My Journey as a Nurse Innovator

Kathleen Puri, MS, RN

Co-Founder, FitsiHealth
2019 ANA Innovation Individual Nurse Award

I am a nurse

I am a registered nurse with many years of experience in nursing and teaching nursing as a faculty member. The lack of adequate patient hand hygiene always bothered me and I never quite figured out how to effectively provide hand hygiene that patients could do independently.

I am a patient

Then I became a patient. A rare cancer found me and I experienced being in the hospital in a very different way from my role as a nurse.

Among many other concerns I found myself staring at the sink in my hospital room but unable to reach it on my own. Likewise, the hand sanitizer dispenser on the wall was inaccessible. A commode next to my bed was convenient but no provision was made for my hand hygiene after using it. The hand sanitizer bottle I brought to the hospital kept getting lost in my sheets.

My cell phone was on my over the bed table but the table was not always within my reach resulting in missed calls. Life as a patient is not easy but it began to slowly dawn on me that being a patient did not need to be this uncomfortable.

A major part of the job of a nurse is health promotion and prevention of complications. Healthcare associated infections (HAI) affect about 1 out of every 31 US hospital patients. https://www.cdc.gov/hai/data/index.html. Hand hygiene is always stated as the most important way to prevent HAI but the implementation of this for patients is usually not specified. https://www.cdc.gov/HAI/patientSafety/patient-safety.html.

I think I can

The devil is in the details. I naively thought I could address the problem of patient hand hygiene by designing a product that would help keep hand sanitizer within easy reach and provide a place to keep a cell phone, glasses, and other personal items.

I truly did not appreciate that I was entering into an entirely new aspect of health care – design. Ignorance is sometimes bliss and, in my case, it allowed me to think I could just design a product that would be patient centered and provide for health promotion and help the prevention of HAI. I started my innovation journey.

An unlikely journey

So, like driving at night, I started and only focused on the part of the journey I could see. My headlights were quite dim, and I had a very steep learning curve. Humility and frustration are frequent emotions on this journey!

My product, a bedside caddy called Fitsi http://www.fitsihealth.com was the result of working with my co-founder to:

• Conceptualize the unique features of Fitsi
• Write guidelines for healthcare workers to implement patient hand hygiene
• Consult with a medical designer to capture the appropriate size, shape, colors of Fitsi
• Address the web design, video, photos, social media and marketing, of Fitsi
• Work with a patent attorney to obtain two US patents and registration of our logo
• Work with our manufacturer to produce, assemble, package and ship Fitsi
• Provide resources for clinical trials to get evidence based data
• Establish relationship with our distributor to market and sell Fitsi
• Control money – Fitsi is self-financed.

Fitsi has won innovation awards from the Patient Safety Movement, Infection Control.tips organization and the American Nurses Association. Wonderful to have the efforts of our company, Fitsi Health, recognized and, of course, the best recognition is the appreciative comments from patients.

When will hospital catch up?

We find hand hygiene supplies almost everywhere now. Grocery stores, pharmacies, homes, schools, and offices have convenient hand sanitizers. Hospitals are one of the few places in society where we still struggle to provide for the hand hygiene of the people we serve. For financial health, patient satisfaction, health promotion and prevention of HAI healthcare facilities would do well to help patients with hand hygiene.

The journey continues

Fitsi Health is an innovation success.

The public is recognizing the need for hand hygiene and demand for this most basic care is growing. Covid-19 has opened a window on the need for patient hand hygiene resources. Fitsi Health asks:

• Public – recognize the need for patient hand hygiene and request hand hygiene supplies for yourself and loved ones when hospitalized
• Healthcare workers – attack the problem of HAIs and assess each patient for their knowledge of and ability to perform hand hygiene
• Healthcare executives – address the HAIs issue with the moral conviction that patient hand hygiene is critical to high quality care while recognizing it will improve the “bottom line”
• Journalists – when reporting on healthcare issues include patient access to hand hygiene in your article and include nurses as media resources for your reporting because, as this Woodhull study shows, nurses voices are infrequently heard https://sigmapubs.onlinelibrary.wiley.com/doi/full/10.1111/jnu.12429
• Media executives – include some images of patients using hand sanitizer when making shows about hospitals; gloves and gowns are seen frequently but patient hand hygiene is missing
• Insurers – adjust your mission to provide coverage for health promotion and HAIs prevention resources
• Legislators – state and federal officials who guide our health policies need to ensure patient hand hygiene is addressed in laws and regulations

We all have a part in this seemingly simple but quite complex problem. One step at a time with commitment and persistence is needed so let’s get going with enthusiasm!

September 2020