Robotic Nurses: Improving Care and Addressing Challenges in ILTC

This essay critically analyzes the importance of robotic technology in assisting patients with daily living activities to avoid accidental falls and medication errors in intermediate and long-term care (ILTC) and hospital settings. It examines the use of robotic shower systems for maintaining personal hygiene, socially assistive robots for improving cognitive performance and social interaction during mealtimes, and robotic systems like RIVA for reducing medication errors. The essay evaluates studies and articles highlighting the benefits of these technologies in promoting patient well-being, reducing nursing workload, and ensuring ethical considerations such as autonomy, beneficence, and non-malfeasance are met, ultimately concluding that robotic technology enhances the overall quality of care.

Running head: HEALTH INFORMATICS
Health Informatics
Name of the Student
Name of the University
Author Note

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Introduction
According to Huston (2013), shortages of staffs and other technical challenges (like
patient lifting and moving) highlighted that there is a growing need to design, develop and
implement robotic technology in the delivery of healthcare. The entire reliance on robotic
technology in the field of surgery has already been effective for decades however, recent
trends and advancements in the domain of healthcare has indicated the importance and
requirement of robotic technology in the delivery of primary healthcare. Eriksson and
Salzmann‐Erikson (2017) are of the opinion that the application of the robotic technology in
the intermediate and long-term care (ILTC) helps to prevent accidental fall and medication
error. Accidental fall and medication errors are regarded as an important health issue in ILTC
throughout the world causing fatal harms. The following essay aims to critically analyze the
importance of the nurse robot or robotic technology in assisting patients in the daily living
activities like showering, ambulating and eating in order to avoid accidental fall and
medication errors.
Critical Analysis
Robotic technology for assistance in bath
The research conducted by Klein and Schlömer (2018) was solely based on the
robotic shower system. Maintenance of the personal hygiene is crucial for the independent
living older adults or with person with disabilities. The information communication
technology (ICT) supported bath robots (I- Support) is regarded as an intelligent robotic
shower system which enables patients to take shower independently at their home or within
institutionalized settings. The aim of research conducted by Klein and Schlömer (2018) was
to elucidate whether I-support is ethically safe for the use of older adults and physically
disabled persons. Their analysis highlighted that I- Support is an intelligent robotic shower
system which is fitted with motorized chair in order to enable safe to stand-to-sit integrated
shower system for the service use. It is also fitted with human robotic interaction modalities
in order to ensure safe operation and controlling navigation of the system. The pressure
sensors are also implemented in order to detect the substantial contact with the body of the
users. Thus the study conducted by Klein and Schlömer (2018) highlighted that the I-Support
system is ethically safe and potent for the operations of the older adults. The MEESTAR
model further highlighted that socio-technical arrangements of I-Support are in sync with te

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ethical consideration while providing autonomy, safety, justice and privacy to the service
users. It also highlighted that the I Support system is completely safe to use and promotes
healthy and wellbeing of the patients via negating the chances of accidental fall injury (Klein
& Schlömer, 2018).
Figure: Robotic Shower System
(Source: Klein & Schlömer, 2018)
The study conducted by Klein and Schlömer (2018) aligns with the results reported by
Werle and Hauer (2016). Werle and Hauer (2016) highlighted that the bath robot system
follows the guidelines of the users requirements as proposed by the international
classification of functioning of disability and health. Thus, robotic system not only helps to
reduce the manual error or labor but also promotes patients health and wellbeing via
satisfying the concept of autonomy, beneficence and non-malfeasance.

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Robotic technology in social assistance (eating)
The McColl and Nejat (2013) conducted study on application of robotic technology in
ILTC and their analysis was mainly based on mealtime with a socially assistive robot for the
older adults in a long term care facility. Their study highlighted that as people get older their
capability of performing basic activities for self-maintenance is reduced due to the increase in
the occurrence of the physical and cognitive impairments or as a result of social isolation
(McColl & Nejat, 2013). The socially assistive robots, which are capable of providing
cognitive assistance, motivation and targeted engagement, are useful in improving the health
and well-being of the older adults. Their study majorly highlighted application of human-like
robot, Brain 2.1, a social motivator for assisting the service users in eating. Brain 2.1 was
found to generate promising results in engaging older adults (82 to 93 years) in effective
interaction during meal eating sessions. Via providing active communication, the robotic
technology for social interaction helps to promote health and well-being among the older
adults (McColl & Nejat, 2013). The exploratory study of McColl and Nejat (2013) also
showed that there in an increase in the acceptance of robotic technology among the older
adults as according to them, while interacting with robots, they can enjoy their meal and there
are less chances of miscommunication.
In relation to the socially assistive robot technology, Abdi et al. (2018) conducted a
systematic review. Their main objective was access whether socially assistive robot (SAR)
technology is helpful to take new roles in health and social care in order to meets the high
demands in ILTC. They conducted literature search from CINAHL, Cochrane library,
Embase, MEDLINE, PsychINFRO and Scopus databases. This database search selected 61
research articles during the tenure of 2016 to 2017 (Abdi et al., 2018). The analysis of these
studies highlighted that SAR help in improving the health and well-being of the older adults
and their ability in overcoming the mood disturbances. This role is collectively regarded as
the affective therapy. SAR was also found to promote cognitive thinking among the older
adults and thereby helping the prevent miscommunication among the patients with the other
members of the family, about the care plan and with the human nurses. The SAR helps in
promoting neurological functioning of the older adults, which help to promote effective
thinking skills, and thereby preventing miss communication. The sense of companionship or
the social facilitator ship as promoted by SAR further helps in the overall improvement of the
health and well-being of the older adults. However, at the end of the review, Abdi et al.
(2018) proposed for further studies in order to obtain a clear picture about the role of robotic

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interventions in order to solve real problems so that the shift occurs from novelty to
functionality in the elderly care unit.
Robotic technology in medication error
The article published in the official website of Powers & Santola (2018) indicated that
the application of the robotic technology is helpful in reducing medication errors under the
hospitals settings for ILTC. The article is mainly based on the reports of The New York Daily
News which indicated that investment of St. Barnabas Hospital in the robotic system in order
to combat drug errors was useful. The machine RIVA system was able to handle tasks like
filling of syringe, medicine sanitization while ensuring that the patients receive right among
of drug dose and at right point of time. This robotic technology was not only proved to be
beneficial for the patients but proved to be helpful for the nursing professionals as well as it
help to reduce the chances of manual error while decreasing the level of nurse fatigue and
stress.
In relation to the medication error, another article was published by the official
website of Kennedy Hodges in 2017. According to their publication, robotic IV systems help
to prevent infection along with drug error in hospitals and thereby helping to improve the
ambulatory care. The increase in the rate of IV medication has further promoted the
importance of the use of the robotic technology in the prevention of the medication error like
the medication administration error and the medication dosage error. Under the use of the
robotic technology, the robotic system is used to prepare the IV solution and thereby reducing
the chances of the human error and hand borne infection transmission. The article published
in the website of Kennedy Hodges (2017) also highlighted the same robotic system as
mentioned by Powers & Santola (2018), RIVA. RIVA introduced in 2008 helps to prepare
accurate medication for intravenous administration under the sterile environment. The article
published by Kennedy Hodges and written by Gabriel Assaad, is also of the opinion that there
are further advancement in the robotic technology towards the management of the medication
error and this advancement include proper medication dissension, performance of self-
cleaning routines and correction in the drug dosage if the order to incorrect. RIVA is truly an
assistive technology for the nurses. It not only helps to reduce the workload but also prevents
the adverse health outcomes.

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Conclusion
Thus from the above discussion, it can be concluded that the application of the robotic
technology in the health and social care not helps in the improvement of the health and well-
being of the patients but also help in the improvement of the overall quality of care via
decreasing the workload from the nursing professionals and reducing the chances of the
manual error. In the domain of the ILTC, few domains of the robotic technology that have
gained prominence is the use of robotic technology in assisting the older adults or disabled
individuals in bathing, SAR for improvement of the cognitive performance and RIVA for the
reduction of the medication error. Thus these technologies cumulatively help in the
prevention of the accidental fall, medication errors and the chances of miscommunication.
The technologies are also ethically competent as it abides the technical domains of autonomy,
beneficence and non-malfeasance.

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References
Abdi, J., Al-Hindawi, A., Ng, T., & Vizcaychipi, M. P. (2018). Scoping review on the use of
socially assistive robot technology in elderly care. BMJ open, 8(2), e018815.
Assaad., G. (2017). Hospitals Use IV Robots to Reduce Medication Errors and Injuries.
Kennedy Hodges. Access date: 30th July. Retrieved from:
http://www.pharmacyerrorlawfirm.com/blog/hospitals-are-using-robots-to-combat-iv-
medication-errors.cfm
Eriksson, H., & Salzmann‐Erikson, M. (2017). The digital generation and nursing robotics: A
netnographic study about nursing care robots posted on social media. Nursing
inquiry, 24(2), e12165.
Huston, C. (2013). The impact of emerging technology on nursing care: warp speed
ahead. The Online Journal of Issues in Nursing, 18(2).
Klein, B., & Schlömer, I. (2018). A robotic shower system. Zeitschrift für Gerontologie und
Geriatrie, 51(1), 25-31.
McColl, D., & Nejat, G. (2013). Meal-time with a socially assistive robot and older adults at
a long-term care facility. Journal of Human-Robot Interaction, 2(1), 152-171.
Powers & Santola . (2018). Will Robots Reduce Hospital Medication Errors?. Access date:
30th July. Retrieved from: https://www.powers-santola.com/blog/will-robots-reduce-
hospital-medication-errors/
Werle, J., & Hauer, K. (2016, August). Design of a bath robot system—User definition and
user requirements based on International Classification of Functioning, Disability and
Health (ICF). In Robot and Human Interactive Communication (RO-MAN), 2016 25th
IEEE International Symposium on (pp. 459-466). IEEE.