situCare

The aim of the project is to develop new human-technology interaction systems and nursing care processes and structures based on them, which

• offer technical options for situational support in crisis situations (at various levels for both non-professional carers and professional carers)
• use mobile IT-supported tools for care management and corresponding approaches to care management to ensure efficient coordination of the players in the care network and at the same time provide instruments for quality assurance
• provide caregivers and care recipients with opportunities for exchange and shared experiences, thus offering psychosocial support and promoting well-being

To this end, case studies are used to examine two fields of application, both of which are characterized by specialized care needs, a high workload for caregivers and dependence on technical equipment: Outpatient intensive care for home ventilation and specialized outpatient palliative care. The following approaches are to be integrated to provide support in crisis situations

• situational provision of knowledge modules (e.g. video instructions)
• Low-threshold, situational support and assistance, particularly in the event of problems with technical devices
• Provision of options for synchronous and asynchronous communication with players in the care network
• Approaches for the automatic detection of crisis situations or their initiation, if necessary

Current topics

Telepresence

In the basic research, nursing staff from the outpatient and intensive care sectors were interviewed. Particularly in outpatient services, the nursing staff interviewed often criticized the fact that caregiving relatives contact them about "minor issues". These can often not be clarified verbally and the nursing staff visit the person concerned directly on site.

Sometimes a professional carer will spend half a day on a trip just to confirm that the correct switch has been used on a pain pump. On the one hand, it is understandable that family members would prefer to have double confirmation - on the other hand, this can be extremely unfavorable from an economic and care service perspective.

An easier solution than explaining devices, behaviors or responses on site is offered by today's technology via telepresence. With the help of tablets, smartphones and robots, video conferences can be held and devices and behaviors can be explained using visual information.

The project uses tablets with Skype, the two remote-controlled robots Kubi and Double, as well as a so-called gooseneck.

With the help of professional care services, the use and effectiveness of these technologies will be recorded and evaluated in practice. Among others, professional caregivers, caregiving relatives and patients will be interviewed.

Suctioning

In the basic research, nursing staff from the outpatient and intensive care sectors were interviewed. The issue of suctioning for people with a tracheostoma proved to be particularly critical. These people have an opening in the pit of the throat through which they are ventilated. The fluid that builds up in the lungs must be regularly suctioned out using a special device.

Many nursing staff said that they are afraid of this procedure and prefer to contact a doctor or colleague if in doubt. Sometimes there is insufficient training and the procedure is carried out incorrectly. Irregular or unclean suctioning also increases patient discomfort.

One idea to further develop training and reduce the fear of the procedure among nursing staff is the use of VR (virtual reality). The procedure can be practiced on a model in a virtual space. There are already numerous applications for this in surgery, such as NeuroSimVR for training brain operations.

The scientific principles from medicine and computer science were used to develop a VR simulation for suctioning people with a tracheostoma. Nursing staff can use this to practice the procedure.

The implementation was carried out using Unity and the HTC Vive is used as the hardware. The user puts on a pair of glasses, the HTC Vive (a so-called head-mounted display), and finds themselves in a virtual room with medical devices and a patient.

A step-by-step guide to suctioning is then followed. Virtual gloves, a virtual suction device and a virtual ventilator are used. The focus is less on mechanical precision and more on immersion and taking away the fear. The patient model reacts to the procedure with coughing and painful reactions and turns red with shortness of breath, making the scenario feel immersive.

The practical suitability of the developed simulation will next be tested and evaluated in studies with students and professional nursing staff.