For patients in the intensive care unit at Sentara Obici Hospital, there’s an extra level of care they’re not likely to see or hear, but it is improving patient outcomes, officials say.

Most intensive care units in the Sentara network participate in the eICU program, which allows experienced intensive care nurses and doctors to watch over the patients electronically.

“What we offer is an extra level of care and vigilance for the patient,” said Mirna Medina-Gonzalez, clinical manager for the program. “We’re being proactive instead of reactive.”

Twelve ICU beds at Obici have been on the system for almost a year now. Sentara has been doing eICU since 2000, and the program now monitors 119 beds in multiple Sentara hospitals.

The nerve center of the program rests on an upper floor of the Raleigh Building on the Sentara Norfolk General Hospital campus and looks very much like a police dispatch center, with multiple screens at each desk displaying multiple pieces of information.

A nurse at each desk monitors part of the workload each day. The screens display real-time information on each patient, including the main reason they’re in the hospital, any problems that have cropped up, their pulse and respiratory rates and other vital signs, their medications, whether they have IVs or drainage tubes, their recent lab results and more.

Specialized algorithms send alerts when any of the metrics fall outside of a set of parameters they have set. The nurses can use a camera to watch what’s going on in the room, as well as a two-way microphone and speaker to talk to those in the room.

“We’ve kept people from pulling lines, kept people from getting out of bed,” Medina-Gonzalez said.

The eICU nurses can also call the unit and speak directly with the nurses on the floor.

During nighttime hours, when a doctor is not physically present on the floor in the hospitals, a doctor is present in the eICU center. They can write prescriptions and give other orders, so time is saved from paging the on-call doctor in the hospital.

“The only thing they can’t do is put hands on a patient,” Medina-Gonzalez said.

After Sentara first implemented eICU, the system saw a reduction of 25 percent in ICU mortality, spokesman Dale Gauding said.

“People are going home that might have otherwise died in the hospital,” he said.

Janet Balius, one of the nurses in the eICU center, said the program also helps newer nurses benefit from the experience of older nurses.
“We’re giving newer nurses someone with a little more expertise to nurture them along,” said Balius, who has been a nurse for 30 years.

The nurses at eICU lovingly refer to it as the “retirement unit,” as it helps nurses keep working after they can no longer perform the demanding physical labor.

“You don’t have to physically do the work, but you can still use your skill,” Medina-Gonzalez said.

Even so, the unit has desks that can adjust to a standing position and keeps several small pieces of workout equipment on hand to help the nurses stay active.

Medina-Gonzalez said families and patients are informed of the fact eICU is in use, and most of them are appreciative.

“Families appreciate there’s an extra set of eyes,” she said.

Medina-Gonzalez said eICU is yet another advancement of technology in the medical field.

“Telemedicine is growing by leaps and bounds,” she said.