Paper Example: Robot-Assisted Surgery as a Technological Innovation

The Quality and Safety Education for Nurses (QSEN) is concerned with ensuring that nurses have the necessary skills, knowledge, and attitudes that will allow them to improve the quality and safety of their workplaces. One of the ways of improving safety and quality is undertaking evidence-based practice. The ability to embrace technology and new ways is dependent on attitude. One of the technologies in healthcare that is quickly gaining traction is robot-assisted surgery. The QSEN objective of improving quality and safety is realized by the use of this technology. Like any other surgery, robot-assisted surgery requires the use of nurse both in the operating room and during postoperative care. Knowledge of the technologys advantages and limitations can help nurses embrace it. Robot-assisted surgery is not only feasible in the long run, but is advantageous in its ability to improve the quality and safety of patient care.

Contribution to the QSEN Initiative

Minimally invasive surgery has allowed procedures to be carried out in a more efficient and safe manner. Traditionally, these types of surgeries are typically performed by highly proficient surgeons. These surgeons require highly and continuous training as the procedures are highly technical and use unnatural visual and haptic perceptions (Diana & Marescaux, 2015). However, technology has increasingly become useful in complementing a surgeons skills and improving safety and quality of procedures and general patient care. According to Diana & Marescaux (2015), robotics supplements a surgeons skills and improves precision and accuracy during complex minimally invasive surgeries.

Robot-assisted surgery has the advantages of a minimally invasive surgery with other added advantages that lead to the overall improvement in quality and safety. The advantages include a reduction in postoperative pain and hospitalization time, and fewer wound complications (Sharkey & Sharkey, 2013). Additionally, robot-assisted surgery enhances visualization during surgery, deftness, consistency in manipulating the instruments and higher degrees of freedom, hence significantly improving surgical performance (Diana & Marescaux, 2015). Robot-assisted surgery also leads to a reduction in blood loss during surgery, lower in-hospital mortality rate and transfusion rate, and stability in an operator-controlled camera (Ng, & Tam, 2014).

Adverse Effects of Robot-Assisted Surgery

Cost is the main hurdle to the widespread use of robot-assisted surgery. The increased cost is due to the cost of the equipment, installation, hospital modification, consumables, depreciating costs, insurance against injury and equipment damage, and the cost of the personnel (Iavazzo, Papadopoulou, & Gkegkes, 2014). The equipment used for robot-assisted surgery require the hospital environment to be modified to accommodate it, an aspect that increases the cost of surgery. Moreover, the cost of consumables such as cost According to Ng, & Tam, (2014), the cost can increase to up to 17%.

Additionally, it requires more than 300 surgeries per year for seven years for the amortization of the initial cost of a robotic system (Ng, & Tam, 2014). As such, the system is only feasible for a large scale operation where there is a large number of patients to reduce the cost of each case. Robotic systems used in surgeries are also limited in their use as they perform around ten uses per instrument. Given the high cost of each instrument, robot-assisted surgeries become costly. Despite the numerous advantages and possibilities of this technology in contributing to QSEN initiative in improving quality and safety of patient care, it is out of reach for many patients due to the often prohibitive costs.

Solutions to Reducing Cost

One of the major drawbacks of robot-assisted surgery is the cost. According to Iavazzo, Papadopoulou, & Gkegkes (2014), the cost of this technology is increased by a lack of competition, the limited number of uses for the equipment, cost of equipment and cost of setting up among others. Consequently, effectively addressing these issues would lead to a significant cost reduction in robot-assisted surgeries. Additionally, the disparity in operating time can influence cost. Although robot-assisted surgeries are usually less time consuming than a typical open surgery, interruptions during surgery can increase operating time and thus increase costs. According to Allers et al. (2016), strategies for cost reduction and increased efficiency for robot-assisted surgery can be formulated by first analyzing and identifying interruptions that occur during these surgeries. Operating times can also be reduced by improving the training of surgeons in this field (Iavazzo, Papadopoulou, & Gkegkes, 2014). Highly trained surgeons can reduce the time spent in the operating room hence cut costs.

The cost of robot-assisted surgery can also be reduced through increased competition, the creation of specialized robotic units, increase the number of uses for a robot, and discharge patient early where possible. Allers et al. (2016) argue that the manufacturers of robotic system enjoy a monopoly on the market, which leads to an increase in the cost of these systems. Consequently, introducing competition can significantly reduce the cost of instruments and the robotic system. Iavazzo, Papadopoulou, & Gkegkes (2014) suggest that creation of specialized robotic units can also reduce the overall cost of robot-assisted surgery. By having specialized units that can handle more patients per year, the cost of surgery can be reduced through economies of scale. Additionally, these specialized units can reduce the number of instruments used per operation to four rather than five, hence reducing cost (Allers et al., 2016).

Robotic systems used in surgery are limited in the number of uses, by creating multi-use robotic systems, the cost of this technology can be reduced as one system can be able to perform an assortment of surgeries, reducing the need to acquire a variety of systems. One of the factors that increase the cost of surgery is the time spent in the hospital. According to Iavazzo, Papadopoulou, & Gkegkes (2014), discharging patients at the earliest possible time can reduce the overall cost of robot-assisted surgery. Therefore, in certain cases, the use of robot-assisted surgery is cost-effective.

Continuous improvement of health systems in individual working areas is an important aspect of the QSEN initiative. Improvements can be made through acquiring the necessary knowledge, skills, and attitude. Knowledge and attitude can be improved through using evidence to influence practice. An analysis of the literature on robot-assisted surgery illustrates both its feasibility and contribution to improving safety and quality of patient care. Robot-assisted surgery reduces the time a patient spends in hospital, increases safety by reducing errors caused by a lack of accuracy and precision and reduces postoperative pain. As such, the use of this technology not only improves the performance of surgical procedures but also leads to better patient outcomes. By embracing this technology, nurses can get the opportunity for continued education as they seek to improve their skills in the delivery of care to patients who have undergone robot-assisted surgery.

References

Allers, J. C., Hussein, A. A., Ahmad, N., Cavuoto, L., Wing, J. F., Hayes, R. M., Guru, K. A. (2016). Evaluation and Impact of Workflow Interruptions During Robot-assisted Surgery. Urology, 92, 33-37. doi:10.1016/j.urology.2016.02.040

Diana, M., & Marescaux, J. (2015). Robotic surgery. British Journal of Surgery, 102(2), e15-e28. doi:10.1002/bjs.9711

Iavazzo, C., Papadopoulou, E. K., & Gkegkes, I. D. (2014). Cost assessment of robotics in gynecologic surgery: A systematic review. Journal of Obstetrics and Gynaecology Research, 40(11), 2125-2134. doi:10.1111/jog.12507

Ng, A. T., & Tam, P. (2014). Current status of robot-assisted surgery. Hong Kong Medical Journal, 20(3), 241-250. doi:10.12809/hkmj134167

Sharkey, N., & Sharkey, A. (2013). Robotic Surgery: On the Cutting Edge of Ethics. Computer, 46(1), 56-64. doi:10.1109/mc.2012.424