Back to the future: personal digital assistants in nursing education

This article provides an overview of the current state of the art for incorporating personal digital assistants (PDAs) into nursing education. The development of PDA technology and the lessons learned by educators integrating PDA technology into nursing curricula are described. The current cycle of PDA evolution is discussed and contrasted with a proposed model for maximizing the impact of PDAs on technological innovation in nursing education and practice.     

Experience of using a personal digital assistant in nursing practice - a single case study

johansson p., petersson g. & nilsson g. (2011) Journal of Nursing Management 19, 855–862 Experience of using a personal digital assistant in nursing practice – a single case study Aim The aim of this study was to describe one nurse’s experience of using a personal digital assistant (PDA) in nursing practice. Background Nurses handle large amounts of information and a PDA may contain valuable information that nurses need in their daily work. Methods In this qualitative single case study, data were collected through an open-ended interview with one registered nurse and were analysed by content analysis. Results The findings show that the PDA provides immediate access to information anywhere and at anytime, with advantages for both the nurse and for her patients. The PDA increased her confidence and efficiency in practice; it was easier to keep up-to-date and spend more time with the patient. Furthermore, the PDA was perceived as improving patient safety and patient participation. Conclusions The PDA requires improved content and more functions. Ease of use should also be improved. This study indicates that PDAs could be valuable and may inspire further research. Implications for nursing management The incorporation of a multifunctional PDA is an important issue for nursing management, as it could both change and provide new possibilities for nursing practice. The use of PDAs could also aid decision-making, improve patient safety and benefit patient outcomes.     

Use of personal digital assistants with acute care nurse practitioner students

Personal digital assistants (PDAs) are attaining increased functionality by acute care nurse practitioners (ACNPs). Supplemented by recently developed medical software, these devices assist nurse practitioners in having information available at the point of care. This article reviews the introductory use of PDAs throughout ACNP graduate training with an emphasis on clinical and classroom application.     

Value of wireless personal digital assistants for practice: perceptions of advanced practice nurses

Aims and objectives. The aims were to explore advanced practice nurses’ perceptions on wireless Personal Digital Assistant technologies, to establish the type and range of tools that would be useful to support their practice and to identify any requirements and limitations that may impact the implementation of wireless Personal Digital Assistants in practice. Background. The wireless Personal Digital Assistant is becoming established as a hand‐held computing tool for healthcare professionals. The reflections of advanced practice nurses’ about the value of wireless Personal Digital Assistants and its potential to contribute to improved patient care has not been investigated. Design. A qualitative interpretivist design was used to explore advanced practice nurses’ perceptions on the value of wireless Personal Digital Assistant technologies to support their practice. Methods. The data were collected using survey questionnaires and individual and focus group interviews with nurse practitioners, clinical nurse specialists and information technology managers based in British Columbia, Canada. An open‐coding content analysis was performed using qualitative data analysis software. Results. Wireless Personal Digital Assistant’s use supports the principles of pervasivity and is a technology rapidly being adopted by advanced practice nurses. Some nurses indicated a reluctance to integrate wireless Personal Digital Assistant technologies into their practices because of the cost and the short technological life cycle of these devices. Many of the barriers which precluded the use of wireless networks within facilities are being removed. Nurses demonstrated a complex understanding of wireless Personal Digital Assistant technologies and gave good rationales for its integration in their practice. Conclusions. Nurses identified improved client care as the major benefit of this technology in practice and the type and range of tools they identified included clinical reference tools such as drug and diagnostic/laboratory reference applications and wireless communications. Relevance to clinical practice. Nurses in this study support integrating wireless mobile computing technologies into their practice to improve client care.     

Critical care nurse practitioners and clinical nurse specialists interface patterns with computer-based decision support systems

PURPOSE: The purposes of this review are to examine the types of clinical decision support systems in use and to identify patterns of how critical care advanced practice nurses (APNs) have integrated these systems into their nursing care patient management practices. The decision-making process itself is analyzed with a focus on how automated systems attempt to capture and reflect human decisional processes in critical care nursing, including how systems actually organize and process information to create outcome estimations based on patient clinical indicators and prognosis logarithms. Characteristics of APN clinicians and implications of these characteristics on decision system use, based on the body of decision system user research, are introduced. DATA SOURCES: A review of the Medline, Ovid, CINAHL, and PubMed literature databases was conducted using "clinical decision support systems,"computerized clinical decision making," and "APNs"; an examination of components of several major clinical decision systems was also undertaken. CONCLUSIONS: Use patterns among APNs and other clinicians appear to vary; there is a need for original research to examine how APNs actually use these systems in their practices in critical care settings. Because APNs are increasingly responsible for admission to, and transfer from, critical care settings, more understanding is needed on how they interact with this technology and how they see automated decision systems impacting their practices. IMPLICATIONS FOR PRACTICE: APNs who practice in critical care settings vary significantly in how they use the clinical decision systems that are in operation in their practice settings. These APNs must have an understanding of their use patterns with these systems and should critically assess whether their patient care decision making is affected by the technology.     

Reconceptualizing the core of nurse practitioner education and practice

Purpose: The movement to the doctor of nursing practice (DNP) is progressing rapidly with new programs emerging and curricular documents being developed. We argue that the implementation of the DNP is a good move for nursing, provided that we use the opportunity to reconceptualize the core of advanced practice nursing, especially nurse practitioner (NP) practice.
Data sources: Theory and research articles from nursing focused on advanced practice nursing, NPs, and doctoral education.
Conclusions: The foundation of NP education is currently based essentially on borrowed or shared content in assessment, pharmacology, and pathophysiology. We argue that the heart and soul of nursing is in health promotion, both in healthy persons and in those dealing with chronic illness. Current master's programs do not prepare NPs to assume high-level practice focused on health promotion and disease management using the latest theoretical developments in health behavior change, behavioral sciences, exercise physiology, nutrition, and medical anthropology. Although these are touched upon in most NP programs, they do not represent the core science of NP education and need to be a critical part of any DNP program.
Implications for practice: Ultimately, our vision is for NP care to be consistently "different," yet just as essential as physician care, leading to positive outcomes in health promotion and disease management.     

PDA在提高临床护理质量中的应用

目的进一步探讨PDA在临床护理实践中的应用,使其为提高临床护理工作质量带来创新与变革。方法将PDA技术应用于临床护理实践,使信息系统的触角延伸到病床旁,实现病人信息的动态采集,即时记录病人的病情变化。结果通过此项技术的应用,有效保证了护理安全,护理缺陷发生率由3.06%降至0.64%。护士用于表格书写的时间大大降低,服务于患者的时间较前更多,有利于建立良好的护患关系,病人满意率由95.4%提高到98.2%,激发了护士的工作积极性。结论PDA的应用有效提高了临床护理质量,有效推进医院信息化建设的进程。     

护理专业本科实习学生临床决策能力的现状调查

目的了解护理专业本科学生临床决策能力。方法对在重庆市5所三级甲等医院实习的护理专业学生253人进行临床决策能力测量。结果护理本科实习学生临床决策能力总分为（81．60±9．85）分,临床环境适应性、临床思维、知识结构、护患沟通能力、综合基础素质得分较低。结论护理专业学生临床决策能力水平偏低,提示应采取针对性干预措施,不断提高其临床决策能力。     

掌上电脑在医嘱处理及生命体征测量中的应用

目的探讨应用掌上电脑(personal digital assistant,PDA)在处理与执行医嘱及测量记录生命体征中的应用效果。方法应用PDA处理与执行医嘱及测量记录生命体征,分别统计应用PDA与传统护理方法 50例患者医嘱处理及核对和生命体征测量及录入间接和直接护理时数。结果应用PDA处理和执行医嘱及生命体征测量和录入的总护理时数和直接护理时数较传统护理方法多;间接护理时数较传统护理方法少,两种方法比较,均P0.05,差异具有统计学意义。结论应用PDA可缩短处理与执行医嘱及测量与记录生命体征的时间,减少了护士重复性工作,使护士有更多的时间护理患者,从而提高护理质量。     

基于掌上电脑的护理质量评价系统的开发与应用

目的建立更加科学、有效的护理质量评价方法。方法在原有的护理质量评价体系的基础上，将电子信息技术应用于护理质量评价过程，通过移动设备（掌上电脑）与计算机终端的有机结合，形成了更加科学、有效的护理质量评价系统。结果护理质量评价系统的应用提高了护理质量管理的科学性和有效性，降低了管理成本，提高了工作效率。结论护理质量评价系统的开发与应用为信息化时代护理管理提供了新的思路和方向。     

少数民族地区移动护士工作站的使用意愿及对策分析

[目的]了解少数民族地区护理人员对移动护士工作站的使用意愿,并提出相应对策。[方法]采用自行设计的移动护士工作站的使用现状调查问卷对新疆某三级甲等医院1 068名临床护理人员进行调查。[结果]护理人员对移动护士工作站的使用意愿得分为65.86分±9.21分,处于中等偏上水平;不同年龄、性别、科室、职务、职称、岗位、每天分管病人数、培训频次的护理人员得分比较差异有统计学意义(P<0.05);年龄、性别、科室、职务、分管病人数和培训频次进入回归方程。[结论]护理人员更愿意使用移动护士工作站优势明显的功能板块;护理管理人员应根据少数民族地区特色,采取针对性措施提高少数民族地区护理人员对移动护士工作站的使用意愿。     

A qualitative analysis of how advanced practice nurses use clinical decision support systems

PURPOSE: The purpose of this study was to generate a grounded theory that will reflect the experiences of advanced practice nurses (APNs) working as critical care nurse practitioners (NPs) and clinical nurse specialists (CNS) with computer-based decision-making systems. DATA SOURCES: A study design using grounded theory qualitative research methods and convenience sampling was employed in this study. Twenty-three APNs (13 CNS and 10 NPs) were recruited from 16 critical care units located in six large urban medical centers in the U.S. Midwest. Single-structured in-depth interviews with open-ended audio-taped questions were conducted with each APN. Through this process, APNs defined what they consider to be relevant themes and patterns of clinical decision system use in their critical care practices, and they identified the interrelatedness of the conceptual categories that emerged from the results. Data were analyzed using the constant comparative analysis method of qualitative research. CONCLUSIONS: APN participants were predominantly female, white/non-Hispanic, had a history of access to the clinical decision system used in their critical care settings for an average of 14 months, and had attended a formal training program to learn how to use clinical decision systems. "Forecasting decision outcomes," which was defined as the voluntary process employed to forecast the outcomes of patient care decisions in critical care prior to actual decision making, was the core variable describing system use that emerged from the responses. This variable consisted of four user constructs or components: (a) users' perceptions of their initial system learning experience, (b) users' sense of how well they understand how system technology works, (c) users' understanding of how system inferences are created or derived, and (d) users' relative trust of system-derived data. Each of these categories was further described through the grounded theory research process, and the relationships between the categories were identified. IMPLICATIONS FOR PRACTICE: The findings of this study suggest that the main reason critical care APNs choose to integrate clinical decision systems into their practices is to provide an objective, scientifically derived, technology-based backup for human forecasting of the outcomes of patient care decisions prior to their actual decision making. Implications for nursing, health care, and technology research are presented.     

The mental health nurse practitioner in the emergency department: an Australian experience

This paper describes the establishment of a mental health nurse practitioner (MHNP) position in New South Wales, Australia. The authors report on a MHNP role that functions collaboratively within a large inner city emergency department. Attention is centred on what constitutes advanced mental health nursing practice in the emergency department setting. Three areas associated with the work of MHNPs--therapeutic techniques, prescribing and care coordination and referral--are highlighted to explore the scope of the MHNP role. The authors propose that the success of this position is based on a process of consultation and evaluation, partnership between disciplines and clinical services and the role maintaining a truly nursing focus rather than attempting to replace or replicate psychiatric medicine.