A little-known, not-taught facet of the nursing profession is the art of the workaround, Allison Hurt said — taking something that isn’t working in the situation and making it fit for whatever the patient or fellow staff members need.

When she started working in the University of Iowa Hospitals & Clinics burn unit, Hurt said one workaround was cutting gauze and dressings to better fit the burned area of a patient’s body.

Later, when she transferred to the medical intensive care unit that later became the COVID-19 unit at the start of the pandemic, workarounds involved using long lines of IV tubing to have machinery and equipment outside of a patient’s room, allowing nurses to administer medicine and check information while saving important personal protection equipment.

“I didn’t realize I was innovating when I was doing it,” Hurt said.

In her current role as a Nurse Innovator Liaison for the UI Office of Innovation, Hurt helps other nurses identify challenges, recognize the innovations they’ve been making without realizing it and look ahead to how they can help others with their ideas.

The University of Iowa’s Iowa Nurse Innovators Program connects nurses to the resources and expertise they need to turn workarounds into specially crafted, even marketable, solutions. With early successes from UIHC nurses currently getting off the ground, the program is working to reach health care professionals across the state.

UI Chief Innovation Officer Jon Darsee, who oversees and helped launch the program in fall 2022, said there are many programs aimed at helping faculty or physicians develop their ideas into products or services, but nothing geared specifically toward nurses. With his background in medical technology, Darsee said he learned early on to listen to nurses and their needs.

Since the project’s launch, 1,300 nurses have engaged with the nurse innovation program, according to a newsletter from the UI Office of Innovation. There are 38 active projects in the program, eight of which came from nurses outside of the UI system, and several patent disclosures have been filed. There are four products currently being used by nurses.

A requirement of a donation from the Ewing Marion Kauffman Foundation in Kansas City was that the innovation program expand beyond the UI and offer opportunities to nurses across the state, which Darsee said was a brilliant idea that hadn’t come to him yet.

“Contributing to the health and happiness of nurses in rural Iowa environments is one way this program can influence patient safety and ultimately the quality care on a local level,” Darsee said.

Bringing resources to the experts

Each of the products designed by nurses have come from challenges they’ve faced in their profession or see others struggling with in the health care system. They’ve developed their own ways of dealing with these issues in the day-to-day, using “workarounds” as Hurt described them.

Nurses commit to around 27 workarounds per 12-hour shift, Hurt said, and program staff learn about them by visiting different hospital units personally to speak with staff.

“We’ve discovered that the way that works best is having nurses identify their challenges where they’re happening,” Hurt said. “It’s obviously kind of fresh in their mind — in-the-moment frustration is really kind of what we’re going for.”

Once a nurse has identified a challenge, Hurt said the program and its partner, prototyping company MakerHealth, work with the nurse on their schedule to further discussions about the problem, how they’ve tried to solve it in the past and what solution they’re hoping to develop.

It was on one of these visits when Courtney Smith learned about the program. The nurse innovator team had brought their “innovation station” to a nurse staff council committee meeting and asked if anyone knew about innovation projects, which Smith had previous experience with at a different job.

With the help of the nurse innovators program, Smith collected all the information and materials belonging to her from her previous work and got started where she left off — developing a tool to get cords and wires off the operating floor and out of the way.

Smith has created and tested multiple iterations of her invention, a cord clamp designed to attach to a patient’s bed and hold cords out of the way of foot traffic. She and those helping her in the program are working on different attachments to handle other materials that may need to be held out of the way.

Staff members who have worked with Smith while she used it have enjoyed its functionality and simplicity, she said, and that it is easy to sanitize after doing its job.

“I think right now, our biggest barrier is the fact that I’m the only one that currently carries it around with me, I take it with me when I go,” Smith said.

For nurses just starting out on their idea, Hurt said the program provides them with a kit full of materials to design and craft a low-fidelity, or rough draft, version of their product. After figuring out what works and what doesn’t, the nurse has more discussions with the team before trying out new materials and designs, until they have a functional prototype. All of this is at no cost to the nurse.

At this point the nurse graduates from the MakerHealth portion of the program, Hurt said, and from there they can work with the UI Office of Innovation to eventually bring their idea to market, if that’s what they wish.

The program has also helped nurses who are already making products to think bigger about how — and who — they could help.

Lynette Kenne, a retired UIHC nurse with decades of experience in different areas of the field, said her product was inspired by her first grandchild, who was diagnosed as an infant with mild-to-moderate permanent hearing loss.

Her daughter reached out to her one day asking if she still had a sewing machine and could make something to cover her grandchild’s ears, as he would keep taking out his hearing aids and try to put them in his mouth.

After some trial and error, Kenne said she’s developed a small beanie with a band around the bottom and mesh patches over the ears in order to keep it on but comfortable for the wearer. She connected with a UI Health Care audiologist to give the extra hats she made to other babies and toddlers getting fitted for hearing aids before ever connecting with the innovators program.

“I think this has made me think big about how (to) bring a good service to more than just the people locally,” Kenne said.

The innovation program helped Kenne expand her knowledge about how infants’ heads change as they grow, what would be needed for older children with disabilities to be able to use the hats, what materials are best and more.

Kenne’s eyes were also opened to the idea of eventually marketing the hats in order to reach more people in need. Her next steps include reaching out to audiologists across the state to gauge their interest in the product and finding ways to make the sewing process faster.

Nurses were neither told nor taught in school about workarounds and how often they would need to adapt their materials and equipment to fit patients’ needs, Kenne said, and having this program just for them is an immense help.

“We have lots and lots of nurses across the state and across the nation that for years and years and years have been doing workarounds simply because they don’t have a product or a process that currently works,” Kenne said. “And this is a little tickler to say, if you have an idea, come talk to us and we’ll help you make it a reality.”

Expanding ideas and program reach

Without the UI Nurse Innovators Program, Smith said her cord clip would still be an idea she left behind, and Kenne said she would still be thinking small when it came to who her hats could help.

Both innovators have taken steps to determine whether their products can be patented, something Smith said she would have never been able to accomplish without the program’s support.

“I feel like the nurse innovators program makes me feel limitless when it comes to the capabilities that we are able to achieve with these products,” Smith said.

While it may have been in a different way for her than program participants, Hurt said the innovators program helped her get to a better place in her career while looking for the next step. Like the nurses she meets at their stations, the innovation team came to Hurt while she was working on her unit and asked about her challenges, leading her to find and be selected for the liaison position.

Beyond aiding in turning nurses’ ideas into reality, Darsee said the program helps improve quality of life for the nursing profession in general, hopefully leading to more nurses staying in their jobs and combating the national nursing shortage.

“From the leadership perspective, leadership is excited that their nurses are happy, their nurses aren’t chomping at the bit to get away from patient care,” Hurt said. “And by no means are we trying to steal nurses away to start companies. We’re really trying to make nurses’ days better in the place they work, and solve challenges where they are spending 40 hours a week.”

To Darsee and Hurt’s knowledge, there are no other programs like UI Nurse Innovators, in academic settings or otherwise. Other health care systems, including hospitals, nursing homes and more, have spoken with the team about trying to start their own, similar programs, Darsee said.

“There is no reason why this couldn’t go to any hospital, anywhere you have a nurse,” Darsee said.