Pocket Digital Assistants and Use for Staff Nurses

The personal digital assistant PDA) is a handheld device originally designed as personal organizers but over the years have advanced becoming the newest tool in the academic toolbox. It had broad capabilities is a powerful reference source as well as a computer and communicator that can be stored in a pocket.

The PDA was first developed in 1993 by Apple Computer and was named the Newton. Later Palm, Inc. released the Pilot 1000 and 5000 which retailed for about $500 (Wikipedia). Today the PDA has become a necessity to many people. It has a broad range of functions which may include a cell phone, address book, GPS receiver or camera and retails for about $250 (Wikipedia).

The use of the PDA has found a place in the general life of the public but also has become an essential part of many professions. The medical and nursing professions have embraced this technology as well. Due to the ease of programming of the PDA, many programs for use in the medical community have been developed for that operating system. According to Hunt, in 2002 an estimated 18 percent of physicians and only 1 percent, approximately 25,000, of all nurses were using the PDA in their practices.

Currently the PDA is used in a fairly limited manner. Many people use the PDA as a personal organizer, memo pad and phone book whereas many healthcare professionals use it as a resource for patient care. However, some healthcare professionals use it to organize patient data, track patient visits, in addition to writing and transmitting prescriptions. The PDA is also widely used by healthcare professionals for information about drugs; the information that the professional can obtain about drugs are their side effects, interactions as well as dosages. Medical calculators are also frequently used to estimate measures such as arterial blood gases, body mass indexes, laboratory values and drip/infusion rates (Fischer, eta.)

The healthcare community has not been left behind in the development of resources for the PDA. However, it may be reasonable to assume that full usage of its capabilities is lagging behind the development. The technology is developing faster than the practitioners can incorporate it into their practice. There are currently some very common uses in the medical community of the PDA. There are many resource books that are sold in a formal that allows the downloading of the entire text onto the PDA.

PDAs are in use by nurses in some of the same ways that other healthcare providers are using them. However, they are also being used in some unique ways as well. Hunt (2002) describes a variety of ways that nurses use the PDA. Intensive care unit and emergency room nurses found PDAs to be helpful for emergency and reference protocols as well as for various laboratory references and drip calculations. Hunt also suggests that pre-operative nurses use the drug references during the preoperative evaluations.

Nurses in the inpatient units will benefit from the PDA. In their pockets will reside one of the most powerful reference tools that the profession has seen. Calculations will be made without error; reference books and journal articles will be stored for immediate reference capabilities. Medications can be investigated for their dosages and side effects. The medication profiles can then be checked quickly and accurately. The nurses will also be able to access their schedules, their patient responsibilities and send report from one shift to the next.

Nurses in the outpatient setting and nurse practitioners (NP) will also benefit from the use of a PDA. Charting will involve checklists and these will be completed on the PDA that the nurse or NP holds in their hand while interviewing the patient. The nurse and the NP will have access to patient care records as well as other records that will make the job easier, such as a current list of medications and long term diagnosis lists, graphs of vital signs and a current medical history. The nurse practitioner will have access to

Home health nurses use it to store valuable information about patient care in a portable manner. Houck (2001) reports that the nurses of the Visiting Nurses' Association Home Health Systems in Santa Ana, California have PDAs and have decreased the three to four hours that they spent doing paperwork at night to a period of 90 minutes. Each PDA was loaded with patient care forms, charts and references. This allowed the nurses to complete necessary paperwork at the time that the service was rendered. It provided nurses, who originally felt overworked, a feeling of greater job satisfaction.

Another use noted in the literature is for the self-management of chronic illness by the patient. A program used by Healthcare professionals (Lusky, 2000) in Ontario, Canada is designed to help patients log their blood glucose levels, insulin doses, exercise and meal plans. The program includes decision trees for hyperglycemia, hypoglyccmia and acute illnesses. It informs the patient of what steps to take and when to call the provider. Information can be downloaded for the provider, if necessary, for the immediate review online. This type of approach could be adapted to many types of chronic illnesses allowing the patient to have autonomy and support simultaneously.

Nurse educators will find that the PDA is increasingly becoming a necessary part of their students' education and practice. The textbooks will be available