Just as Charles Darwin believed in evolution and survival of the fittest for the natural world, the same can be applied to the medical profession. In an ever-changing and over-regulated field, hospitals must make themselves more abreast and compatible with modern technology to adapt and survive.
An influential nurse educator once taught us, "it's not knowing the answer to everything; it's knowing where to find it." This concept is wonderful in that it allows registered nurses to understand that they do not have to know everything, but the problem is in where these resources are kept. In the real world, these answers are hidden within endless binders of machine operation, medication calculation, and titration tables, policies, and procedures. These typically have a table of contents that has items scratched through in pen with whiteout dotted about the page, the included documents are not the latest revision, and to top it all off, this information is probably tucked away in a locked med room or hidden in the back of a cabinet[horizontal ellipsis]not accessible in an emergency. If the facility has this information in an electronic database, searching for them would mean leaving the patient to find an available computer and then relying on the mercy of those responsible for naming these documents as something easy to retrieve via key word search. This all too often leads to irritated discussions about how nothing is retrieved using the search terms such as central line and having to use the exact terminology of central venous catheter. These antiquated systems are not only frustrating, they also are time-consuming and inconsiderate of the ever-increasing workload of the bedside nurse. Simpler solutions are available and more cost effective-especially for an arena where every minute counts, but why would a nurse's greatest tool in providing safe and necessary care be banned?
BACKGROUND
Although everyone has the same goal of safe and effective patient care, there are significant barriers to the utilization of mobile devices within any treatment setting. Many hospitals have implemented policies for banning nurses and staff from carrying or using personal mobile phones within patient care areas. This controversy toward advancing personal technology began with the inception of the Health Insurance Portability and Accountability Act of 1996. These standards initiated the first wave of fear of mobile device usage in or near patient care areas, with the main concern being potential violations of patient confidentiality. By banning the use of cell phones and having strict consequences for violators, many hospitals felt that they had regained control over potential security breaches.
Another fear was the potential risk of vital machine failure or malfunction due to interference from cell phones and electronic devices within the acute care setting. Some early studies have demonstrated that equipment such as monitors, ventilators, and intravenous pumps were affected by cell phone electromagnetic interference. This cannot be attributed solely to the phone itself; there are many factors to consider, such as whether the device is 2G, 3G, or 4G; the signal strength within the facility; and the age of hospital equipment. Instead of investigating safety concerns or addressing the need for updating equipment, several hospitals simply prohibit the use of cell phones, especially in the critical care environment.
BENEFITS: PARADIGM SHIFT
"Technology, when implemented well, has the potential to revolutionize the way in which care is delivered, but the attitudes of health-care staff towards new technologies will play an important role."1 Instead of reacting to modernization of technology with fear, hospitals and their administrative team should strive to educate themselves and use such equipment to their benefit. There are several benefits to the use of mobile devices within the hospital setting. First and foremost, using mobile devices is convenient and cost effective for facility implementation, as most staff already own personal devices. Mobile phones allow for all resources to be located within a single-compact source and can be easily carried, and these resources can be updated and regulated through specific applications or "apps" as well as designated platforms per facility standards. For facilities that wish to maintain control of such technology, some hospitals provide mobile devices for their staff with approved apps and information preprogrammed, an ability to limit inappropriate usage, and a lockout function should the device leave the property. This may be an initial investment for the hospital, but it can allow for greater control and security.
FORESEEABLE CHALLENGES
One of the major challenges that the health care field faces in facilitating the use of technology at the bedside is addressing appropriate learning styles for their staff population. Most new nurses can be considered millennial learners, which are more responsive to the utilization of technology, interaction, and a group-oriented approach.2 The other majority of current practicing nurses are considered the population of "Generation X," which includes those who were born from 1965 to 1974.2 According to Billings and Halstead,2 this older population may require more attention, remediation, and a variety of learning modalities to become more comfortable with changes in technology such as mobile devices. Existing generation gaps between health care providers can affect the level of comfort and knowledge they have in technology utilization for improvement of patient care. Training for the appropriate use of mobile devices will require the development of educational programs that can accommodate all educational levels and learning styles.
In addition, many administrative teams will have to adapt their gatekeeper mentality to allow for the influence of technology for the betterment of nursing satisfaction as well as patient care and satisfaction.
LIFESAVING MOBILE APPS
Mobile applications are software programs for smartphones and other handheld devices. There are thousands of apps available for download; the most common mobile apps for health care workers are electronic drug manuals, drug calculators, tools to help evaluate laboratory and diagnostic studies, and differential diagnosis guides. Having access to this information in a portable source allows for convenience and fewer wasted minutes in critical scenarios. Imagine that a nurse has a patientwho is crashing, and that nurse can calculate the necessary dosage and rate for vasoactive infusions without leaving the room; these types of applications are not only time saving, they are also life-saving!
4 WAYS YOU CAN SAVE YOUR PATIENT'S LIFE WITH YOUR CELL PHONE
1. Drug guides/dosage calculators: These apps allow for a concise and easy-to-navigate interface that allows the user to directly access information. In addition, updates can be made electronically through downloading current versions as medications change.
2. Barcode/QR code scanning: Some hospitals have specialized barcodes/QR codes that are placed on their equipment so that staff members can scan the device with their smart phone and then be presented with a brief video on product use or troubleshooting.
3. iTranslation: Being able to communicate with a patient is vital for obtaining an accurate and comprehensive assessment, discussing treatment plan, and determining the effectiveness of nursing care and evaluation of outcomes. It is important that the patient has understood what you are communicating. This app offers translations for more than 50 languages and phrases and includes voice recognition and conversation mode.
4. Preprogrammed contact lists: Some facilities provide preprogrammed phones with resources and physician phone lists, eliminating the need to search for contact numbers via antiquated systems. This is also considerate of the physician as they can contact the requesting nurse directly.
DISCUSSION
Mobile apps for nurses will revolutionize nursing as we know it today; smartphones have enormous potential both as communications devices and for giving access to reference and training materials. Nurses must advocate for and take action toward the advancement of their profession, as this will ultimately help to facilitate the needs of patients and their families. Consider how the utilization of such technology would benefit your facility and your practice. Patient privacy is and will continue to be a concern, but the benefits to using smartphone technology far outweigh the risks when supported appropriately. "When barriers are recognized and addressed, mobile technologies can change working lives, facilitating rapid access to information and supporting efficiency in practice."1
Katherine Baca, RN, MSN, PHN, CCCC
Graduate Student
California State University
San Bernardino
Melissa Rico, RN, MHA, MSN, PHN
Graduate Student
California State University
San Bernardino
Marilyn Stoner, RN-BC, PhD
Professor
Department of Nursing
California State University
San Bernardino
References