At medication rounds you learn your newest patient is on eight different drugs for various conditions, two of them newly prescribed during this hospital stay. You need to know quickly which drugs interact with which.
You could go to a drug guide text and look up each individual medication and then look up the interactions for each of the eight drugs. Or you could whip out your cell phone and dial up a mobile app specially designed for this situation!
That's what senior nursing student Roman Zitser did during clinical rotations as a student at Long Island University (LIU). So did Anna Klyauzova, another LIU senior. In fact, all junior and senior nursing students at the LIU Brooklyn campus are required to subscribe to a medical mobile technology application that is downloaded to their cell phones.
Besides providing all manner of drug information for any age of patients, the multi-functional application from a Massachusetts mobile medical information company offers a myriad of resources including patient education information, lab manuals and values for diagnostics, disease information, a medical dictionary and even updates on the latest medical breakthroughs. In some schools it is even used in test taking, although not at LIU.
Keeping up with Technology
All nursing students at LIU get the mobile application mid-semester junior year, said Esther Levine-Brill, PhD, MSN, ANP-BC, director of the Doctorate of Nursing Practice Program and professor of nursing at LIU. "This is just in time for learning and application for the beginning of clinical rotations, which right now is mainly where the app is used. But as of September, I'm proposing the technology for the start of junior year," Levine-Brill added, to support education in foundational nursing courses at the beginning of the semester.
Levine-Brill, who describes herself as a "techno," proposed the mobile application to the dean at LIU about 2 years ago. "I felt the IOM and other reports prove nurses need to be well-versed in technology for safety reasons; students need to be learning these things," she explained.
The program began with grant funding. When the grant ran out, students were required to purchase a mobile platform to support the application ¾ at a manufacturer's reduced cost of $155. The app works on almost any brand of phone or tablet computer. Students graduating from LIU this month are the first group to have used the mobile technology throughout their nursing education.
Levine-Brill said it was an easy transition because the mobile application company provides all technical support and training. "The company offers webinars and tutorials for students and their website is available 24/7 to answer questions," said Levine-Brill, who uses the app in her own work as a nurse practitioner.
Once students learn how to use the technology, they begin using it during clinical rotations, when allowed. "Some agencies where our students go [for clinicals], don't want the phones," Levine-Brill said. "We're trying to change that. We feel it's just like another textbook."
"In clinicals, it's great if you are doing patient teaching," Zitser said. "If a patient is having difficulty understanding the instructions, it can be helpful to bring the technology to the bedside to verify what you are instructing the patient to do." However, Zitser said the phone is never pulled out at the bedside to look up information or respond to a call.
(LIU student guidelines address hygiene issues around the use of phones in a hospital setting. "Students should wash their hands before and after using the phones," Levine-Brill said. "They also should wipe the phone with a disinfectant towel, preferably before and after use.")
Zitser, 28, who graduated LIU along with Klyauzova this year, said he appreciated the app most when it was time to distribute medications. "You'd go to the medication record and make a copy and circle the meds to be given to your patients and when they should be administered," he explained. "I'd input the meds into my drug guide and see whether there were any interactions between drugs. There's an application in the program that allows me to input all the medications my patient is taking and then tell me whether any two or three drugs can't interact."
Klyauzova found the mobile technology especially useful in caring for international patients. "You have people in New York from all over the world and they all have different names for different drugs," the 25-year-old senior student said. "The app gives you all the generic names for a drug, then you scroll down and find the brand name. It is so useful. It's a source you can go to in an instant."
Recognizing the Issues
Veteran bedside nurses are also beginning to recognize that. Nursing students tell Levine-Brill it is not unusual for bedside nurses to approach them to look up something. Zitser and Klyauzova verified that. "I had nurses of 30 years tell me we have all the information in our pockets with these apps," Klyauzova said.
It is also a great way to study for an exam on the subway or during classroom breaks, Klyauzova said. "You just plug in the name of a disease and it gives you all the information you need."
But does Levine-Brill worry students will not know the material because they can depend on a mobile technology?
"This doesn't take the place of learning," the educator said. "It won't do away with textbooks. But students won't have to buy drug guides and some other texts now.
"In terms of testing, students will have to know what is an abnormal value and what isn't and that is knowledge they must have at hand, without having to look it up.
"Students won't be taking their mobile app into the room with them when they take the NCLEX exam," Levine-Brill said. "They will need to know this information."
Levine-Brill said future nurses will know where to go to verify medication and other medical information because of this technology. "Having this type of resource will help increase safety."
And it looks like new nurses being educated with these mobile applications are sold on them. "I probably will continue to subscribe to this program when I practice as a nurse," Zitser said, and Klyauzova agreed.
"It's hard to keep up with every medication and interaction. Using this program saves time because you aren't searching pages and pages of a book. It's very convenient."
Gail O. Guterl is a frequent contributor to ADVANCE.