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Project Initiation Document.doc

  1. 1. Knowledge in the palm of your hands; PDA’s in the clinical setting Project Initiation Document V2 31/10/02
  2. 2. Index 1. Introduction 2 2. Project overview 2 3. Project team 3 4. Work plan 3 Overview Project initiation 5. Evaluation 3 6. Communication 3 7. Timetable 3 Appendix 1 OVID@Hand 4 Appendix 2 Clinical Evidence 9 2
  3. 3. 1. Introduction 1.1 Personal Digital Assistants (PDAs) are handheld computers that originally were designed as personal organizers. The basic features of a PDA are an address book, note pad, clock, calculator and email. The advantage of the PDA is the easy synchronization of information with the desktop – information transferred from the computer to the PDA when the PDA is plugged into the computer. 1.2 PDAs are increasingly being used in healthcare. In a recent survey1 of clinicians in Toronto 42% of general internists (mean age 46), 70% of housestaff (mean age 25) and 32% of family physicians (mean age 45) owned a PDA. Advanced features of the PDA include medical textbooks, drug reference books, journal table of contents, evidence based summaries and guidelines. In the Straus study1 the resources clinicians identified as useful for PDAs were 1.2.1 the clinical bottom line from pre-appraised resources, 1.2.2 management algorithms, 1.2.3 drug dosages and 1.2.4 numerical summaries. Clinicians did not want traditional practice guidelines on PDAs. 1.3 Ovid@Hand provides software for Palmtops (one form of PDA) that allow health professionals to find answers to clinical questions, remember important searches relevant to patient care, and stay up-to-date with the latest in medical research. This software has been available in the USA for some time but has only just been released in the UK. [See Appendix 1] 1.4 Micromedex provides a mobile section of its databases: 1.4.1 The Drug information component includes dosing, drug interactions, adverse effects, administration, how supplied, pregnancy warnings, lactation, indications, contraindications, therapeutic class, and brand information. No charge to subscribers! 1.4.2 The Alternative Medicine information module includes dosing, administration, how supplied, indications, contraindications, adverse effects, drug interactions, therapeutic class, pregnancy, and lactation for herbals, vitamins, minerals and other dietary supplements. 1.4.3 The Acute Care information component includes treatment, diagnosis, and key point information. 1.4.4 The Toxicology information module includes clinical effect, treatment, and range of toxicity information. 1.5 CogniQ provide a trial of the: 1.5.1 quick-reference sections of Clinical Evidence, a database of evidence on the effects of common clinical interventions, providing the clinical bottom line from pre-appraised resources [the Straus survey identified this as relevant in the clinical setting]. 1.5.2 and the latest table of contents and abstracts from the BMJ and BMJ Specialist Journals [See Appendix 2]. 1.6 Free software for PDAs. There is a multitude of freeware and shareware on the Internet that can be downloaded to the Palmtops: 1.6.1 Dataviz Documents to go allow you to import Word, Excel & Powerpoint documents from your PC to your Palm. These can be viewed and edited on your Palm and then synchronised with the file on your PC. Also available via the bonus software disk that comes with the Palm. 1.6.2 John Hopkins Division of Infectious Diseases Antibiotic Guide. This site is designed for primary care providers and other non-infectious disease specialists as a tool that can be used at the point of care to assist in prescribing antibiotics. It should also be useful for the infectious diseases expert seeking more in depth material. 1 Straus SE et al 2001 Bringing evidence to the point of care [accessed 27/6/02]. 3
  4. 4. 1.6.3 providing health channels and general channels. 1.6.4 1.6.5 1 Project overview 2.1 The knowledge in the palm of your hand project aims to 2.1.1 Identify the impact of handheld computers on patient care Identify how often the clinicians access the resources on handheld computers to inform their clinical decision-making. Identify which handheld resources are most useful to clinicians in the clinical setting Identify the barriers to using handheld resources to support patient care 2.1.2 Evaluate the software in terms of: Content Accessibility Ease of use (including an evaluation of the natural language query interface) Relevance in the clinical setting – can questions arising in the clinical setting be answered via the software on the Palmtop 3. Project team The project team comprises: Claire Honeybourne, Library Services Manager, LGH Jacqueline Verschuere, Library Services Manager, GH Joanne Dunham, Deputy Librarian Clinical Sciences Library, LRI (University of Leicester). 4. Work plan 4.1 Overview The project will be undertaken in 2 (three month) stages. Stage 1 is split into two 6-week blocks. Group A (six clinicians) are provided with CogniQ Clinical Evidence and BMJ journals and encouraged to download some freeware from the Internet. Group B (six clinicians) are provided with Avantgo Clinical evidence and OVID@Hand. Six weeks into the trial Group A and Group B swap the software they are evaluating. Stage 2: Martindale’s drug textbook is added into the OVID@Hand software. Having now trailed all the software that is available the clinicians are allowed to select any of the software used in Stage 1. All the clinicians are provided with Martindale’s. 4.2 Project initiation 4.2.1 The 3 clinical librarians at UHL have been given one palmtop each. Four nurses, four junior doctors, and four consultants will be recruited to take part in the trial. Other health professionals that currently have their own palmtops will be invited to participate in the trial. 4.2.2 A questionnaire will be sent to participants to identify current practice. 4.2.3 The project team will meet with the participants to load the software and provide training in how to use the palmtops. 4.2.4 The project team will meet with the participants on a weekly basis for the first month to discuss problems encountered and usage. 5 Evaluation 5.3.1 A questionnaire will be sent to each participant on a monthly basis. Completion of the questionnaire is compulsory (failure to do so will result in the palmtop being returned to the library). 5.3.2 Individual interviews will be carried out with each of the participants at the end of Stage 1 and the end of stage 2. 6. Communication plan 4
  5. 5. 6.1 Monthly meetings of the project group will be held. The clinical librarians will also be invited to these meetings. 6.2 Participants will be able to discuss the project amongst themselves through an e- discussion group. 7. Timetable Start End Resources Stage one Group A 27 Aug 2002 22 Nov 2002 CogniQ CE BMJ journals Internet freeware Group B 27 Aug 2002 22 Nov 2002 Micromedex & OVID@Hand Stage two Group A&B 25 Nov 2002 21 Feb 2003 Selection of above ?plus Martindale’s 5
  6. 6. Appendix 1 OVID@Hand software Features • Stay current of latest Table of Contents • Create Medline searches during clinical workflow • Have access to Critical drug information and drug interaction information at the point of care – to promote quality care • Help reduce medication errors • Promote information to end users • Leverage existing Ovid online investment Content Channels A to Z Drug Facts is an ideal resource for students and practicing clinicians. Using either the alphabetical or therapeutic class index, quickly access 700 full drug monographs, covering over 3500 new and orphan drugs. Monographs are divided into pharmacological and patient care considerations, and include indications, dosages, and side effects. Drug Interaction Facts Module contains all of the drug-drug and drug-food interaction information busy clinicians need. This sophisticated multi-check module covers more than 20,000 brand and generic drugs and more than 70 therapeutic classes. Lippincott’s Nursing Drug Guide is a must have for all student and practicing nurses in classroom and clinical settings, including home care. Using either the alphabetical or therapeutic class index, user can access 900 full drug monographs, covering over 3600 medications. Each monograph provides Medweaver Disease Profiles, users get immediate access to over 700 profiles of diseases and conditions, providing information on etiology, symptoms, associated terms & conditions and physical findings all on the handheld Access to Medline Journal Table of Contents with abstracts: AACN Clinical Issues: Advanced Practice in Acute & Critical Care AIDS Alcoholism: Clinical & Experimental Research Alzheimer Disease & Associated Disorders American Heart Journal American Journal of Cardiology American Journal of Clinical Oncology American Journal of Dermatopathology American Journal of Forensic Medicine & Pathology American Journal of Infection Control American Journal of Medicine American Journal of Nursing American Journal of Obstetrics & Gynecology American Journal of Physical Medicine & Rehabilitation American Journal of Physical Medicine & Rehabilitation American Journal of Psychiatry American Journal of Public Health American Journal of Surgery American Journal of Surgical Pathology American Journal of the Medical Sciences Anesthesia & Analgesia Anesthesiology Annals of Emergency Medicine Annals of Internal Medicine Annals of Surgery Annals of Surgical Oncology 6
  7. 7. Anti-Cancer Drugs Applied Immunohistochemistry Archives of Dermatology Archives of General Psychiatry Arteriosclerosis, Thrombosis & Vascular Biology ASAIO Journal Behavioural Pharmacology BJU International – Supplement BJU International Blood Coagulation & Fibrinolysis Blood Pressure Monitoring BMJ British Heart Journal British Journal of Dermatology, Supplement British Journal of Dermatology British Journal of Haematology Supplement British Journal of Haematology British Journal of Psychiatry British Journal of Surgery – Supplement British Journal of Surgery British Journal of Urology – Supplement British Journal of Urology Cancer Nursing Chest Circulation Research Circulation Clinical Journal of Pain Clinical Journal of Sport Medicine Clinical Neuropharmacology Clinical Nuclear Medicine Clinical Obstetrics & Gynecology Clinical Orthopaedics & Related Research Clinical Pharmacology & Therapeutics CMAJ: Canadian Medical Association Journal Computers in Nursing Cornea Coronary Artery Disease Critical Care Medicine Current Opinion in Anaesthesiology Current Opinion in Clinical Nutrition & Metabolic Care Current Opinion in Critical Care Current Opinion in Endocrinology & Diabetes Current Opinion in Gastroenterology Current Opinion in Hematology Current Opinion in Infectious Diseases Current Opinion in Lipidology Current Opinion in Nephrology & Hypertension Current Opinion in Neurology Current Opinion in Obstetrics & Gynecology Current Opinion in Oncology Current Opinion in Ophthalmology Current Opinion in Organ Transplantation Current Opinion in Orthopedics Current Opinion in Otolaryngology & Head & Neck Surgery Current Opinion in Pediatrics Current Opinion in Psychiatry Current Opinion in Pulmonary Medicine Current Opinion in Rheumatology Current Opinion in Urology Diabetes 7
  8. 8. Diagnostic Molecular Pathology Ear & Hearing Epidemiology European Journal of Cancer Prevention European Journal of Gastroenterology & Hepatology Fertility & Sterility Gastroenterology Nursing Genetics in Medicine Gut Health Physics Heart & Lung: Journal of Acute & Critical Care Heart Hypertension International Anesthesiology Clinics International Journal of Gynecological Pathology International Journal of Pharmaceutical Medicine International Ophthalmology Clinics Investigative Radiology JAMA Journal for Nurses in Staff Development – JNSD Journal of Acquired Immune Deficiency Syndromes Journal of Advanced Nursing Journal of Allergy & Clinical Immunology Journal of Assisted Reproduction & Genetics Journal of Bone & Joint Surgery - American Volume Journal of Bone & Joint Surgery - American Volume Journal of Bone & Joint Surgery - British Volume Journal of Cardiopulmonary Rehabilitation Journal of Cardiovascular Pharmacology Journal of Cerebral Blood Flow & Metabolism Journal of Clinical Endocrinology & Metabolism Journal of Clinical Gastroenterology Journal of Clinical Investigation Journal of Clinical Neurophysiology Journal of Clinical Nursing Journal of Clinical Oncology Journal of Clinical Pathology-Clinical Molecular Pathology Edition Journal of Clinical Pathology Journal of Clinical Psychopharmacology Journal of Computer Assisted Tomography Journal of ECT Journal of Endodontics Journal of Family Practice Journal of General Internal Medicine Journal of Hypertension Journal of Immunotherapy Journal of Infusion Nursing Journal of Intravenous Nursing Journal of Investigative Dermatology. Symposium Proceedings Journal of Investigative Dermatology Journal of Medical Microbiology Journal of Nervous & Mental Disease Journal of Neurology, Neurosurgery & Psychiatry Journal of Neurosurgical Anesthesiology Journal of Nursing Administration Journal of Nursing Staff Development Journal of Occupational & Environmental Medicine Journal of Orthopaedic Trauma Journal of Pediatric Gastroenterology & Nutrition Journal of Pediatric Hematology/Oncology 8
  9. 9. Journal of Pediatric Orthopedics Journal of Pediatrics Journal of Spinal Disorders Journal of the American Academy of Child & Adolescent Psychiatry Journal of Thoracic Imaging Journal of Trauma-Injury Infection & Critical Care Journal of Urology Journal of Vascular & Interventional Radiology Kidney International – Supplement Kidney International Laboratory Investigation Laryngoscope Lippincott's Case Management Mayo Clinic Proceedings MCN, American Journal of Maternal Child Nursing Medical Care Medicine & Science in Sports & Exercise Medicine Melanoma Research Menopause Modern Pathology Molecular Pathology Nature Neurology Neurosurgery Nuclear Medicine Communications Nurse Educator Nursing Case Management Nursing Management Nursing Research Nursing Standard Obstetrical & Gynecological Survey Ophthalmic Plastic & Reconstructive Surgery Optometry & Vision Science Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics Outcomes Management for Nursing Practice Pancreas Pediatric Emergency Care Pediatric Infectious Disease Journal Pediatric Research Pharmacogenetics Plastic & Reconstructive Surgery Psychiatric Genetics Psychological Medicine Psychosomatic Medicine QJM Sexually Transmitted Diseases SGIM Forum Soil Science Spine Stroke Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Therapeutic Drug Monitoring Thorax Topics in Magnetic Resonance Imaging Transplantation Appendix 2 ConiQ software PDAs 9
  10. 10. The CogniQ software delivers to your handheld: 1) quick-reference sections of Clinical Evidence: Clinical evidence provides brief summaries of the state of evidence on certain topic areas. Topic areas are selected based on research2 that identified important clinical questions. The team at BMJ then searches for and summarise the best available evidence to answer these questions. Clinical evidence is up-to-date, quantified and referenced. 2)and the latest table of contents and abstracts from the BMJ and BMJ Specialist Journals: Thorax Heart Archives of Diseases in Childhood BMJ Gut Journal of Clinical Pathology Western Journal of Medicine Quality in Health Care British Journal of Sports Medicine British Journal of Ophthalmology You can request the full text for content of interest; on synchronization, the requests are sent to your personal library on the web where you can link to the full text of Clinical Evidence and BMJ journals as well as perform sophisticated searches of MEDLINE. CogniQ is compatible with Palms only, but will be available for Pocket PCs soon. Download the CogniQ software now: 2 Ely JW, Osheroff JA, Ebell MJ, et al. Analysis of questions asked by family doctors regarding patient care. BMJ 1999;319:358-361. 10