Smart nurses use smartphones

By Jan M. Nick |

It was the most reassuring and trust-building experience I have ever had while visiting my healthcare provider. Last year we were discussing my laboratory results, and I told her I didn’t want to go on medication. Her response to me was, “Well, let me check my smartphone and see what the new guidelines say. Based on your age, you may not have to.”  

Right then and there, I knew I was receiving the most current and best evidence-based care when she looked this up while acknowledging my values and preferences. And luckily the clinical practice guideline indicated I did not have to start the medication. If she had not used her smartphone in that moment to look up the current guideline, I  would be taking a medication that only helps one in 25 and has significant side effects.   

Smartphones have clinical value
We are now faced with a “need to check” culture since we can’t possibly know everything, especially given how quickly it all changes! These health apps are a perfect addition for supporting and creating competencies in safety and quality, informatics and healthcare technology, and person-centered care. All three competencies are expectations by professional, educational, and hospital accrediting organizations. Simply being knowledgeable about unit procedures, medications, diagnostic tests, and treatments is not enough since practice is still often based on history, authority, or logic. In today’s informatics rich environment, all nurses should have the knowledge and skill to use smartphones to clarify, verify, or investigate information and see how medical apps can aid them in the provision of safe, quality care. 

The first time I realized how smartphone apps could improve healthcare outcomes, I had found an app for fetal kick counts. It allows pregnant mothers to keep track of daily fetal movement and send results to their healthcare provider if desired. Fetal kick counts are a no-cost, highly effective assessment that can dramatically decrease the incidence of fetal demise. How cool is that?

Now, I am always on the lookout for health apps to assist me in my professional career as a nurse. I’ve found apps that offer information on medications, drug concentration and drip rate calculators, vein finders, symptom checkers to assist with diagnosis, and schedulers to coordinate and trade shifts. There are also apps to analyze sleep patterns, calm anxiety, improve water consumption, connect people to telehealth offices, and help students study for exams. Add in an attachment, and your phone can be used to take a temperature, EKG, blood pressure, check glucose levels, monitor jaundice, or glaucoma, to name just a few. 

And who knows what is currently in development! Smartphone apps specializing in health topics are on the rise in both high resource and low resource countries.

Let’s empower our patients, too
Of all the medical or health apps available, over 40 percent are geared toward empowering people everywhere to take control of their health. Nurses are the key to introducing these health management apps to their clients.  Why miss out on an opportunity to help our patients be healthier? 

I love using speak and translate apps to communicate with others—of which there are several for the smartphone. Once, I used such an app to communicate with dinner guests from Russia. We conversed in simple sentences the whole evening by speaking into the app, and the app translated our words verbally and in writing to the other language. We created human connection and mutual understanding by using a tool.  I can easily see how these types of apps could be used in expanded situations.   

A double-edged sword?
While I see advanced healthcare practitioners like physicians, physician assistants, and nurse practitioners use smartphones frequently for clinical information, the same institution often has policies not allowing nurses to use cell phones in the clinical area. 

I have spoken with nurse leaders and faculty about it—and have heard four main reasons they impose the no smartphone rule. They say: 

  • Nurses use them during work time for social surfing and social communication. 
  • Nurses could accidentally use them inappropriately and violate HIPAA regulations.
  • There are computers on the unit that can do the job.
  • Personal phones are a microbial health hazard. 

Opinion pieces and research studies mirror these reasons. A research gap currently exists--studying nurses’ use of cell phones for medical use, rather than for personal use.   

But nurse leaders can circumvent that 
We already teach nurses to avoid inappropriate use of social media to discuss professional work issues, how to use and keep accurate records of controlled substances, maintain patient confidentiality, and provide ethical treatment to all clients. Professional issues such as these are included in our policies and procedures. So why can’t we also teach nurses and nursing students how to use their smartphones to make smart decisions in the clinical area? 

It is up to us to develop appropriate cultural norms on the unit. These strategies apply to all healthcare personnel in the hospital—not just nurses:

  • Feature medical apps that care practitioners successfully use that promote client safety and evidence-based care.
  • Find health management apps specific to your unit’s population that can be used by patients to monitor or maintain their health condition. 
  • Teach phrase reminders that alert others when using the smartphone, like, “May I use my smartphone to look up this information?” when in the presence of patients or other clinicians.  
  • Incorporate reminders for daily cleanliness routines for smartphones, just like we do for hand hygiene. Create policies on how to clean the device, and maintain cleanliness (e.g., put it in a zippered plastic bag, etc.) 
  • Be clear on the consequences of unprofessional smartphone use (e.g., personal use in the clinical area), just like when nurses display other unprofessional behaviors.

As leaders in healthcare, we must be forward-thinking, visionary, responsive, and evidence-based. We must seek to remove barriers that inhibit the provision of safe, current, and effective care. Everybody has what is fast becoming a supercomputer in their pocket—it’s what we do with it in the clinical area that makes the difference.  In the end, patients will benefit because we are using the most current, evidence-based information available. In a word, the smartphone needs to be part of today’s professional nurse uniform.

 

Jan Nick is a member of Sigma’s Gamma Alpha Chapter at Loma Linda University in Loma Linda, California, USA. She is Professor of Nursing and specializes in teaching Informatics and Evidence-based Practice content locally and internationally. She was a 2008-2009 HRSA Health Informatics Technology Scholar.

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