TECHNOLOGY: The newest practice tool for Nurses?
Handheld technology: is it the greatest invention since sliced bread? Trade and professional journals alike are predicting that these wireless devices could change the way medicine and nursing are practiced.
The Personal Data Assistant (PDA) was initially introduced as a way to organize ones' life, allowing its' owner to carry and easily access their personal calendar, daily planner and address book. Where once such content would have been accessible only via databases on stationary PCs, now the same applications are contained in a 5 to 8 ounce package that can be held in the "Palm" of your hand. The functionality provided by PDAs has expanded exponentially from simple personal organizer to include healthcare databases and applications that check for drug interactions, aid in IV calculations, analyze lab results, provide charge capture information, scheduling functions, prescription refilling and other practice management tasks.
Other uses include data capture for research and clinical trials, as tracking devices for medical student training and to transmit telemetry waveforms from monitors at the nurses' station directly to the bedside nurse. Clinical applications for direct entry of patient data continue to be developed for acute and home healthcare settings. The potential mobility that these devices can provide could make point of care data entry and access a reality if its' use can be incorporated into the workflow and daily practice of the clinician.
The Palm operating system does allow the development of task specific applications by non-technical users. The majority of these task specific / form-like applications have been created by physicians wanting to address specific practice management issues. These applications are then shared and can be downloaded and used for free. Few of these applications are nursing specific.
The ubiquity of the devices' uses by nurses remains to be seen. Statistics report that less than 1% of physicians currently use handhelds and no statistics are available on the device's use by nurses.
A website that hopes to facilitate
the use of handhelds by nurses, incorporate the devices' use in nursing practice
and encourage nurse developed applications is www.rnpalm.com. The site was started by a group of nurses lead by Yvonne
Stolworthy, RN, BScN. Ms.
Stolworthy is the Research Coordinator of Anesthesia at the QEII Center for
Clinical Research, Halifax, Nova Scotia. Launched in July of 2000, the site
provides a listserve, information on hardware, software critiques, downloads of
healthcare and nursing-specific applications for the Palm, tutorials, news
links, articles and commentaries related to handhelds and their use by nurses
and other healthcare professionals. Discussion
of adoption or lack of adoption by nurses is also provided on the site.
The majority of this discussion seems to focus on the technical, i.e. lack of knowledge or technophobia and economic barriers to nurses' use of this technology. Few have addressed the realities of the hierarchical organization of healthcare. The physician, as director of his own practice, has a great deal more authority and flexibility to introduce and independently utilize technological innovations for practice management, than the average staff nurse. Physicians drive medicine and healthcare, not nurses. Perhaps these factors explain why nurses have not traditionally been the initiators of new technological tools. To identify the use of handheld technology by nurse practitioners and those in nursing, who have more autonomy in daily practice, would perhaps provide more realistic findings as to why the technology is not being assimilated by nurses. Looking at this segment of nursing for methods to facilitate and promote handheld technology by all nurses could be the answer.
Whether or not handheld technology can be utilized to improve patient care and nursing practice remains to be seen. So far PDAs are not on the level of 'sliced bread'. Maybe peanut butter but not sliced bread…. yet.