The call of the smartphone

Author
Nienke Beekers
Published on
23-11-2018
Category
Columns

 

The expression ‘Do you have what it takes?’ has never been so apt when it comes to nursing. There seems to be a constant battle between spending time at the patient’s bedside and registering data accurately. Nursing staff spend no less than 35% of their work time entering and retrieving data [1]. Clinical computer scientist Nienke Beekers examined how a smartphone can help nursing staff to work more efficiently.


“It is often said that developments in healthcare are slow. This is true to some extent, although it is often with good reason. Furthermore, the use of technology in the workplace has turned out to be more difficult than it is at home. I was very interested to find out what nurses thought about the use of ‘smart devices’. Almost all of them use such devices a lot in private, and would be happy to do so in the workplace too. They have plenty of ideas about how smartphones could be integrated in the workplace, and about how things could be improved.”


When it comes to processing and retrieving information, nursing staff generally use the PC at the nurses’ station or a computer on wheels (COW). These static communication media are not sufficiently in line with the dynamic and unpredictable nature of nurses’ work. This means that nursing staff often lack access to the resources they need to carry out their work efficiently.

The study
As part of the study, 25 nurses took part in an in-depth interview. In order to test the interview results qualitatively, a digital questionnaire was drawn up based on input from the interviews. This questionnaire was filled in by 100 nurses from approximately 25 different hospitals.

A lack of up-to-date information

If patient data cannot be entered or retrieved immediately, it can have various negative consequences. One example is in the event of emergency cases, when there is a lack of up-to-date information because the latest information on the patient’s state of health is known only by the nurse. It is not yet recorded in the patient’s electronic health record and therefore not available to other healthcare providers. Moreover, this means that nursing staff often have to walk over to a PC or COW. This is not only a significant waste of time, but indirectly increases the risk of mistakes because nurses meanwhile have to remember which information they wanted to look up or enter..

Which tasks do nurses want to use smartphones for?

In order to determine how a smartphone could help nursing staff in their work, an inventory was made of the entire nursing process and the accompanying information requirements. In-depth interviews and questionnaires clearly showed which processes could be improved through the use of a smartphone. Nurses considered the smartphone’s camera function to be an important advantage, with respect to wound healing, for example. By taking photos, the healing process can be accurately tracked and documented. Nurses would also like to use a smartphone for the following tasks: to register vital signs such as respiration, heart rate and body temperature, to record EWS and VAS scores, and to register patients’ medication. With regard to information retrieval, nurses would also like to have immediate access to results and vital parameters as well as protocols.

In addition to processing and retrieving information, smartphones can be implemented on a wider scale using additional applications and actively providing others with information. The study showed that nurses require the following functions in particular: The‘Farmaco-therapeutisch Kompas’ app (a wide spectrum of information on prescribing and pharmacology) (72%), followed by a barcode scanner (68%), a calculator (63%) and Google Translate (48%). The option to receive reminders is a function that many nurses would particularly appreciate having. Above all, they would like to receive a reminder when results are available and when medication has to be administered (at non-standard times). It has been shown that this helps nurses as they don’t forget clinically relevant procedures as often [2]. It is important, however, that nurses themselves determine what types of reminder they receive in order to prevent alarm fatigue.

In addition to the useful functions that a smartphone offers, its main advantage is the continual access to information which means that nursing staff work more quickly and more safely. One study participant wrote the following: ‘A smartphone gives you independence from a static workplace. You can access information anywhere and at any time (…). The nursing process with all its obligations and protocols is too extensive to remember by heart.’.

Potential disadvantages and benefits

The study also examined the potential disadvantages of smartphone use. Nurses consider the impersonal character of a smartphone a disadvantage, asking themselves whether they would still speak to colleagues if they used a smartphone so much, and whether they would still give patients enough attention. Nurses also wonder what patients think about the use of a smartphone. They also wondered if patients would know they were using a phone for work and not to make private arrangements.

If hospitals or healthcare facilities want to start using smartphones, it is important that their functionality and apps communicate directly with electronic patient health records. This prevents nurses having to register information twice over. It is also important that the smartphones used are specially designed for use in healthcare and that they are durable and can be cleaned properly. Finally, if smartphones really are implemented in healthcare, it is important that practices and processes are completely adapted for use with a smartphone.

Conclusion

Smartphones make most data processes quicker and better for nurses. They are particularly suitable for small amounts of data, which nurses can quickly enter or retrieve, such as the results of vital functions and EWS and VAS scores. Smartphones also provide access to supporting and compact apps and functions, such as the ‘Farmacotherapeutisch Kompas’ app, calculator and camera. Extensive desk work such as reading and writing reports are less suitable tasks to carry out with the smartphones. Nurses prefer to do these tasks at a PC.

References

  1. Keenan G., et al. Challgenges to nurses’ efforts of retrieving, documenting, and communicating patient care information. Journal of the American Medical Informatics Assocation, 20, 245-251. 2012
  2. Piscotty R. J., et al. Electronic nursing care reminders: implications for nursing leaders. The journal of nursing administration, 5, 239-242. 2015

Nienke Beekers

Nienke Beekers (28) completed her study as a trainee Clinical Information Scientist (PDEng) at the Technical University in Eindhoven. She had previously gained a PhD in ‘Health Education and Promotion’ with cum laude honours from Maastricht University. Nienke now works as a Clinical Information Scientist/Project Manager at Amphia Ziekenhuis in Breda (the Netherlands). The study was commissioned by Ascom. Ascom optimises
workflows using ICT solutions and developed the MyCo, a purpose-built smartphone for healthcare.