PDAs for Nursing Students: Technology at Your Fingertips

PDAs for Nursing Students: Technology at Your Fingertips Stacy Garza Jerry Russell Rebecca Show Brenda Stalls Kelli Young

Identified Problem BCHS needs to continue being a leader in educating nursing students who have experience with the latest technologies that support the provision of evidence-based care for positive patient outcomes. Other schools of nursing require students to use PDAs in their undergraduate programs. We were interested in collecting information that could help BCHS administration & faculty decide whether to initiate a PDA requirement.

Triggers for the Study
Students need fast access to a variety of information at the point of care
Books & printed reference materials are out of date as quickly as they are printed
BCHS students are not keeping up with the competition

Significance to Nursing Practice
PDAs are portable
PDAs are timesavers
PDAs promote evidence-based decision-making by providing reliable, trustworthy information

Examples of Required PDA Software
Quick Drug References
Calculators
Diagnostic Tests
Clinical Reference
Dictionary
George, L. E., & Davidson, L. J. (2005). PDA use in nursing education: Prepared for today, poised for tomorrow. Online Journal of Nursing Informatics, 9 (2). Retrieved November 6, 2006, from http://eaa-knowledge.com/ojni/ni/9_2/george.htm

Quick Drug References
Latest drug updates
Many free programs
Adult & pediatric dosages
ePocrates: >3,300 brand and generic drugs, including dosing, interactions, black box warnings, safety & monitoring, adverse reactions, & pricing
MultiCheck multiple-drug interaction checker
Replace outdated unit medication manuals
ePocrates

Calculators
Drug dosages
IV drip rates
Pediatric/adult conversions
BMI
Glasgow coma scale
Urine output
Mean arterial pressure
Pregnancy calculator
And more!
MedCalc

Diagnostic Tests
Laboratory, imaging, & microbiology tests
Unbound Medicine’s Pocket Guide to Diagnostic Tests:
Which test is best to diagnose, screen, or follow a certain condition?
How do I interpret an abnormal diagnostic test?
How do I collect the appropriate specimen or prepare the patient for testing?
Where can I find more information on this test in the medical literature?
Unbound Medicine

Clinical Reference
Look up diseases & diagnoses
Differential diagnosis information
Recommended diagnostic tests
Recommended treatments
Updated frequently with web resources
Unbound Medicine

Dictionary
Definitions of medical terms
Cross-links to other content in dictionary
Pronunciations for some terms
Unbound Medicine

Research Questions
What are the attitudes, opinions, & experiences of BCHS and UTHSC senior nursing students about PDAs?
How do the attitudes, opinions, & experiences of the two groups compare?
We hoped to obtain data that could assist BCHS administration & faculty to identify the need for & recognize possible issues associated with instituting a PDA requirement for nursing students.

Rationales for PDA Use in Nursing Schools
The American Association of Colleges of Nursing, National League for Nursing, and the Institute of Medicine all recommend the incorporation of technology into the processes of nursing education. 1
Two distinct benefits: 2
Instant access to a tremendous amount of clinical information in one small mobile device
Gain technical skills from using the devices that can be used throughout their careers
1 George, L. E., & Davidson, L. J. (2005). PDA use in nursing education: Prepared for today, poised for tomorrow. Online Journal of Nursing Informatics, 9 (2). Retrieved November 6, 2006, from http://eaa-knowledge.com/ojni/ni/9_2/george.htm 2 White, A., Allen, P., Goodwin, L., Breckinridge, D., Dowell, J., & Garvey, R. (2005). Infusing PDA technology into nursing education. Nurse Educator, 30 , 150-154.

How Schools Implement PDAs in Nursing Programs
Selection of software & web-based programs most supportive of BSN program & clinical course objectives
Orientation of students & faculty to PDAs
Provision of support services to students & faculty
Evaluation of program
Miller, J., Shaw-Kokot, J. R., Arnold, M. S., Boggin, T., Crowell, K. E., Allgri, F., et al. (2005). A study of personal digital assistants to enhance undergraduate clinical nursing education. Journal of Nursing Education, 44 , 19-26.

Examples of Schools Currently Using PDAs in Nursing Education

Other Benefits & Challenges of Using PDAs in Nursing Education Programs
Anywhere/anytime use
Increase student-faculty time management in documenting clinical performance
Encourages timely recording of events from clinical setting
Reduces paper use through wireless transmission
Complying with HIPAA regulations
Protecting patient confidentiality
Encouraging consistent use by faculty & students
Troubleshooting synchronization problems
Breakage or inoperable units
Acquiring software beyond available freeware
Benefits Challenges White, A., Allen, P., Goodwin, L., Breckinridge, D., Dowell, J., & Garvey, R. (2005). Infusing PDA technology into nursing education. Nurse Educator, 30 , 150-154.

Gaps Found in the Literature
Sample sizes too small
Research needs to be broadened
More schools need to be included in research
Research needs to be more rigorous
Most studies used surveys
Most data based on personal opinions

Steps of the Research Project
Used an exploratory/descriptive survey approach
Data to be used to provide the basis for BCHS to explore instituting a PDA requirement for nursing students
Limitations of Surveys
Obtain superficial information (breadth vs. depth)
Unable to clarify responses
Advantages of Surveys
Obtain large amount of information from a variety of people
Easily administered

Survey Process & Sample
Senior graduating class
Anonymous
Everyone asked to respond
All questions pertained to PDAs
Yes/No, Likert-type scale, Open-ended
BCHS N=35 n=30, 86% PDAs not required In-class survey UTHSC N=31 n=11, 35% PDAs required Online survey COMMONALITIES

Online Survey Process
Online survey program
No-cost
UTHSC students commonly respond to surveys in this program
Survey okayed by the Director of the Professional Entry Program
Survey link distributed by the Assistant Director of the Professional Entry Program
UTHSC faculty member entered questions in program & printed off final results for our group
My name is Jerry and I am a senior nursing student at Baptist College of Health Sciences. Like you, I will be graduating in December. I am in my last class and we are required to do a project. Our group decided to do a survey on PDAs in nursing school. I understand at UTHSC that you are required to purchase and use a PDA. Please take a few minutes to answer the few questions on our survey, located at http://CTLSilhouette.wsu.edu/surveys/ZS56802 . The survey is anonymous. If you would, please help out your fellow nursing students by responding no later than 8am Monday, November 20. Thank you so much, in advance, for your help.

Validity & Reliability Issues
Diverse questions used because of the exploratory nature of the survey
Questions were worded differently because of the difference between the two groups
We primarily focused on taking steps to enhance the validity of our study, realizing this was an exploratory study whose results should be viewed as a first step
yes/no
Likert-type scale
open-ended
What do you think about this
versus
What was your experience
We enhanced the reliability of our study by using inter-rater reliability procedures
Haber, J., & LoBiondo-Wood, G. (2006). Reliability and validity. In G. LoBiondo-Wood & J. Haber (Eds.), Nursing research: Methods and critical appraisal for evidence-based practice (6 th ed., pp. 335-356). St. Louis, MO: Mosby.

Validity
Do the survey items adequately reflect the needed breadth of students’ opinions, attitudes, & experiences with PDAs?
Survey content determined by:
Reviewing literature
Consulting with faculty experts in use of PDAs
Does the survey appear to appropriately explore opinions, attitudes, & experiences with PDAs in an understandable way?
Survey items reviewed by:
Students
Faculty experts in use of PDAs
Content Validity Face Validity

Inter-rater Reliability
Independent analysis of answers to open-ended questions
Comparison of our analysis
Discussion of rationales for coding where we disagreed
Arrive at consensus on the final coding

Survey Questions
Costs of PDA
Learning about PDA
Beneficial effects of PDA
Effect of PDA use on stress
Recommendations for future use
Advantages/Disadvantages of PDA
BCHS UTHSC COMMONALITIES
Likelihood of attending BCHS if PDA required
PDA ownership
Observations of PDA use
Other programs installed on PDA
Coverage of PDA costs
Faculty encouragement

PDA Ownership
Do you own a PDA?
Yes = 2
No = 28
Use in clinical setting:
Yes = 1
No = 1
Did you own a PDA
before coming to UTHSC?
Yes = 1
No = 10

Likelihood of Attending BCHS if PDA were Required

Type of Person Observed Using PDA in Clinical Setting 80% of respondents reported seeing others use PDAs in the clinical setting.

Learning About PDAs

Learning about PDAs

Advantages of PDA Use Responses: BCHS = 53 UTHSC = 39

Disadvantages of PDA Use Responses: BCHS = 39 UTHSC = 13

Required & Other Programs on PDA
Mosby's 2006 Nursing Drug Reference
Mosby’s Nursing PDQ.
Mosby's Diagnostic and Laboratory Test Reference (7th ed.).
Taber's Cyclopedic Medical Dictionary (20th ed.).
Games (4)
Medication program (2)
Medical dictionary (1)
Spanish-English dictionary (1)
Music (1)
Pictures (1)
Required Other

Perceptions of how Beneficial a PDA would have been in School

Benefits of PDAs

Perceptions of Effects of PDA use on Stress Levels

Maximum Amount to Pay for PDA Hardware & Software

Actual Cost of PDA

Additional Costs

Recommend PDA for Future Nursing Students

Implications for Nursing Education
Coordinated effort to incorporate PDAs
Involve students, faculty, library, information technology, & administration
Develop PDA hardware & software requirements
Design PDA training – variety of methods
Identify PDA support system

Implications for Nursing Practice
All nurses on a unit use PDAs
Hospitals provide PDA hardware, software, & docking stations
PDA training provided by hospitals
PDA support groups developed across units
Develop PDA competencies
Administrator, nurse, & patient satisfaction & perception of usefulness

Evaluation
Does BCHS institute a PDA requirement?
Do faculty evaluations of students who use PDAs differ from those who do not?
Do student evaluations support the usefulness of PDAs?
Do students continue using PDAs after graduation?

Summary
Embrace the future: PDAs are here to stay
Several schools implementing PDA use
BCHS should explore implementing PDA use
Conduct further research on PDA use
Our findings showed:
Most students would have attended BCHS even with PDA requirement
Perception & experience of stress levels with PDA use
Other people observed using PDAs in clinical settings
There needs to be support for PDA use
Cost & financial aid are considerations

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PDAs for Nursing Students: Technology at Your Fingertips

by Cynthia.Russell on Nov 26, 2006

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PDAs for Nursing Students: Technology at Your Fingertips — Presentation Transcript