Rounding out this blog series on mobile health applications (apps) or mHealth apps, I wanted to touch on apps specifically designed to provide educational tools and quick references for the nursing profession. According to a survey conducted by Wolters Kluwer Health, 65 percent of nurses said they currently use a mobile device for professional purposes at the bedside.¹  The study also found that 95 percent of health care organizations allow nurses to consult websites and other online resources for clinical information at work.¹  A major advantage of mobile apps is that they provide a variety of references in one central location, that is easily attainable, from almost anywhere there is a reliable internet connection. Nurses employed in every clinical setting stand to benefit from resources at their fingertips, particularly those in home and public health settings, where access to evidence-based information may be limited.

As discussed in Part 1 of this blog series, there are thousands of mHealth apps available to clinicians. The most common are drug manuals, tools to help evaluate lab and diagnostic studies, and differential diagnosis guides². Utilization of mobile devices in professional nursing practice may improve efficiency and assist clinicians to:

• Complete professional development;
• Stay up-to-date with the latest research and literature;
• Provide patient and peer education;
• Translate medical terms for patients and family members;
• Compute drug dosages;
• Calculate physiologic assessments, such as Body Mass Index (BMI), Mean Arterial Pressure (MAP), Glascow Coma Scale score, Apgar score, Stroke Scale and many more;
• Organize shift work; and
• Communicate with other health care professionals.

With an ever increasing number of mHealth apps on the market, how can nurses decipher which are useful and contain the most relevant and accurate information? In order to utilize these resources effectively, nurses should be competent in several key areas, including basic computer knowledge and use, information literacy, (IL) and information management³. Information Literacy (IL) is defined as the ability to recognize when information is needed and to locate, evaluate, and effectively use that information. Therefore, nurses must be able to assess mHealth apps for accuracy, credibility, bias, timeliness, and breadth of information.³  A study, conducted by Arith-Kindree and Vandenbark (2014), asked nursing students to assess a variety of mobile apps for usefulness. The study found that some apps, while from reputable sources, provided recommendations that were incomplete.³  Based on the findings from this study, nurses should critically evaluate each app to ensure it is:

• Credible – verify the author’s credentials, publisher’s reputation, and peer-review status;
• Relevant – assess the intended audience, purpose, and publication date;
• Current – check that the content is consistently updated on a regular basis;
• Utilitarian – confirm the app is useful and functions as it was designed; and
• Comprehensive – establish that the information is complete and derived from a trusted source.

Health care apps can serve as useful tools for clinicians at the bedside, however, there are logistical and cultural obstacles that stand in the way of implementation and utilization. This opens up many opportunities for nurses in the field of informatics to develop policies, organizational infrastructure, and competencies for integrating mHealth solutions within health care organizations and communities.⁴  Several challenges, however, must be overcome which include:

• Establishing hospital administrator support;
• Overcoming staff resistance to change;
• Training to different learning styles and comfort levels with technology;
• Securing patient confidentiality;
• Cost of infrastructure and maintaining consistent internet access;
• Preventing vital machine failure or malfunction due to interference from handheld devices; and
• Ensuring that mobile devices are not a distraction in the workplace.

Digital tools can potentially make us more efficient, effective, and informed practitioners. We are fortunate to live in an age of innovation where tools are available at our fingertips, any time, and anywhere. Unfortunately, not all mHealth apps are accurate and some cannot be trusted. We, as health care providers, need to develop a critical eye when evaluating the use of new technologies and verify that they are consistent with evidence based practice prior to full integration into the health care delivery system. In addition, more research is needed in the area of mHealth to assess the true impact it could have on workflow, quality, and patient outcomes.

References:

1. Wolters Kluwer Health Survey Finds Nurses and Healthcare Institutions Accepting Professional Use of Online Reference and Mobile Technology. (2014). Retrieved on July 11, 2016 from http://wolterskluwer.com/company/newsroom/news/health/2014/09/wolters-kluwer-health-survey-finds-nurses-and-healthcare-institutions-accepting-professional-use-of-online-reference--mobile-technology.html

2. Baca K, Rico M, & Stoner M. (2015) Embracing Technology to Strengthen Care and Enhance Human Connection. Dimensions of Critical Care Nursing, 34(3), 179-80.

3. Airth-Kindree  N & Vandenbark T. (2014) Mobile Applications in Nursing Education and Practice. Nurse Educator, 39(4). 166-169.

4. Austin, R. & Hull, S. (2014) The Power of Mobile Health Technologies and Prescribing Apps. CIN: Computers, Informatics, Nursing, 32(11). 513-515. 

Myrna B. Schnur, RN, MSN 

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