Personal Digital Assistants and Nursing - Essay Example

Personal Digital Assistants (PDAs) and Nursing Introduction Nursing is largely a people-dependent profession that relies mostly on a humane approach and personal care. However, excessive dependence on this aspect divorced from technology solutions can at times lead to major human errors, especially in the matter of administering the correct prescriptions. Human errors in nursing may result from constraints in communication, comprehension, memory, time and distance. In this era of information and technology applications across all domains, nursing as an important activity in healthcare management can ill afford to ignore computer-enabled information and communication technology (ICT) solutions in preference to conventional point-of-care methods of nursing. As Pottruck and Pierce (2001) observed, "the growing global market in information has driven advancements in technology so powerful that the traditional barriers of time, distance, and form are now transcended by universal, ubiquitous connectivity and international protocols for information transfer and translation." Personal digital assistants (PDAs) have today emerged as an increasingly used information technology tool to enhance the quality and speed of patient care services. While mobile computing has claimed a rightful stake as the "next technology frontier for healthcare providers", a whole range of applications, such as "data capture and retrieval using a PDA by physicians, nurses and allied healthcare professionals, are enhancing patient care and improving efficiency." (Rnpalm.com, 2005). This paper attempts to examine the role that PDAs can play in minimizing the problem of human errors with a view to maximizing the efficiency of nursing services. What is a PDA Webopedia (2005) defines a PDA or personal digital assistant as "a handheld device that combines computing, telephone/fax, Internet and networking features." Also known under the names, palmtop, pocket computer, or handheld computer, a PDA can also double up as a personal organizer, Web browser, or cellular phone. This pocket-sized mini-computer is capable of storing large chunks of voluminous information and "a variety of searchable databases useful to nurses" that include calendar, address book, clinical notes, reference books and drug lists, assessment tools and laboratory values, IV drug and infusion information, and even games (Quan, 2005). Nurses can thus have access to this large library of digital information on real time whenever they need. The range of useful PDA applications for nurses includes preparation, saving, and retrieval of daily schedules, charge capturing, e-prescribing, clinical tools, patient care education tools, research and reference. Wilcox and La Telle (2001) see the personal digital assistant as "a new medical instrument for the exchange of clinical information at the point of care". The Solution The lacunae in people-based nursing systems in general and that of human errors in particular arise from a number of factors that include the following: Manual scheduling and writing of prescriptions Manual observation and noting of clinical parameters Possibility of mixing up prescriptions Memory problems that some nurses may suffer from Extra time taken to operate in the conventional ways Inadequate references and knowledge content available to nurses at points of care Inability to access physicians or experts on real time in case of doubts The majority of these problems can be eliminated by using a state-of-the-art PDA as an essential tool in the hands of nurses. Digitally prepared schedules can be stored on PDAs and accessed on real time basis by nurses. This not only eliminates paper-based schedules, but also enables additional assistance tools such as programmed alerting by the PDA. The time and date at which certain prescriptions need to be administered to a patient can be entered and saved to generate alerts. Digital entries will not be subject to any possibility for errors due to mix-up of prescriptions. Conventional practice depends upon manual noting of clinical parameters and physiological readings, which is not only time-consuming but also prone to errors in transcribing. Today PDAs can be linked to electronic clinical and diagnostic gadgets to register periodical readings. With mobile computing features, these can be transmitted on real time basis to the physicians or specialists, who in turn can convey their follow-up prescriptions instantaneously online. Yet another advantage is that a nurse with a PDA can perform multiple tasks in hand. While the nurse is attending to a patient, digital prescriptions or information pertaining to other patients can still flow into the PDA to be retrieved and acted upon by the nurse on completion of the first task. Programming of priority tasks with alerting functions can also be done on a PDA, which makes the job of a nurse more efficient and error-free. Vital omissions due to failure of memory can prove to be fatal in patient care. With a PDA programmed alert mechanism, such errors can invariably be averted. Medical repertoire, drug lists, and reference books are always available on fingertips for a nurse with a PDA. The greatest of all advantages in using a PDA lies in the enabling of real time communication between nurses, physicians, wards, and administrators. As Ackerman (2003) noted, a PDA can virtually act as a powerful "portal to knowledge sources in a wireless setting." PDA Hardware and Software Options Early models of PDA were pen-based and used a stylus for input, unlike a keyboard for portable computers. This also meant that they had features enabled for handwriting recognition and response. Today PDAs are available in both versions - stylus as well as keyboard. Apple Computer was among the first companies to bring out a PDA (called Newton MessagePad) in the year 1993 (Webopedia). New generations of PDAs are now available with more sophisticated features and functions, including GPS application and mapping tools that enable navigation and tracking of automobiles. One of the most trusted and state-of-the-art brands today is the Palm Pilot of Palm, Inc. The hardware of a PDA system primarily consists of the Palmtop or the Pocket PC, while software is needed for basic operations, and different applications including mobile/wireless enabling systems. A PDA can normally function in tandem with a desktop PC, and needs to be put in the 'Sync' mode with the hardware unit that is linked to the PC slots. This is done in order to ensure that the database is maintained for future use. When used with a mini modem and portable keyboard, the PDA enables nurses to have access to "schedules, patient charts, extensive medical references, and to fill out and submit nursing forms" (Vanessa & Shroff, 2005). Comprehensive application suites for PDAs useful for nurses are today available from several vendors. One such suite, branded as 'Nursing Constellation' is marketed by the e-store of skyscape.com (2005) for about $87 per piece. The company advertises this PDA application set as a "comprehensive suite of need-to-know clinical, drug, and diagnostic references and tools specially designed for nurses". Yet another vendor, LEXI-COMP (2005) offers a suite of 15 medical databases for PDAs that includes: Palm operating software or Pocket PC software; Lexi-drugs; Lexi-Lab & Diagnostic medicine; Griffith's 5-minute Clinical Consult; and Stedman's Concise Dictionary. A combination of the Palm Pilot and either of the Nursing Constellation or the Lexi-Comp would be ideal for equipping nurses with PDA technology. Standard PC hardware, with Windows XP or Windows NT operating software, a local LAN, enabled with mobile applications (GSM/GPRS), 256 MB RAM memory, 80 GB hard disk, server, firewall and anti-virus, anti-spam security system, broadband connection (Cable/DSL) would also be recommended so that PDA mobility and full utilization can be ensured. Alternative Solution The problems within the solution can be resolved by preparing a cost-effective strategy to introduce PDA-based nursing systems that also include suitable training and familiarization programs for nurses. For instance, limiting the number of PDA units to one shift strength would reduce the cost greatly, while also ensuring that these gadgets are not misused for personal purposes. Nurses need to be motivated and guided to overcome any initial unwillingness to learn the new applications. Conclusion The ICT revolution is currently witnessing a rapid shift of informatics to the wireless and mobile platforms from desktop applications, which spells tremendous possibilities in the days to come. These developments are also bound to have a "significant impact on future healthcare delivery systems and their globalization" (Rnpalm.com). Application of PDAs in nursing services can greatly enhance the quality and speed of healthcare services by improving efficiency, cost, and competencies of nursing staff. It can have wide-ranging applications in patient care, prescription, scheduling, clinical and diagnostic monitoring and follow-up, education and training, research and administration. References Ackerman, F.P, Kim, G., & Locatis, C. (2003). PDA as a portal to knowledge. Telemedicine Journal and e-Health, 9(2), 141-7. Fitzpatrick, J.J., & Montgomery, K.S. (2004). Internet for nursing research: A guide to strategies, skills, and resources. New York: Springer, 55. LEXI-COMP. (2005). Looking for medical software for your PDA: Improving point-of-care decisions. Retrieved December 10, 2005, from www.lexi-com/web/news Pottruck, D.S., & Pearce, T. (2001). Clicks and Mortar: Passion driven growth in an Internet driven world. San Francisco: Jossey-Bass, p. 3. Quan, K. (2005, November 4). What would a nurse do with a PDA About Newsletter. Retrieved December 10, 2005, from http://nursing.about.com/od/nursingsoftware Rnpalm.com. (2005). PDA Cortex. The Journal of Mobile Informatics. Retrieved December 10, 2005, from http://www.rnpalm.com Skyscape.com (2005). Nursing Constellation: All-in-One nursing solution. Retrieved December 10, 2005, from www.skyscape.com/Estore Vanessa & Shroff, S. (2005). PDA for nurses. Retrieved December 9, 2005, from www.medindia.com Webopedia. (2005). PDA. Retrieved December 9, 2005, from http://www.webopedia.com/TERM/P/PDA.html. Wilcox, R.A., & La Telle, R.R. (2001). PDA. Medical Journal of Australia, 175 (11-12), 659-62. * * * * Read More