Leveraging palm technology in the advanced practice nursing environment

The use of personal digital assistants (PDAs) in healthcare has expanded exponentially in the past several years. In addition to common feature functions such as contact lists, calculators, calendars, and expense logs, current PDAs boast a wide variety of practical healthcare-related applications such pharmacologic databases, infectious disease programs, medication calculators, and patient scheduling and billing applications. This article examines PDAs in general and the Palm series of handheld devices in particular for use in the advanced practice setting. These devices have several implications for advanced practice nursing including support of both differential diagnosis and diagnostic reasoning, reduction of medication errors, and development of effective treatment protocols. Personal digital assistant technology will inevitably become part and parcel of advanced practice nursing. The rapid, almost daily, changes in the healthcare environment require immediate access to the myriad resources and databases used by advanced practice nurses. Personal digital assistant technology provides such access.     

A study of personal digital assistants to enhance undergraduate clinical nursing education

This study reports on personal digital assistants (PDAs) as a means to prepare nurse professionals who value and seek current information. An interdisciplinary team of nursing and library faculty, information technology and bookstore staff, students, and educational consultants developed this project. A pre-post and comparative group design of second-degree students in the accelerated and traditional baccalaureate nursing degree (BSN) options was used to examine students' information-seeking behaviors, and the effectiveness and cost of innovation strategies associated with incorporation of PDAs into students' clinical practice. Results of this study support PDAs as an effective student learning resource, especially for reference materials. The student group with PDAs had increasing numbers of questions associated with clinical situations and a greater recognition of the need to use current resources. Students made substantial use of their PDAs and health team members, while decreasing reliance on textbooks and clinical faculty. Students' use of and satisfaction with this technology is linked to access speed and readability. Providing faculty with PDAs is recommended to enhance their comfort with and incorporation of PDAs into clinical teaching.     

Benefits and costs of integrating technology into undergraduate nursing programs

Advances in technology over the last decade have resulted in increased opportunities for educators to become more innovative in classroom and clinical teaching. These innovations have allowed students and faculty to access essential clinical information at the point of care/need. By capitalizing on technologies such as personal digital assistants and course delivery shells, faculty and students have both portable and remote access to information that can guide practice and learning activities in clinical, classroom, and distance settings. For instance, a student can use a personal digital assistant to research a patient's new medication at the bedside, study course information, access references during class in response to a question, or download clinical materials from home. Although the benefits of having ready access to information seem obvious, there are costs and strategic planning activities associated with implementing these projects. Clearly, the objective of any academic nursing program is to develop skills among students so they can efficiently access information and use that information to guide their nursing practice. To do so, academic nursing administrators must have the forethought to envision how new technologies can support achieving this goal as well as the ability to put in place the infrastructure supports needed for success. This article presents a case study of how one institution developed the necessary infrastructure and garnished the appropriate resources to implement an ambitious technology initiative integrated throughout a large undergraduate nursing program. In addition, how the integration of technology, online and mobile, can enhance clinical learning will be discussed.     

Introducing personal digital assistants to enhance nursing education in undergraduate and graduate nursing programs

This article describes how a school of nursing implemented an innovative program to introduce personal digital assistants to undergraduate and graduate nursing students. Undergraduate students studying pharmacology and nurse practitioner graduate students in an adult health course were asked to purchase a personal digital assistant privately or through the university bookstore. Faculty selected an appropriate software package. After students were oriented to the hardware and software package, innovative teaching strategies were implemented to help guide students to use their mobile devices to access clinically relevant information. Student feedback about this experience was positive. The most important elements for successful adoption of personal digital assistants are to provide training for both faculty and students, and to develop learning opportunities using the technology. Use of mobile technologies is an important competency that will improve the quality of nursing practice and therefore should be included in nursing curricula.     

Mobile technology: lessons learned along the way

Although mobile technology has the potential to promote patient safety by increasing accuracy and efficiency, faculty may find instituting a personal digital assistant (PDA) program overwhelming. In addition, there is a dearth of information on how students are using this technology. The authors discuss the implementation of a PDA program that required all nursing students entering their first clinical rotation to purchase a PDA loaded with nursing software and describe how the students used this technology. Lessons learned along the way are emphasized to help faculty develop, implement, and/or improve their school's PDA/software program.     

Personal digital assistants change management more often than paper texts and foster patient confidence.

INTRODUCTION: Rapid retrieval of information, including drug treatment options, is critical to emergency department practice. OBJECTIVES: To assess feasibility and patient acceptance of personal digital assistants and to determine the scope of management changes. METHODS: Emergency medicine residents (EMRs, n = 18) and emergency medicine attending (EMAs, n = 12) used personal digital assistants with drug database and clinical references. Text versions were also available in the emergency department. We did a prospective, random, cross-over time-motion study, recording retrieval time, source, and changes to patient care for 16 and 8 h for EMRs and EMAs, respectively. We surveyed patients for confidence in EMRs and EMAs with personal digital assistants, and perceived efficiency. RESULTS: EMRs accessed paper (n = 131) or personal digital assistant (n = 181) information on 92.3% of patients (n = 17, both). They accessed personal digital assistant on 61.4% of patients vs. 44.5% with texts (odds ratio 1.99, 95% confidence interval 1.4-2.80). Mean access times were 9.3 and 9.4 s, respectively, +1.4 for both. Personal digital assistant access was 75%/25% between pharmacopeia and clinical resource. Personal digital assistants changed drug choice in 39/181 patients (21.5%), and other management (diagnosis, treatment or disposition) in 15/181 patients (8.3%). Odds ratio for change in management for personal digital assistant vs. paper was 2.00 (95% confidence interval 1.11-3.60). We surveyed patient perception for 198 of 295 patients (67.1%). Fifty percent reported more confidence in their EMRs and EMAs with a personal digital assistant, while 5% reported less confidence. Sixty percent agreed strongly that there is too much medical information to remember. CONCLUSIONS: Personal digital assistants are feasible in an academic emergency department and change management more often than texts. EMRs accessed personal digital assistants more often than paper texts. Patient perceptions of physicians who use personal digital assistants are neutral or favorable.     

Tracking clinical use of personal digital assistant reference resources

Mechanisms are needed to evaluate the effectiveness of ever-increasing technological resources for nursing student use. The authors tracked the use of personal digital assistants versus textbook resources by junior-level baccalaureate nursing students throughout 1 semester. The authors discuss the results of that activity and provide a starting point for the evaluation of the use of personal digital assistants by nursing students.     

Infusing PDA technology into nursing education

Use of the personal digital assistant (PDA) has been infused into the accelerated baccalaureate program at Duke University to help prepare nursing students for professional practice. The authors provide an overview of the use of PDAs in the classroom, laboratory, and clinical setting. Technical aspects of PDA infusion and steps to ensure regulatory compliance are explored. Benefits of PDA use by both faculty and students in the program and challenges met with the infusion of this technology are also described.     

Medication error reduction and the use of PDA technology

The purpose of this study was to determine whether nursing medication errors could be reduced and nursing care provided more efficiently using personal digital assistant (PDA) technology. The sample for this study consisted of junior and senior undergraduate baccalaureate nursing students. By self-selection of owning a PDA or not, students were placed in the PDA (experimental) group or the textbook (control) group, provided with a case study to read, and asked to answer six questions (i.e., three medication administration calculations and three clinical decisions based on medication administration). The analysis of collected data, calculated using a t test, revealed that the PDA group answered the six questions with greater accuracy and speed than did the textbook group.     

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。     

Personal digital assistant applications for the healthcare provider

OBJECTIVE: To review some common medical applications available for personal digital assistants (PDAs), with brief discussion of the different PDA operating systems and memory requirements. Key search terms included handheld, PDA, personal digital assistants, and medical applications. DATA SOURCES: The literature was accessed through MEDLINE (1999-August 2002). Other information was obtained through secondary sources such as Web sites describing common PDAs. DATA SYNTHESIS: Medical applications available on PDAs are numerous and include general drug references, specialized drug references (e.g., pediatrics, geriatrics, cardiology, infectious disease), diagnostic guides, medical calculators, herbal medication references, nursing references, toxicology references, and patient tracking databases. Costs and memory requirements for these programs can vary; consequently, the healthcare provider must limit the medication applications that are placed on the handheld computer. CONCLUSIONS: This article attempts to systematically describe the common medical applications available for the handheld computer along with cost, memory and download requirements, and Web site information. This review found many excellent PDA drug information applications offering many features which will aid the healthcare provider. Very likely, after using these PDA applications, the healthcare provider will find them indispensable, as their multifunctional capabilities can save time, improve accuracy, and allow for general business procedures as well as being a quick reference tool. To avoid the benefits of this technology might be a step backward.     

Handheld computers in nursing education: PDA pilot project

Interest in the use and application of handheld technology at undergraduate and graduate nursing programs across the country is growing rapidly. Personal digital assistants (PDAs) are often referred to as a "peripheral brain" because they can save time, decrease errors, and simplify information retrieval at the point of care. In addition, research results support the notion that PDAs enhance nursing clinical education and are an effective student learning resource. However, most nursing programs lack the full range of technological resources to implement and provide ongoing support for handheld technology use by faculty and students. This article describes a 9-month pilot project for the initial use of PDAs by novice faculty and students at Simmons College.     

Multiple sclerosis pathways: an innovative nursing role in disease management.

Multiple sclerosis (MS), a chronic disease of the central nervous system, is characterized by a variable and unpredictable course. The most common pattern of the disease is the relapsing-remitting form in which clearly defined relapses (also called exacerbations) are followed by complete or incomplete recovery. Interferon beta-1b (Betaseron), a drug that affects the natural course of the disease, was developed for the treatment of relapsing-remitting MS. Multiple Sclerosis Pathways (MSP), a disease management program, was developed to provide comprehensive and personal support to MS patients taking interferon beta-1b and to serve as an information resource for all people with MS, their families, and healthcare professionals. The MSP program includes personal patient assistance, reimbursement services, a 24-hour nurse hotline, training program, educational resources, and injection supplies. The nurse hotline counselor (NHC) utilizes the nursing process in a unique telephone nursing practice in this program. The positive impact of education and support on adherence to therapy has been validated by training and nurse hotline data.     

Update on personal digital assistant applications for the healthcare provider

OBJECTIVE: To review the common general drug information applications and specialty drug information applications available for personal digital assistants (PDAs). DATA SOURCES: The literature was accessed through MEDLINE (2003-June 2004). Other information was obtained through secondary sources, such as Web sites describing common PDA applications as well as actual product trials. The key search terms used were handheld, PDA, personal digital assistants, drug information, pharmacokinetics, medical information, and medical applications. STUDY SELECTION AND DATA EXTRACTION: Articles or studies that provided a review of drug information references for the PDA since 2002 were included. Data pertaining to cost and application size were obtained from product or vendor Web sites. DATA SYNTHESIS: There are numerous medical applications available for the PDA including general drug information references, specialty drug information references (eg, pediatrics, cardiology, infectious diseases, oncology, psychology, herbals), diagnostic applications, medical calculators, nursing references, and patient tracking databases. Due to the huge array of programs, as well as factors such as cost and memory requirements, the healthcare provider must be selective in the medical applications that are placed on the PDA. CONCLUSIONS: There are many excellent PDA drug information applications that provide fast and accurate drug information and other features that assist the healthcare provider.     

Information technology in nursing: using the decision-making support system in the OPD nursing instruction information system

In line with Department of Health promotion of electronic medical records, health care institutions have increased their information technology facilities in order to improve medical quality and patient safety, streamline healthcare procedures, reduce hospital management costs, and increase the use of statistical analysis in medical teaching, research and administration. However, applying information technology must consider many factors apart from system design and development. Such other factors include effectiveness in reducing user reliance on memory faculties, ability to streamline work processes, and capacity to recommend viable decisions. This paper provides an example of the nursing instruction information system deployment process. In addition to describing the development and implementation, applications of patient education and nursing decision-making are also presented. It is hoped that this experience may serve as reference to other healthcare institutions in the process of building nursing information systems.     

Empowering a safer practice: PDAs are integral tools for nursing and health care

hudson k. & buell v. (2011) Journal of Nursing Management  19 , 400–406
Empowering a safer practice: PDAs are integral tools for nursing and health care Aim This study’s purpose was to assess the characteristics of personal digital assistant (PDA) uptake and use in both clinical and classroom work for baccalaureate student nurses (BSN) within a rural Texas university. Background Patient care has become more complicated, risk prone, automated and costly. Efficiencies at the bedside are needed to continue to provide safe and successful within this environment. Method Purposive sample of nursing students using PDAs throughout their educational processes, conducted at three campus sites. The initial sample size was 105 students, followed by 94 students at end of the first semester and 75 students at curriculum completion at the end of a 2-year period. Students completed structured and open-ended questions to assess their perspectives on PDA usage. Results Student uptake varied in relation to overall competency, with minimal to high utilization noted, and was influenced by the current product costs. Conclusions PDAs are developing into useful clinical tools by providing quick and important information for safer care. Implications for nursing management Using bedside PDAs effectively assists with maintaining patient safety, efficiency of care delivery and staff satisfaction. This study evaluates the initial implementation of PDAs by students, our future multitasking nurses.