‘Net Nurses

Help is only a click away in this innovative program at Tripler Hospital.

February, 2001

Nineteen-year-old Sarourn Nun has no family or friends in Hawaii, she doesn’t have her drivers license, and in less than a month her husband will be sent off on military duty to Egypt for six months. And as if her situation wasn’t stressful enough, she’s also due to give birth in 10 weeks. But thanks to the Joint New Parent Support Program Hawaii, a research project that combines traditional nursing methods with innovative teleconferencing services, Nun is sleeping a little better. “The program really helped me out a lot and took out at least 90 percent of my stress,” says Nun.

Conducted by a medical research team at Tripler Army Medical Center, the program provides support for military families who have been identified as high risk during the prenatal and early postpartum period. High risk meaning families with no local support system (i.e. family and friends), abusive families, or negligent teen-age parents.

The newest method of treatment the team is exploring is teleconferencing. “The best way to offer support is through home visits,” says Lt. Col. Joann E. Hollandsworth, chief of Tripler’s Community Health Nursing/Health Education and Promotion Center. “But travel time on this island is really hard. We still want to see and interact with the family, so teleconferencing offered a real positive approach.”

Two months prior to giving birth until two months after the delivery, personal computers and video cameras are set up at the homes of both patients and nurses, between which live video footage is transmitted back and forth. This type of technology has been allowing doctors worldwide to communicate over the Internet for years, however this project, using teletechnology in a home-based program, is the first of its kind in Hawaii. Hollandsworth says, “If we’re successful with this technology, maybe we can become kind of the experts and people can access us from remote locations.”

Teleconferencing has proven successful in that it allows patients like Nun—who lives 20 minutes away from the hospital and doesn’t drive—the luxury of maintaining visual contact with her nurse at all times. “I am very grateful for the video conferencing because being a first-time mom, and being so young, there’s a lot I don’t know. There’s a lot of questions I have,” says Nun.

According to Hollandsworth, the video cameras are most commonly used to make visual assessments of patients and view parent/infant interactions. “What’s nice about the picture is that it can help cue the nurse as to what’s going on,” she says.

The first video cameras were installed in January 2000 and there are currently 16 families on Oahu being monitored via the Internet. Backed by a two-year research grant of $500,000, Hollandsworth says the plan is to have approximately 50 families on-line by the end of the program.

Hollandsworth admits, “Due to the special nature of the project, we initially met some barriers getting service to the homes.” GTE Hawaiian Tel (now Verizon Hawaii) was originally approached to establish the Internet connections, however, was unable to meet the program’s tight time requirements. In accordance with program guidelines, the video teleconferencing must be in a patient’s home no later than eight weeks prior to the delivery of the baby.

“Once they inform us of a hook-up, Road Runner services need to be in the home within one week’s time,” says Kiman K. L. Wong, general manager of Oceanic Cable’s Internet Services, which was eventually chosen as the program’s Internet Service Provider. Wong says services are rushed in order to meet the program’s time requirements.

Minor complications aside, Hollandsworth says she can’t complain about how the program is running. She says there are obvious benefits, but the real measurement tool of success comes from patient and nurse satisfaction. “In the end, we can ask ourselves, ‘Did we become more efficient by using the teletechnology?’ and that’s how we really gauge our success,” she says. According to one satisfied patient, mother-to-be Sarourn Nun, the program has already proven its success with her.


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Jacy L. Youn