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Long Island Business News: Technology Changing Nursing

by Kristen D'Andrea
Published: March 20, 2012
Source: Long Island Business News

A heart rate monitor, a drug dosage calculator, an antibiotic guide? Yeah, there's an app for all that.

As with most professions, the nursing field has embraced the technological revolution. The variety of apps currently available for hand-held devices means nurses can gain immediate access to information pertinent to the treatment of their patients. However, some educators are concerned nurses may spend more time with their touch screens and not enough time providing that personal touch so crucial to their patients' well-being.

A few of the many nursing apps currently available to Android phone users include: Instant Heart Rate, which turns a smartphone into a heart rate monitor; Mini Nurse, featuring dosage and IV calculations and medical terms; Pocket EKG, which helps its user interpret the 25 most encountered cardiac dysrhthmias; and RxShortages, designed to help health care providers access information about drug shortages. In addition to these tools, which can provide assistance in the field, there are apps available to help nurses pass exams and use for reference.

Dr. Jeannine Muldoon, dean of the division of nursing at Molloy College, said today's technology enhancements, including the many health care apps available, are "truly magnificent," yet she cautions nurses to avoid becoming too reliant on the information available in the palms of their hands. "You have to depend upon your own knowledge base," she said, noting time is often so critical when caring for a patient, a nurse may not have time to look up information.

"No matter what application or piece of technology we devise as an assistive piece to us as health care providers, we have to remember that the greatest tool we have is ourselves," Muldoon said.

Kara Theal, director of clinical informatics at Huntington Hospital, agreed. One of eight RNs who works in the IT department at Huntington Hospital, Theal said assuring patients are not suffering at the hands of technology is a priority. Last summer, the hospital instituted an electronic medical record. The wireless technology available on the "workstation on wheels" enables nurses to complete their documentation at patients' bedsides, rather than sitting at their workstation with a pen and paper chart, Theal said.

"We turned a lot of nurse's worlds upside down" with the switch to electronic medical records, Theal said.

Prior to making the move, hospital staff chose to educate and communicate the change to its staff and patients. Theal and a professional videographer produced a 15-minute video, utilizing hospital employees as actors, which highlighted best practices for computerized charting. Scenarios depicted in the video included a nurse facing the computer screen toward the patient so he or she could feel included in the documentation and another in which a nurse stated, "I'm logging off the computer now," to relieve a patient's potential concerns about confidentiality.

Huntington Hospital administrators are considering getting health care-related apps for the 350 cell phones they have issued to their employees. But the use of personal cell phones is not allowed while on duty, according to Theresa Jacobellis, hospital spokeswoman.

Distraction is just one of the concerns raised when nurses use high-tech, hand-held devices such as iPhones and iPads. Reliability of sources is another, said Dr. Dan Roberts, associate director of nursing quality, research and medicine at Stony Brook University Hospital. While websites and apps such as PubMed.gov, Health On the Net Foundation, and the Institute for Healthcare Improvement offer reliable medical information such as actual clinical pathways and best practices, other sites such as Wikipedia should never be used to understand the clinical presentation for treatment of a patient, he said.

Within the next two years, Stony Brook University Hospital plans to provide each member of its nursing staff with an iPod touch, Roberts said. At that time, if nurses need to access patient's electronic records, they can do so on hospital-issued devices without using their personal iPhones and, in turn, violating privacy regulations.

This month, each nurse was given a new Rubbermaid patient management cart from which they can access patient's electronic records. (Stony Brook University Hospital implemented electronic nursing documentation in 2009.) Within the next six months, the hospital plans to incorporate a bar code scanner on the carts. At that time, all meds will be scanned and required to match scans of the nurse's ID bands.

"We are swimming in technology," Roberts said.

Implementing all of this technology comes at a cost. In addition to the expense of providing the devices to staff, training time is time away from a patient's bedside, Roberts said.

And that time spent at the bedside, providing a reassuring touch on a patient's shoulder, is so basic, yet so critical, Muldoon said. "That touch and those words of assurance take only moments, yet can decrease anxiety and lower blood pressure," she said.

"Sometimes we have to be reminded that the computer is representing a human being. We can't just nurse the computer, we need to nurse the patients."