As healthcare becomes increasingly more complex, nurses must maintain the competencies necessary to deliver high-quality care. This includes the ability to respond appropriately to new technologies, which always have the potential to change nursing practice. As patient advocates and frontline caregivers, nurses must ensure that new technologies do not devalue the human element in healthcare.
Bioprinting is one of the most exciting new technologies in healthcare. It evolved from 3D printing, also known as additive manufacturing, in the industrial world. The additive process involves building an object in layers, typically from liquid plastic that serves as “ink,” to create a three-dimensional object. In the early 2000s, researchers began experimenting with a similar technique, known as bioprinting, for medical applications.
Bioprinting uses a bio-ink made of living cells, collagen, hormones, etc., to create solid tissue layer by layer. The idea is to create “replacement parts” for the human body. These parts are made of the patient’s own genetic material, eliminating the problem of rejection so common in tissue grafting and transplant procedures today. To date, the technology allows for the printing of simple tissues like skin and heart muscle for grafts, and researchers hope to be able to print viable, whole organs within 30 years. A major challenge has been finding ways to include blood vessels in printed organs.
Bioprinted tissue can also be useful in medical research, particularly in applications where ethics preclude using human beings as test subjects. By creating a natural cellular environment, researchers can use bioprinting to study wound healing, disease progression, factors that induce disease, and the safety and efficacy of new drugs. It could potentially be more effective than animal testing.
Many experts extend the definition of bioprinting to include biocompatible materials like plastic or titanium that can be used to build body parts. For example, in 2013, a Belgian woman received a prosthetic jawbone that was printed from layers of titanium powder and then coated with bio-ceramic artificial bone. Another case involved a baby born with tracheobronchomalacia, or a collapsing trachea. Biomedical engineers were able to keep him breathing until his windpipe strengthened, by printing a splint from a bio-polymer that his body would reabsorb over time.
A 3D printing process could also create exact models of a patient’s diseased or damaged organ, for surgeons to study and handle before entering the operating room. The opportunity to develop a surgical plan from a multi-dimensional model is a distinct advantage over using an MRI or CT scan, possibly improving outcomes or reducing the likelihood of complications.
As with any new technology, there are major considerations. Does the cost of bioprinting justify the benefits? Who will have access to the new treatments? How will printed tissues, organs, and prosthetics be evaluated and regulated? And what about unintended consequences? It’s possible that bioprinting will cause harm as well as good, or will prove successful in some types of procedures or medical specialties but not others. It may require new regulatory processes or a reorganization of multiple parts of the healthcare system (including insurance), which could take many years of trial and error or cost millions of dollars.
Another looming question is how bioprinting will affect nursing practice. As a new resource with the potential to improve patient outcomes, bioprinting can change the tasks that nurses perform in various areas. For example, imagine that the need for dialysis or long waiting periods for organ transplant are suddenly eliminated. This might mean fewer—or different—nursing interventions. It could perhaps result in shorter hospitalizations or fewer hospitalized patients, which in turn could affect the workplace environment, staffing ratios, etc. It’s possible that the entire care process could change for the better, with nursing staff able to spend more time developing positive relationships with each patient, encouraging healthy behaviors, and providing support.
Nursing’s patient advocacy role will likely come into play if bioprinting becomes a common treatment option. While nurses are not legally responsible for obtaining informed consent, the ANA maintains that nurses have an ethical obligation to ensure patients understand the implications of their medical decisions and are able to remedy any knowledge gaps they identify. Nurses may also have to advocate for and respect the values of patients who have religious or cultural objections to tissue regeneration or transplantation. And of course, nurse leaders and educators will have to prepare for all of the challenges associated with an emerging technology, in order to assure that nurses have the competencies they need. The profession as a whole should be proactive, rather than reactive, when it comes to addressing the future of nursing.
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