HLSC4300 Literature Review

Introduction

Since time immemorial, healthcare has been addressed as the most challenging profession all over the world, however it is evolving gradually over the recent years, so much so that it has now been evolved the concept of ‘robotic-nursing’.  This serves as an important tool and helping in dealing with the various complicated issues that patients are subjected to face when in intermediate or long-term care (Khaksar et al., 2016). Statistical data figures reveal that Japan hosts about 23.6% of the old-age population, aged 65 and above that makes it top the list of the country with the largest old-age population. It should also be noted that 10% population from the 23.6% proportion either is placed under long-term care or are diagnosed with chronic illness requiring professional care (Bennett & Doub, 2016). This in almost 9 out of 10 cases is provided by the professional nurses and midwifes with the financial assistance for the service being provided by the family members of the senior citizens. However, it is important to note that in order to serve the aged patients the nurses have to be continuously associated with the patients and that exposes them to a number of serious problems including developing chronic infections and prolong work hours (Chang, Šabanovic & Huber, 2014). This paper would essentially discuss the challenges faced by the nursing professionals and devise an explanation pertaining to the feasibility of incorporating robotic nursing for decision making in healthcare organizations all over the world in future.

According to the documentation furnished by the WHO document on terminal age care, it is suggested that on an average about 50 million people of the entire world population die on being affected with a deadly disease. While caring for these patients, it is important for the clinicians as well as the nursing professionals entrusted with the duty to provide care to the patients to cater to the physical as well as the psychological needs of the patients as well as their family members (WHO, 2014). If the patients are extremely critical and are almost on the verge of dying, it has been recorded that the nurses do not possess adequate professional knowledge to let the family members of the patient know about the demise or make a critical patient aware of the fact that his life is numbered to a few days (WHO, 2014). In these circumstances, the nurses are often seen to fidget with their own emotional turmoil and a lack of developing a practical approach in designing the required terminal intervention.

Research studies also reveal that on an average 68.5 percent of the terminal care patients require assistance with motor and sensory functions because of being affected with problems involving osteoporosis and other muscular pain related deformities (Šabanovi? et al., 2015). However, on an average it is seen that the responsibility of taking care of the geriatric department is entrusted to the female professionals because of better psychological understanding and care giving to the elderly patients. This makes them put in extra efforts for monitoring added assistance in walking, lying down or even getting up and nurses have reported to find difficulty in managing the heavy body weight of the patients and cater to their needs (Donaldson, 2016).

It has been seen that the level of advancement reached by the robotic technology in the field of nursing and medical assistance is yet to reach the level where these machines can work autonomously; therefore it is obvious that a level of manipulation is needed to handle and work with these machines. This can be called the human intervention that is still required to use robotic nurses. Mast et al. (2012) has stated by research how the remote human handlers are still required to use and manipulate the robots in order to assist the patients in real time medical scenarios and these robots cannot operate independently in order to assist the patients and the elderly people.  Raheem et al. (2017) states that the patients and the elderly people who have been served by the robotic nurses have responded about various glitches in the service and how there is still a vast difference in the service of the robots and the way human nurses have been serving. The formal and informal caregivers who have been replaced by the robots have been found to be better in terms of quick response, human crisis and emotional complications. In these fields the robot counterparts have not done very well, however the accuracy level is higher in the case of the robots.

It is also important to understand the psychological effects of companionship from  robotic nurses. It is a fact that the nurses and caregivers play an important role in terms of emotional support to the patients or the elders. The patients who are suffering from various critical complications generally suffer from depression and emotional complications. Birch et al. (2016) states that nurse play a critical role in emotional restoration of the patients and support them mentally. It is generally held that the human companions are better in social skills than their robotic counter parts. However according to Robinson (2013), the patients in a controlled setting have responded to noticeably lesser stress and pressure when the robotic caregivers have dealt with them and provided them company. “In comparison with the control group, residents who interacted with the robot had significant decreases in loneliness over the period of the trial. Both the resident dog and the seal robot made an impact on the social environment in comparison to when neither was present. Residents talked to and touched the robot significantly more than the resident dog.” (Robinson, 2013). It is important to note that the residents had greater interest on the robots than the dogs.

Further, one of the major issues of employing human nursing professionals in larger amount in countries like Japan, where the number of patients over 65 is increasing, is a great challenge. This is because the healthcare facilities need to spend a major section of time in training and development procedure that lasts as per the ability of the nursing professional to grasp the knowledge and strategies. However, the research article by Qureshi and Syed (2014) mentions that robot nurses are cheaper to train and maintain, as well as they are easy to refuel or recharge. Further, it also mentions that it also can reduce the number of burnouts, which affects the performance of healthcare professionals, as it does not get bored due to repetitive works and functioning. Hird, Ghosh and Kitano (2016) also mentions that usage of robotic nurses can be done in several occupational works such as handling of hazardous chemicals or infections which has the ability to harm human nursing professionals. Therefore, usage, maintenance, training and repair of nursing robots may lead to reduce the cost of healthcare facility, which can be used in infrastructure of machinery development to enhance the ability of the healthcare facility. However, the researchers also mentioned that extensive usage of nursing robotics could affect the relationship between nursing professionals and the patients, affecting the primary goal of healthcare, which is to provide the patient holistic care starting from physical health to mental support (Šabanovi? et al., 2015).

Besides these, increasing number of older patients is the reason behind the emergence of home healthcare facilities that provide nursing professionals quality care at the home of the service user. As per Robinson, MacDonald and Broadbent (2015), the number of healthcare professionals feeling burnouts and trying to quit the nursing profession belongs to the home healthcare center as they are confined to one place and hence, they feel emotional exhaustion and disengaged to their work. Therefore, the researchers Gross  et al. (2015) were determined to find out the effect of using robotic nurses in home healthcare setting for older adults. The researchers identified the primary issues of older adults such as physical; and cognitive decline, psychological issues and health management. However, through the research it was found that there are cases such as recognition of fall, as well as it should also identify the current needs of the patients so that the functional decline of the patient can be addressed. Hence, despite the ability of the robot nurses to provide intensive and having strength, flexibility to support the physical decline of the patient, development for functional decline should be done so that holistic care can be provided to the older patients in home healthcare facility (Jenkins & Draper, 2015).

Conclusion

As the life expectancy of the world population is increasing, the number of nursing professionals required for geriatric wards and healthcare needs of older adults are increasing as well. However, the decreasing number of nursing professionals has increased the need of an alternative using which, the challenges of nursing roles and responsibilities can be addressed. In this assignment, discussion about a holistic approach of nursing roles was assessed and the way robotic nurses can complete such challenges was addressed. Several nursing roles such as, helping the older adults in their physical and emotional as well as in cognitive decline was addressed. Further, their role as companion, the ability to grasp nursing training and knowledge and their manipulation ability was compared so that the increasing challenges in the nursing roles can be addressed by including these robotic nurses in the facility.

References

Bennett, C. C., & Doub, T. W. (2016). Expert Systems in Mental Health Care: AI Applications in Decision-Making and Consultation. In Artificial Intelligence in Behavioral and Mental Health Care (pp. 27-51).

Birch, E., van Bruwaene, S., Everaerts, W., Schubach, K., Bush, M., Krishnasamy, M., … & Murphy, D. G. (2016). Developing and evaluating Robocare; an innovative, nurse-led robotic prostatectomy care pathway. European Journal of Oncology Nursing, 21, 120-125.

Chang, W. L., Šabanovic, S., & Huber, L. (2014, August). Observational study of naturalistic interactions with the socially assistive robot PARO in a nursing home. In Robot and Human Interactive Communication, 2014 RO-MAN: The 23rd IEEE International Symposium on (pp. 294-299). IEEE.

Gross, H. M., Mueller, S., Schroeter, C., Volkhardt, M., Scheidig, A., Debes, K., … & Doering, N. (2015, September). Robot companion for domestic health assistance: Implementation, test and case study under everyday conditions in private apartments. In Intelligent Robots and Systems (IROS), 2015 IEEE/RSJ International Conference on(pp. 5992-5999). IEEE.

Hird, N., Ghosh, S., & Kitano, H. (2016). Digital health revolution: perfect storm or perfect opportunity for pharmaceutical R&D?. Drug discovery today, 21(6), 900-911.

Jenkins, S., & Draper, H. (2015). Care, monitoring, and companionship: views on care robots from older people and their carers. International Journal of Social Robotics, 7(5), 673-683.

Khaksar, S. M. S., Khosla, R., Chu, M. T., & Shahmehr, F. S. (2016). Service innovation using social robot to reduce social vulnerability among older people in residential care facilities. Technological Forecasting and Social Change, 113, 438-453.

Mast, M., Burmester, M., Krüger, K., Fatikow, S., Arbeiter, G., Graf, B., … & Qiu, R. (2012). User-centered design of a dynamic-autonomy remote interaction concept for manipulation-capable robots to assist elderly people in the home. Journal of Human-Robot Interaction, 1(1), 96-118. 

Qureshi, M. O., & Syed, R. S. (2014). The impact of robotics on employment and motivation of employees in the service sector, with special reference to health care. Safety and health at work, 5(4), 198-202.

Raheem, A. A., Song, H. J., Chang, K. D., Choi, Y. D., & Rha, K. H. (2017). Robotic nurse duties in the urology operative room: 11 years of experience. Asian journal of urology, 4(2), 116-123.

Robinson, H., MacDonald, B., & Broadbent, E. (2014). The role of healthcare robots for older people at home: A review. International Journal of Social Robotics, 6(4), 575-591.

Robinson, H., MacDonald, B., Kerse, N., & Broadbent, E. (2013). The psychosocial effects of a companion robot: a randomized controlled trial. Journal of the American Medical Directors Association, 14(9), 661-667.

Šabanovi?, S., Chang, W. L., Bennett, C. C., Piatt, J. A., & Hakken, D. (2015, August). A robot of my own: participatory design of socially assistive robots for independently living older adults diagnosed with depression. In International Conference on Human Aspects of IT for the Aged Population(pp. 104-114). Springer, Cham.

WHO. (2018). Palliative care: Issues and challenges. Retrieved from https://www.who.int/3by5/en/palliativecare_en.pdf