Smartphone distraction during nursing care: Systematic literature review

AimTo investigate the impact of smartphone distraction on the quality and safety of care provided by the nursing population during work.BackgroundAbout 80% of nurses use the smartphone in the workplace both for personal purposes and as a useful support to improve the quality of care. Distraction from smartphones during care is a phenomenon that should be known and managed within each health service.MethodsA systematic review of the literature was conducted using the PRISMA methodology. The sources included in the review study were subjected to a qualitative assessment using the GRADE method.ResultsSixteen articles were included in the review. Studies included highlight the positive and negative consequences of using mobile devices during nursing practice. Findings identify the smartphone as a generator of stimuli capable of diverting the attention of the person from the priority activities and absorbing the cognitive resources useful for carrying out these activities. Some studies aimed to show the restriction policies and/or the strategies for reducing disruptions. This review highlights how the free and indiscriminate use of the smartphone can negatively affect patient safety and the nurse-patient relationship through the dehumanization and depersonalization of care.ConclusionsMobile technology can improve nurses' performance and the quality of care provided. However, the application of regulations and policies by healthcare facilities is desirable to avoid inappropriate use of these devices by nurses. The available data do not provide a precise estimate of the effect that distraction from smartphones has on the outcomes of nursing care.     

Is there a relationship between nursing students’ smartphone use,their fear of missing out and their care-related behaviour?

AimThis study aims to determine the relationship between smartphone use among intern nursing students, fear of missing out and their care-related behaviour.BackgroundToday, smartphone use is common and fear of missing out is a prominent issue in our society; this behaviour and issue are linked and may lead to adverse consequences. Design: The study is conducted as a cross-sectional design.MethodsThe target population in this research consists of senior nursing students (n = 101). There was no sampling selection and the study was completed with 97 students who agreed to participate in the research. Data were collected with introductory questionnaire forms, the Smartphone Addiction Scale (SAS), the Fear of Missing Out Scale (FoMOs) and the Caring Assessment Questionnaire (Care-Q). The valid and reliable SAS, FoMOs and Care-Q were transformed into online forms and the link was distributed to the participants via online Google forms.ResultsBased on the results of the study, the mean scores were 83.30 ± 2.21 of SAS, 21.56 ± 6.42 for FOMOs and 5.54 ± 0.87 for Care-Q scale. There were statistically significant differences between gender and Care-Q score and between the duration of smartphone use, daily smartphone usage time and SAS score (p < 0.05). There was a weak positive relationship between SAS and FoMOs scale scores, along with a weak negative relationship between the accessibility and comfort sub-dimensions of the SAS and Care-Q scale. Also, the SAS score explains 0.4% of the comfort subscale of the Care-Q scale (p < 0.05).ConclusionsFurther research focusing on nursing students is recommended to identify potential adverse effects created by the use of smartphones and the fear of missing out. In addition, educators are recommended to develop guidelines and prepare new policies for smartphone use to minimise the potential negative effects of smartphone use and fear of missing out on student care behaviour.     

Prevalence and predisposing factors of smartphone addiction,sleep quality and daytime sleepiness of nursing students: A cross-sectional design

AimThe current study aimed to determine the prevalence of smartphone addiction, sleep quality and daytime sleepiness of nursing students and to identify the predisposing factors of these parameters.BackgroundThe use of smartphones, which has become an indispensable part of daily life, has various effects on addictive behavior and sleep.DesignThe present study was performed with a cross-sectional design.MethodsThe population of the study comprised of nursing students attending all grades at two universities (N = 940). A total of 771 students were included in the study. Data were collected through a personal information form, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale and the Smartphone Addiction Scale. Logistic regression analysis was used to evaluate the data.ResultsThe prevalence of smartphone addiction was 42.4%. Of the students, 57.3% had poor sleep quality and 82.5% had normal daytime sleepiness. Daily smartphone use duration, owning of a smartphone duration, daytime sleepiness and academic success were significant influencing factors for smartphone addiction (p < 0.05). Daily sleep duration, daytime sleepiness and school region were found significant risk factors for sleep quality (p < 0.05). Sleep quality and smartphone addiction significantly influenced daytime sleepiness (p < 0.05).ConclusionsThe study revealed that almost half of nursing students presented smartphone addiction and more than half of them had poor sleep quality. The prevalence of normal daytime sleepiness among nursing students was high.     

Technology for trauma: testing the validity of a smartphone app for pre-hospital clinicians

Introduction:With the introduction of regional trauma networks in England, ambulance clinicians have been required to make triage decisions relating to severity of injury, and appropriate destination for the patient, which may require ‘bypassing’ the nearest Emergency Department. A ‘Trauma Unit Bypass Tool’ is utilised in this process. The Major Trauma Triage tool smartphone application (App) is a digital representation of a tool, available for clinicians to use on their smartphone. Prior to disseminating the application, validity and performance against the existing paper-based tool was explored.Methods:A case-based study using clinical scenarios was conducted. Scenarios, with appropriate triage decisions, were agreed by an expert panel. Ambulance clinicians were assigned to either the paper-based tool or smartphone app group and asked to make a triage decision using the available information. The positive predictive value (PPV) of each tool was calculated.Results:The PPV of the paper tool was 0.76 and 0.86 for the smartphone app. User comments were mainly positive for both tools with no negative comments relating to the smartphone app.Conclusion:The smartphone app version of the Trauma Unit Bypass Tool performs at least as well as the paper version and can be utilised safely by pre-hospital clinicians in supporting triage decisions relating to potential major trauma.     

Exercise training and postural correction improve upper extremity symptoms among touchscreen smartphone users

BackgroundRepetitive movements and poor posture are associated with over-use of smartphones when texting or playing games and significantly contribute to the symptoms of pain and discomfort in the upper extremities.ObjectiveThis study investigated the effect of exercise training and postural correction on disabilities of the arm, shoulder, and hand (DASH), hand grip and key pinch strength among smartphone users.MethodsOne hundred university students were randomly divided into two groups; the experimental group participated in a 12-week programme of exercise training and postural corrections. The control group were instructed to follow their usual routine for smartphone utilization. Measurements of DASH scores, hand grip strength, and key pinch grip strength were conducted before and after 12 weeks for both groups.ResultsThere were no significant differences between the start values of both groups for DASH scores, hand grip strength, and key pinch strength (p > 0.05). However, there was a significant improvement in all outcomes measured in the experimental group (p < 0.05), with significant changes in the outcomes of the control group.ConclusionPostural correction combined with a selected exercise training programme improved the hand grip, key pinch grip strength, and upper extremity disability and symptoms associated with smartphone use among university students.     

Influence of smartphone use on the median frequency of mastigatory and trapezius muscles in women - a Pilot study

IntroductionThe use of smartphones is growing every year, and their excessive use can cause adverse physical and mental effects.AimThis study aimed to evaluate the influence of smartphone use on the median frequency of the masticatory muscles and upper trapezius muscles in healthy women.MethodSix healthy young women were evaluated. All the volunteers underwent a submaximal bite test to evaluate their masticatory muscles. In addition, the volunteers underwent a test for bilateral shoulder elevation to a submaximal load to evaluate their upper trapezius muscles. Both protocols were performed before and after a task using the smartphone for 30 min. Median frequency (MF) values were collected during the submaximal bite and submaximal shoulder elevation tests.ResultsData were analyzed using specific statistical tests. A statistically significant reduction in the MF for all the masticatory muscles was observed in the bilateral bite task when comparing pre and post smartphone use (p < 0.005). A significant reduction in the MF was also found for the right upper trapezius when comparing pre and post smartphone use in the shoulder elevation task (p = 0.001).ConclusionIt appears that prolonged smartphone use may contribute to fatigue in the masticatory and upper trapezius muscles. Therefore, guidelines for smartphone users should include advice on the moderate use of this device.     

Posture and time spent using a smartphone are not correlated with neck pain and disability in young adults: A cross-sectional study

PurposeTo determine the impact of smartphone use on neck impairment and functional limitation in university students.MethodsA cross-sectional correlational study was conducted in a sample of students selected through convenience sampling between September 2016 and March 2017. The inclusion criteria were university students at the School of Medicine and Surgery, routine/daily use of mobile devices with advanced computing and connectivity capability built on an operating system, and aged 18–30 years. Participants completed questionnaires that measured general characteristics of smartphone use and demographic characteristics. Neck pain was assessed using a visual analogue pain score (VAS) and a pain drawing (PD); disability status was measured using the Neck Disability Index (NDI-I); and cervical postures while using the phone were captured using the Deluxe Cervical Range of Motion (CROM) device.ResultsA total of 238 volunteers were recruited (22.4 ± 2.2 years of age, 53.4% males), 35.9% of whom were overweight (>25 BMI). Regarding neck pain, 42.4% reported mild pain, 8.4% had moderate pain, and the remaining 49.2% had no pain. NDI-I and VAS were 3.8 ± 3.8 and 13.6 ± 18.4 mm, respectively. The pain categories did not influence the variables. No significant correlations were observed between the number of hours spent and posture (CROM) while using a smartphone and neck pain and NDI-I.ConclusionWhile half of young medical students reported neck pain, the use of smartphones was not correlated with neck pain and disability. While we wait for future prospective studies, there is no reason to recommend a change in smartphone use habits among young adults in the meantime.     

Exploring assessment policies for clinical practice: A scoping review of the literature

BackgroundAssessment of pre-registration nursing students in clinical practice is an essential process, ensuring students who graduate meet standards for practice and competently and safely care for patients under their care. However, such assessment remains challenging for individuals and organisations.AimWe aimed to investigate what is known about the application of clinical placement assessment policies guiding pre-registration nursing programmes.MethodsArskey and O’Malley’s five-stage method for scoping reviews was employed. Health and education databases were searched in July 2020 and December 2021. Identified papers were screened. The Joanna Briggs Institute’s critical appraisal tools were used to appraise the quality of the included articles. The Invitational Theory domains of people, processes, programmes, places, and policies were utilised to aid meaningful analysis of the findings.FindingsNineteen articles were appraised: eleven primary data studies, two that psychometrically tested a survey instrument, four discussion articles, and two literature reviews. Article quality varied widely. Three themes were identified: lack of processes around clinical practice, people and clinical practice, and policies and clinical practice.DiscussionAssessment within placement is complex and unique. Uncertainty permeates the literature around assessment of pre-registration students in clinical practice. There is a clear need to promote policies that highlight differences between theoretical and practice assessment, ensuring all stakeholders can access relevant governance processes that support patient safety.ConclusionMore empirical evidence is needed to develop policies and processes that reduce uncertainty and improve patient safety associated with student assessment within clinical placements.     

Dynamic balance measurements: Reliability of smartphone attachment sites

IntroductionDynamic balance devices are costly and uncommon, requiring dedicated space for use. Thus, studies often utilize smartphones to measure dynamic balance by attaching them to body parts, as they are inexpensive, small, and readily available. However, little consideration has been given to determine which body part would yield the most reliable measurements.Methodː A total of 25 healthy college students consented to stand on a balance pad on their dominant leg for 30 s. The test and retests were performed at a one-week interval.Resultsː Agreement between the test and retest values was moderate for those obtained from the sternum and waist (0.50 ≤ ICC ≤ 0.74) and was good for those obtained from the shin (0.75 ≤ ICC ≤ 0.89). There were significant moderate positive correlations between the test and retest results for all the attachment sites (0.40 < r < 0.69, p < 0.05).DiscussionBased on a review of related literature and the experiment's results, this study determined the pros and cons of using a smartphone as a measuring tool and the various measurement locations in the body. Despite the smartphone being a low-cost measuring tool, greater care must be taken to ensure the validity of the interpreted data.Conclusionː Although quantifying balance is necessary for evidence-based medicine, clinics seldom use existing modern devices due to their costliness. This study's results suggest that a smartphone, which is a cheaper alternative, produces the most reliable results when attached to the shin.     

The relationship between smartphone use and subjective musculoskeletal symptoms and university students

[Purpose] The purpose of this study was to investigate the use of smartphones by university students in selected areas, their musculoskeletal symptoms, and the associated hazard ratio. [Subjects and Methods] This involved the completion of a self-administered questionnaire by dental hygiene students in Seoul, Gyeonggido, and Gyeongsangbukdo. The 292 completed copies of the questionnaire were then analyzed. [Results] The most painful body regions after the use of smartphones were found to be the shoulders and neck. In the musculoskeletal system, back pain was found to have a positive correlation with the size of the smartphone’s liquid crystal display (LCD) screen, and pain in legs and feet were found to have a negative correlation with the length of time that the smartphone was used. As a result, it was revealed that the use of a smartphone was correlated with musculoskeletal symptoms. [Conclusion] Therefore, in today’s environment, where the use of smartphones is on the rise, it is necessary to improve the ways that they are used and to develop a preventive program to alleviate the symptoms of musculoskeletal damage.Key words: Smartphone, Musculoskeletal symptoms, Prevent     

Professionals’ views on the use of smartphone technology to support children and adolescents with memory impairment due to acquired brain injury

Purpose To identify from a health-care professionals’ perspective whether smartphones are used by children and adolescents with acquired brain injury as memory aids; what factors predict smartphone use and what barriers prevent the use of smartphones as memory aids by children and adolescents. Method A cross-sectional online survey was undertaken with 88 health-care professionals working with children and adolescents with brain injury. Results Children and adolescents with brain injury were reported to use smartphones as memory aids by 75% of professionals. However, only 42% of professionals helped their clients to use smartphones. The only factor that significantly predicted reported smartphone use was the professionals’ positive attitudes toward assistive technology. Several barriers to using smartphones as memory aids were identified, including the poor accessibility of devices and cost of devices. Conclusion Many children and adolescents with brain injury are already using smartphones as memory aids but this is often not facilitated by professionals. Improving the attitudes of professionals toward using smartphones as assistive technology could help to increase smartphone use in rehabilitation.

• Implications for Rehabilitation

• Smartphones could be incorporated into rehabilitation programs for young people with brain injury as socially acceptable compensatory aids.

• Further training and support for professionals on smartphones as compensatory aids could increase professionals’ confidence and attitudes in facilitating the use of smartphones as memory aids.

• Accessibility could be enhanced by the development of a smartphone application specifically designed to be used by young people with brain injury.

     

Resident Use of the Internet,E-Mail,and Personal Electronics in the Care of Surgical Patients

The use of smartphones, e-mail, and the Internet has affected virtually all areas of patient care. Current university and hospital policies concerning the use of devices may be incongruent with day-to-day patient care. Purpose: The goal was to assess the current usage patterns of the Internet, e-mail, and personal electronics for clinical purposes by surgical residents as well as their communication habits and preferences. Also assessed was residents’ knowledge regarding the institutional policies surrounding these issues. Methods: Surgical residents (n = 294) at a large teaching institution were surveyed regarding their knowledge of university policies as well as daily use of various communication technologies. Communication preferences were determined using theoretical clinical scenarios. Results: Our survey with a response rate of 54.7% (n = 161) revealed that 93.8% of participants indicated daily Internet use for clinical duties. Most respondents (72%) were either completely unaware of the existence of guidelines for its use or aware but had no familiarity with their content. Use of e-mail for clinical duties was common (85%), and 74% of the respondents rated e-mail as “very important” or “extremely important” for patient care. Everyone who responded had a mobile phone with 98.7% being “smartphones,” which the majority (82.9%) stated was “very important” or “extremely important” for patient care. Text messaging was the primary communication method for 57.8% of respondents. The traditional paging system was the primary communication method for only 1.3% of respondents and the preferred method for none. Conclusions: Daily use of technology is the norm among residents; however, knowledge of university guidelines was exceedingly low. Residents need better education regarding current guidelines. Current guidelines do not reflect current clinical practice. Hospitals should consider abandoning the traditional paging system and consider facilitating better use of residents’ mobile phones.     

Second-year undergraduate nursing students’ experiences with clinical simulation training in mental health clinical practice: A focus group study

AimThe aim of this focus group study was to investigate second-year undergraduate nursing students’ experiences with clinical simulation training as part of their clinical practice in acute mental health care.BackgroundThe quality of bachelor programmes in nursing has been criticised for lacking theoretical and experiential learning in the mental health modules. Novice nurses feel unprepared to care for patients with mental health challenges and graduate nurses are reported to lack the necessary knowledge and skills to manage patients with mental health issues confidently and competently. Clinical simulation training can facilitate the teaching of clinical and non-clinical skills simultaneously and is a highly suitable method within mental health care for addressing gaps in knowledge and skills in communicating with patients. Clinical simulation training may enhance nursing students' competence and thereby reduce the risk of adverse events and increase safety. However, we know little about undergraduate nursing students’ experiences with clinical simulation training as an integrated part of nursing students’ clinical practice in acute mental health wards.DesignExplorative qualitative focus group study.MethodThree focus group interviews were conducted using a semi-structured interview guide with second-year undergraduate nursing students from a university in Norway during spring 2020. In total, 14 students who had experienced clinical simulation training as part of their mental health clinical practice participated in the study. The collected data were analysed using systematic text condensation.ResultsClinical simulation training as part of the clinical practice increased the students’ preparedness, coping and self-awareness. Most of the participants had positive perceptions of the use of high-fidelity simulation-based learning. Furthermore, they highlighted three elements that increased the value of the training. First, the simulation felt authentic and increased their professional skills. Second, the standardised patient had clinical qualifications, which made the simulation feel authentic and close to realistic situations. Third, not having a former relationship with the person acting as the standardised patient enhanced authenticity.ConclusionClinical simulation training as part of clinical practice contributed to increasing the students’ self-awareness and in-depth reflection and to broadening their nursing competence. The present study lays the groundwork for future studies on clinical simulation training in mental health clinical practice for nursing students.