MOBILE TECHNOLOGYLESSONS LEARNED ALONG THE WAYK Beard EdD GNP-BC NP-C ACNP-BCHunter Bellevue School of Nursing

Discussion• Impetus behind mobile technology• Strategies used to implement mobile technology• Lessons learned when implementing technology

Medication Use

• Any given wk - 4 out of 5 adults will use some type of medication (prescription, OTC, dietary supplements)

• 1/3rd take 5 or more different medications• Sometimes preventable adverse drug events (ADE)

occur in prescribing or taking the med• As a result Institute of Medicine (IOM) studied the

prevalence of medication error

• What do you think they found?

Deadly Medical Errors

Adverse Drug EventsInjuries Due to Medication

• 450,000 preventable ADEs occur in hospitals each year• 800,000 occur in long term care settings• 530,000 Medicare patients experienced preventable ADEs

in outpatient settings

• Most likely to occur during the prescribing and administering stages

• Hospital patient can expect at least one med error each day• As a result IOM studied the prevalence of medication error

• How many individuals are injured or die every year from medication errors?

What Can We Do??????• 1.3 million injured from ADE 1 person dies every day

• Health care providers can’t keep up with all the information regarding medications

• Use information technologies to reduce medication errors

• Point of care reference information accessed from personal digital assistants

Complex fast paced environment threatens patient safety!!

Mobile Technology

• Mobile technology - a platform whereby nurses can download nursing software and access information at the point of care

• Mobile technology can • Reduce errors• Improve care• Promote patient safety by increasing accuracy and efficiency

Promoting Excellence in Clinical Practice

1. Select a reference tool for point of care access (PDA & Software)

2. Have support readily available (software company)3. Faculty point person4. Acquire financing (cost efficient)5. Educate faculty and students

Nursing Based Software• Contained drug content• Laboratory values• Disease Processes• Medical dictionary

• Required for each student entering their first medical surgical clinical rotation

• Made it a student fee so costs covered by scholarships or loan monies

• Replaced several textbooks (nursing care plan text, medication drug guide, lab guide)

Evaluation of Program• Wanted to know who was using it• When they were using it• What were the likes/dislikes• Did it prevent medication errors?

Who’s using the software and when???

• 95 students completed survey• All used a variety of platforms (PDA, smartphone)• 96.7% used it for clinical• 58.7% used while studying• 46.7 used it during class• 43.5% used it to look up information for patients

Medication Administration Feature

• Students using software to identify• Drug indications (88.6%)• Adverse effects of drugs (77.3%)• Medication contraindications (69.3%)• Generic names (64.8%)• Dose range (27.3%)• Dosage calculator (9.1%)

Error Reduction• 83.7% stated software never helped prevent an error• 16.2% reported that software prevented a clinical error• 6.5% reported it helped on more than 3 occasions• Error reduction was compared between levels 1 and 2

students- no significant difference

Lessons Learned• Multidisciplinary team needed (IT support, student

financing, team leader)• Orientation before and several wks after initiation• Software that can be periodically updated• Cost saving benefit – less medication errors (Although

some students felt the cost outweighed the benefit)• Negative comments from students stemmed from lack of

modeling behavior by faculty• The importance of faculty modeling the behavior of using

the PDA is an important aspect for students’ acceptance of the PDA/software

Questions????????

ReferencesInstitute of Medicine. (2006). Preventing Medication Errors. Retrieved from http://www.iom.edu/~/media/Files/Report%20Files/2006/Preventing-Medication-Errors-Quality-Chasm-Series/medicationerrorsnew.pdf

U. S. Department of Health & Human Services. Medication error report. (2009). Retrieved from http://www.fda.gov/Drugs/DrugSafety/MedicationErrors/ucm080629.htm

Beard, K. V., Greenfield, S., Morote, S., Walter, R. (2011). Mobile technology: Lessons learned along the way. Nurse Educator 36(3), 103-106.