouraging them to unleash their inner innovator. If employees feel motivated and empowered, it can create a stronger work environment.

Knowing how important it is for products to support practice, CHOP and Medline are currently developing a pilot to understand how SeeIV can help improve the delivery of care. To learn more about how the SeeIV became reality through nurse innovation and is designed to drive patient and clinician impact, check out

About the author
Martie Moore is chief nursing officer at Medline, where she provides nursing leadership for solution-driven clinical programs, delivers product development to enhance bedside practice and launches quality initiatives across the continuum of care. Prior to joining Medline, Martie was the chief nursing officer at Providence St. Vincent Medical Center in Portland, Ore. Under her leadership, Providence St. Vincent earned a third and fourth designation for Magnet.

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