Rita Truex- Module 1
Moore, S., Anderson, J., & Cox, S. (2012, October). Pros and cons of using APPS in clinical practice. Nursing Management-UK, 19(6), 14-17. ISSN 1354-5760. Retrieved from CINAHLhttp://resources.njstatelib.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=2011704980&site=ehost-live
Reviewing technology articles that relate to nursing use of
technology to inform their practice is of interest because evidence based care
relies on clinicians having real time, valid and reliable information to
implement best practices. Applications that are available for purchase for use
on smartphones (commonly referred to as APPS), can be a time saving way to put
best practices directly in the hands of nurses who provide care. In the United
States, Dolan (2012) found that seventy one percent of nurses use smartphones
for work, while Krauskopf (2012) found that there was a dearth of literature
available about the adoption of smartphone for clinical practice by nurses.
The authors of this
literature review article found that smartphone APPS are not regulated and
require nurses with the skills to evaluate the validity and reliability of the
information the APPS provide. Pravikoff and Tanner (2005) found that the vast
majority of nurses were not ready to implement evidence based practice because
they were unprepared by their education and did not have the tools to obtain or
evaluate research. In my experience as a staff development educator and a
clinical adjunct instructor for an Associate’s Degree nursing program, I find
that many students use smartphone APPS for clinical information, while usage by
nurses I work with is mixed despite most owning smartphones. The students are not
required to purchase smartphone APPS at this particular school of nursing, and
there is no requirement that I am aware of for them to demonstrate that the
applications are valid and reliable. Perez-Pena (2012) noted that some schools
of nursing encourage students to have a set of APPS because there is so much
data and information available today that it would be impossible to memorize it
all, but there was no mention of whether the school had evaluated the APPS.
The use of smartphone applications has several implications for
nursing practice. Nursing care could be transformed by having valuable information
available at the point of care, which could reduce medication and treatment errors
and improve outcomes. At the same time, technology has developed faster than
nursing education and practice and leaves the individual nurse with the task of
determining if the APPS available are appropriate, valid tools for their practice
environment. It appears as though APP technology will be embraced by nurses. Thus
the conundrum of how to evaluate APPS that are purchased by the individual
nurse is one that nursing leaders should consider. Krauskopf (2012) listed
several sites that evaluated and recommended health APPS; this is a good start
but leadership should make it a priority to educate all nurses about which APPS
are appropriate and how to evaluate new APPS as they become available.
Regulation of health related APPS should also be implemented to require developers
to adhere to health literature standards, which will increase confidence in APP
use.
This has been an interesting topic as I was aware that there is a
need to evaluate information on the internet, but while I have several clinical
APPS on my smartphone, I had not considered researching the validity and
reliability of most of them. I am however, drawn to names I am familiar with
such as the American Geriatric Society, The Registered Nurses Association of
Ontario, Lippincott and Medscape. I feel there is a need for ongoing education in the area of evidence based practice and in the evaluation of sources and am considering now whether it should be included in my agency orientation program.
References
Pravikoff, D. S., Tanner, A. B., & Pierce, S. T.
(2005, September). Readiness of US nurses for evidence based practice: Many
don’t understand or value research and have had little or no training to help
the find evidence on which to base their practice. American Journal of Nursing, 105(9),
40-51.
Rita
ReplyDeleteThis is a good article and I would agree that our current understanding of nurses who use smartphones, apps, and social media is limited...while the NCSBN has a white paper on the use of social media by nurses there is really not much more than this type of publication...
I did find that the Online Journal of Nursing Informatics devoted its September 2012 edition to several articles on social media use, including one on its uses in education...
Nice work with your posting and I agree that social media understanding should be a part of orientation for nurses...did you have a specific focus in mind???
Donna
National Council of State Boards of Nursing. (2011). White paper: A nurse's guide to the use of social media. Retrieved from https://www.ncsbn.org/Social_Media.pdf
Online Journal of Issues in Nursing. (2012, September). 49. Social Media and Communication Technology: New “Friends” in Healthcare. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/JournalTopics/Social-Media-and-Communication-Technology
Donna
DeleteI was not specifically concerned with the social aspect of smartphones for this particular assignment. Although we are currently revising our social media policy at work, so these resources are invaluable. My focus here was how nurses use smartphone apps to enhance their practice and gain knowledge. I have found that often best practices are researched by management but the information is not necessarily relayed to the bedside nurse.Smartphone apps, if used correctly, can be a form of computerized decision support, helping nurses gain a better understanding of the data they have collected and transforming that data to information, actionable knowledge and eventually wisdom that they can apply to future situations. An example of this might be a nurse who has a smartphone app that explains lab results with possible disease processes and evidence based interventions. The nurse retrieves a lab result and looks it up on her app,finding the lab result to be outside the normal range, changing data to information. The nurse then reviews the patient's diagnosis, compares it to the information and determines if this lab result is consistent with the diagnosis, gaining knowledge of the patient's disease state. Assuming the lab result is an indicator of the patient's known disease state the nurse then reviews the EBP interventions and revises and implements the care plan according to this new knowledge.
Hi Rita,
ReplyDeleteVery interesting topic! I believe the use of smartphones in the clinical arena is necessary and should be embraced by all clinicians. All of our patients are using them so we must be the experts on the best APPS, not just for ourselves, but for the people we care for! Nurses can play a vital role in advising patients about tools that can promote health and wellness (Wyatt & Krauskopt, 2012). An example of this can include selecting an application for a smart phone that will help a patient manage his or her chronic disease. Just some food for thought.
Reference
Wyatt, T., & Krauskopf, P. (2012). E-health and nursing: Using smartphones to enhance nursing practice. Online Journal Of Nursing Informatics, 16(2), 10-14.
Joy,
ReplyDeleteMy only concern is that there are no regulations for smartphone app developers, it's a for profit industry that is outpacing our ability to keep up. However, there are some very good apps available and the developers of any app for healthcare users such as nurses should be aware that their apps had best meet our expectations of reliable and valid content if they hope to sell them. Our responsibility, as informaticists and educators, is to ensure that nurses understand how to select a valid and reliable source of information, including apps. Similarly, I agree that the same is true for helping patients who own smartphones understand that not all apps are created equal for managing disease states the same way that we would tell them to avoid fad diets or "miracle" cures for diseases. I think apps are an exciting tool for nurses to implement EBP, but we must offer guidance to assist them to select the right tool for their practice.
Using smartphones at work poses a double edge sword. You have the nurse who is looking up a medication dosage to double check what she is about to give a patient and then you have the nurse that is text messaging friends. I personally love the many medical apps and I would rather look up a medication or contraindication on my iphone because it is so much faster than going to the PDR, it is just difficult as a manager to police the good and the bad. The portability supports quick references and tools that make work easier for the nurse, you wonder why hospitals just don’t supply us with small ipods to keep in our pockets. There are also apps that include patient teaching, u-tube videos that assist with wound care and drains. These tools are often much better than what the hospital is offering to the patient. Applications that are highly rated by healthcare practitioners are epocrates, skyscape, Lexi-Drugs, they also include medical calcuators that help confirm dosing (Wyatt & Krauskopf, 2012). The regulations or lack of do scare me and are these all reputable sources. Can there be mis-information? It is a rapidly changing healthcare arena.
ReplyDeleteWyatt, T. H., & Krauskopf, P. B. (2012). E-Health and Nursing: Using Smartphones to Enhance Nursing Practice. Online Journal of Nursing Informatics.
Fiona,
DeleteI can imagine it can be nearly impossible to oversee the use of smartphones that clinical staff own. Nurses should be able to use good judgement to determine that their use of smartphones falls within the employer's policies and procedures for privacy, productivity and or use of evidence based tools.
Rita
Finally I can read your blog and it is excellent and very appropriate for nurses of today. I am a smart phone user and I often look up things when in the OR scheduleing meeting because there are unfamilair terms and equipment. It is a valauble asset as a reference too but I am not using it for patient care. I agree that it is another concept when you are giving a medication based on your app or you are deterimining exactly what a anal manometer is. I do like Medscape, Epocrates, AF quide, spanish medical dictionary and QX calculate. I mainly use them as a second opinion. I understand that there should be some verification if we continue to use these apps for direct patient care.
ReplyDeleteLessons Learned: It appears that smartphone apps can be significantly useful, easily available tools for nurses to use at the bedside to enhance patient care. However, there are issues related to app use; among them, reliability of the information contained in the app, nurses' understanding of how select appropriate apps, infection control related to use of smartphones at the bedside, managerial issues related to nurses' use of smartphones for personal communication and patient privacy issues related to nurses' use of social media. The use of smartphone apps is popular with nurses because there is a lack of available evidence based information at the bedside and app developers have stepped in to fill that gap. As informaticists and nurse managers, we have a responsibility to educate staff in appropriate use of smartphone apps, infection control in regard to smartphone and how to ascertain valid and reliable content. Additionally, policies and procedures should be developed by nurses to address these concerns and to give guidance to staff regarding the use of apps and social media.
ReplyDeleteRita