Mobile technology for nurses has changed the face of nursing education and clinical practice. During the past decade, colleges of nursing have responded to the call of the Institute of Medicine (IOM), Quality and Safety Education for Nurses (QSEN) and American Association of Colleges of Nursing (AACN) to increase patient safety through nursing informatics and technology. By utilizing mobile resources for nursing education in the classroom, lab and clinical venues, students develop enhanced skills in critical thinking and clinical decision making. Integrating handheld mobile technology into nursing curricula allows nursing students and faculty to provide safer patient care based on current best practices. Reference software applications are now available for download onto smart phones of all types including BlackBerry, iPhone and Android as well personal digital assistant devices such as the iTouch.
A significant number of nursing references are available at a nursing student's fingertips in the classroom, lab and point-of-care. They provide students with instant access to best practice information that can be applied in both simulated and clinical practice settings. Many mobile resources are based on evidence-based practice findings, include illustrations for the multi-modal learner and are updated more frequently than their printed counterparts. Due to the depth and breadth of information readily available on mobile devices, students can be more actively engaged in learning in the classroom and clinical laboratory setting through case study work, concept and conceptual care map development and clinical pathway or care plan work that in the past was limited by lack of textbook availability.
Patient safety is by far the most essential reason for the integration of mobile technology into nursing curricula and practice. Early IOM reports called for all healthcare direct care providers to have immediate access to electronic references. The most recent IOM report, The Future of Nursing: Leading Change, Advancing Health, emphasizes that nurses use technology resources that "require skills in analysis and synthesis to improve the quality and effectiveness of care." This underscores the need for mobile technology to be fully integrated at all levels of nursing education from associate degree to doctoral practice.
|Barbara Yoost, MSN, RN, CNS, CNE
The most obvious use of mobile technology in nursing education and practice is in preventing medication errors. Nurses are often the final step in the administration process to prevent a medication error. Mobile technology provides nursing students and nurses with instant access to safe dose, compatibility, and pharmacokinetic information essential for safe medication administration. Instead of hunting for a medication reference book or calling the pharmacist to verify dosage or correct medication, nursing students and their faculty, and professional nurses now have resources to make safe decisions with up-to-date mobile references at their fingertips.
Mobile software resources help nursing students to be more prepared for clinical assignments and to provide comprehensive nursing care. As students are progressing through their coursework, it is impossible for them to have all of the knowledge of an experienced nurse. Yet even beginning students are expected to provide care similar to that of experienced professional nurses from their first day on a clinical unit.
Using mobile references in the classroom and lab enhances the ability of students to analyze and synthesize critical information and apply it to simulated patient care scenarios. This is done through high fidelity simulation scenarios and case studies that require students to use assessment, nursing diagnosis, laboratory and diagnostic testing and drug references to answer questions and care for simulated and standardized patients. It is also accomplished through student development of care plans and concept maps. At Kent State University College of Nursing, undergraduates use seven mobile references to develop conceptual care maps on clinical patients. The conceptual care map integrates the pedagogies of concept maps and care plans for enhanced student learning. Concept maps and conceptual care maps are similar to diagnostic algorithms. Each is a diagram that identifies relationships among ideas, assisting students to synthesize patient data. Students "map out" their patient assessment data, history, medications, lab values and treatments prior to documenting the reasons for each medication and lab value deviation and developing a patient-centered plan of care.
In the clinical setting, acute or community based, mobile technology allows students to look up medical diagnoses quickly, become familiar with underlying pathophysiology, identify potential patient needs and assessment requirements, develop patient-centered goals, implement appropriate interventions and evaluate patient outcomes. Due to rapid patient discharge and the use of a variety of outpatient facilities for clinical education, the days when nursing faculty would give students their patient assignments the night before clinical are gone. Mobile technology allows student nurses to prepare rapidly for patient care at the beginning of each shift within the clinical setting. Nursing faculty report a significant increase in student knowledge and preparation prior to care when they utilize point-of-care resources.
Requiring students to turn off Internet access while in the clinical setting prevents them from receiving phone calls, accessing email or texting during clinical experiences. These types of restrictions enhance compliance with hospital regulations that prohibit the use of personal cell phones on nursing units. Mentoring students in the proper use of mobile references in the clinical setting minimizes abuse and demonstrates its value as an educational and practice resource.
Patient education is perhaps one of the most challenging aspects of practice for students new to the nursing role. Resources available via mobile technology enhance the ability of students to provide current evidence-based practice information to their patients in the clinical setting. Some handheld references include specific suggestions for patient education based on medical diagnoses. Mobile resources provide step-by-step instructions and photos on hundreds of procedures for students to use prior to or during patient education.
While the advantage of instant, current information available via mobile devices is fairly obvious, unique features make them an even greater educational tool. Features such as the ability to simultaneously search all software and link from one software reference to another enhance the ability of students to connect, analyze and synthesize disease and patient information. The search function provides research capability across references, while linkages connect one source to another. Simultaneous searching allows nursing students to type in a term on their mobile device and obtain a list of locations in which that term appears. Linking features connect related information among references. For instance, when a student is reading about heart failure and sees that digoxin is a drug of choice, the student can hit the link to look up information on digoxin in a drug reference and then hit another link to obtain safe digoxin blood levels from a diagnostic test reference. These features support a more rapid and deeper understanding by students of the multi-faceted nature of patient care.
Integrating mobile technology into nursing curricula is much easier now than it was even 2 years ago. A majority of college students own mobile technology such as an iTouch or smart phone, reducing the initial hardware cost. Software from leading providers is available for every platform including tablets such as the iPad. Software references are significantly less expensive than textbooks and if the software is required for coursework, financial aid typically will cover costs. Confidentiality agreements are overcoming barriers in facilities that have been reluctant to allow mobile technology due to potential privacy concerns. The vital role of mobile technology in patient safety can no longer be ignored.
Nursing faculty can choose from hundreds of references and decide what best fits the needs of their specific student population and course. A special website can be set up unique to a college of nursing to simplify student purchase of required software, often with a significant savings for bundled resources. Free trials for faculty and expert training and tutorials for both students and faculty are available through online and phone 24/7 support.
The goal of nursing curricula is to educate future nurses to provide safe, patient centered care based on scientific evidence. Mobile technology is an essential 21st century part of achieving that goal.
Barbara Yoost is the Fundamentals Level and Honors Program Coordinator at Kent State University College of Nursing in Kent, OH. Yoost has taught in associate, diploma and baccalaureate nursing programs over the past 30 years and is a recipient of the Excellence in Nursing Education Award from Sigma Theta Tau International, Delta Xi Chapter. She is also a faculty advisor and consultant to Skyscape.com, Inc., a company that provides mobile apps for medical professionals.