Personal Digital Assistants in Clinical Practice

1
Personal Digital Assistants in Clinical Practice

• By Katherine Scicchitano

2
Objectives

1. Describe the trend of PDAs in nursing
2. Describe and evaluate the hardware software
   utilized with this trend
3. Assess the role functions of the informatics
   nurse when working with this trend
4. Examine legal issues related to PDAs in nursing
5. Discuss the advantages/disadvantages from a
   nursing perspective

3
What is a PDA

• Acronym for personal digital assistant
• Portable handheld computer
• Extension of your PC or network
• Rapidly emerging technology in healthcare
• 
  (Santori, 2008)

4
Functions of a PDA

• Electronic organizer
• Calendar
• Note taking
• Store contact information
• Calculator
• Email

• File Storage
• Browse the web
• Reminders
• Phone
• Voice recorder
• Camera
• Video

5
Functions of a PDA in Nursing Practice

• Patient information
• Medical reference
• Documentation
• Drug information

• Medical calculator
• Time management
• Web Access
• Email
• (Davenport,1999)

6
Types of PDA Nursing Hardware

• Palm OS
• Palm Tungsten 2
• Sony Clie
• Samsung Black Jack
• Handspring Visor Neo

• Pocket PC
• HP iPAQ
• Casio Cassiopeia
• Toshiba Garmin Ique
• Dell Axim
• (Booten-Hiser, 2005)

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Palm Devices

• Smaller, lighter, less expensive
• Ease of use
  
• Market leader
• More medical software availability
• Largest number of applications
• Requires less memory to run
• Longer battery life
• (George Davidson,
  2005)

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Types of PDA Nursing Software

• Tabers Medical Dictionary, 20th Ed.
• Pocket Guide to Diagnostic Tests
• Ultimate Drug Guide by Davis
• Epocrates
• PEPID RN
• Nurses Manual of Lab Diagnostic Tests
• 
  (PDA Cortex, n.d.)

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Epocrates

• Complete drug formulary reference
• More than 3300 brand generic drugs
• More than 400 alternative medicines
• Black-box warning, contraindications cautions
• Adverse reactions drug interactions
• Pharmacology information, half-life, drug class
  mechanism of action

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Epocrates

• Disease reference
• Lab diagnostic test reference
• Infectious disease information
• Medical calculator
• Available for Palm Pocket PC
• Free downloads available
• http//www.epocrates.com /
• (Yale
  University, 2005)

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Evaluation of Epocrates Usability

• Developed by MDs pharmacists
• Free software available
• Easy installation
• Simple to navigate
• Time-efficient
• Auto-Update function
• Multi-check function
• Allows for confident decision making
• Improves patient care safety

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Mobile Nurse TM

• Clinical nursing information system
• Mobile setting
• Nursing PDA communicates with HIS
• Retrieves patient information and tests
• More efficient, less time-consuming
• 
  (Suszka-Hildebrandt, 2000)

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4 Modules of Mobile Nurse TM
(Sookyung, et al, 2001)
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Review of Mobile Nurse

• Clinical information system
• Used mainly by nurses
• Allows for retrieval of patient information, MD
  order check, nursing documentation, patient care
  plans
• Data transformed at point of care
• Utilized Nursing intervention classification
  (NIC)
• Recommended for PDAs in nursing
• (Sookyung, et al,
  2001)

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Advantages of PDAs in Nursing

• Anywhere/anytime use
• Point of care usage
• Rapid access to relevant clinical data
  information
• Time management
• Reduces risk of drug errors
• Reduction of paper use

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Disadvantages of PDAs in Nursing

• Complying with HIPAA regulation
• Technical problems
• Security
• Cost/durability
• Reservoir for microorganisms/ transfer of
  pathogens

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Ethical/Legal Issues of PDAs in Nursing

• HIPAA privacy, confidentiality, security
• -use of PDA by authorized person
• -administrator will access and grant
  control
• -audits are available
• -integrity must be maintained
• -must remain tamper-free
• -transmission must be secure
• Codes of conduct
• 
  (Santori, 2008)

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Informatics Competencies to Use PDAs in Nursing

• Requirements needed by any professional RN
• USER Level Competency
• Technical competencies word-processing,
  keyboarding, emails, internet use, computer and
  data-base applications.
• Utility competencies understands/recognizes
  basic computer applications and networks.
• Leadership competencies understand patients
  rights/code of ethics.
• 
  (Kaminski, 2007)

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Functions of Informatics Nurse

• Plan/implementation for use in practice
• Consults in design production
• Identifies updates relevant software programs
• Develops/implements educational materials work
  sessions

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Summary

• PDAs are portable references educational
  resources
• PDAs are time-savers
• PDAs promote evidence-based decision making by
  providing reliable, trust-worthy information.

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References

• Booten-Hiser, D. (2005). Using PDAs in advanced
  practice Electronic version. Retrieved Oct.
  11, 2008 from http//nursing.ouhsc.edu/npweb/ONP_P
  DA_Presentation_11_05.pdf
• Davenport, C. (1999). What nurses need to know
  about personal digital assistants Electronic
  version. Retrieved Sept. 16, 2008 from
  http//eaa-knowledge.com/ojni/ni/8_3/davenport.htm
  
• George, L. Davidson, L. (2005). PDA use in
  nursing education Prepared for today, poised
  for tomorrow. (OJNI). Vol.9, No. 2 Electronic
  version. Retrieved Oct. 6, 2008 from
  http//ojni.org/9_2/george.htm/
• Kaminski, J. (2000 2007). Nursing informatics
  competencies self-assessment. Electronic
  version. Retrieved Nov. 22, 2008 from
  http//www.nursing-informatics.com/niassess/users.
  html/
• Oh, R. (2005). An easy way to evaluate software
  for your PDA. American Academy of Family
  Physicians. June 2005. Electronic version.
  Retrieved Oct. 12, 2008 from http//www.aafp.org/
  fpm/20050600/67anea.html/

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References

• PDA Cortex. (n.d.) The Journal of Mobile
  Informatics and PDA resources for healthcare
  professionals. Electronic version Retrieved
  Oct. 11, 2008, from http//www.rnpalm.com/
• Santori, C. (2008). The use of personal digital
  assistants in clinical practice. Med-Surg
  Matters. Pitman March/April. Volume 17(2)
  pg. 1, 10-11.
• Sookyung, H., Jinwook, C., Jonghoon, C.,
  Sang-goo, L., Donghoon, S., Daihee, K., Donggyu,
  K. (2001). Implementation of mobile computing
  system in clinical environment Mobile Nurse TM.
  Electronic version Retrieved Nov. 2,
  2008, from
• http//www.rnpalm.com/downloads/MobileNurse.
  pdf/
• Suska-Hildebrandt, S. (2000). Mobile information
  technology at the point-of-care. Electronic
  version Retrieved Nov. 2, 2008, from
• http//www.rnpalm.com/mitatpoc.htm/
• Yale University (2005). PDA basics. Retrieved
  Oct. 11, 2008 from http//www.med.yale.edu/librar
  y/nursing/pda/basics.html