The Cons
Starting with the "cons". Naysayers to the use of smartphones in the workplace have very few arguments on which to base their beliefs. That said, the arguments they raise are huge. Let's look at three key issues in the fight against leaving the dark ages: violation of HIPAA, security risks, and infection control.
Violation of HIPAA
American Nurse Today (2014) expresses concerns over nurses violating federal laws and the ANA Code of Ethics by using cellphones. Patient information must be protected and sending health information over the phone can put that information at risk. Posting photos of your patient or tweeting about your patient may seem like a "no-brainer" to most, but apparently, that is just not the case for ALL. Doing so could cost a nurse not only their job, but their license and possible fines and jail time. Even something as innocent as posting on your patient's hospital based support page to show support for them could be a violation - as most of these sites will list the name of the poster that can be seen by others! This is an example of inadvertent release of confidential information through social media.
Security
Hackers. They get into everything - including cell phones. More and more people are using some type of security password on their phones, but a recent survey found that two of five people do not use basic security precautions. Of the 1,000 American workers surveyed, 88.6% state they use their phone for work, but 39% do not have it secured with a password, and 52% use an unsecured Wi-Fi network (a security vulnerability at high risk for data theft), according to American Nurse Today (2014). This is another risk for a HIPAA violation. Sending a text to a physician with patient information could not only be hacked, but accidentally sent to the wrong person.
Infection control issues
According to Occupational Health and Safety (2012) the health risks involved in using mobile devices in the workplace are obvious, considering the factors that contribute to harboring bacteria on cellphones. In order to determine how MUCH bacteria grew on our cellphones, a study was conducted using swabs on healthcare workers phones. Of the 51 phones that were swabbed, only 5 phones showed no growth, and the rest were action packed with everything from Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. To name a few.
This is a concern, of course, because of the increased risk it places on our patients to obtain a hospital acquired infection.
Now for the not so big issue, but an argument against cellphone use, nonetheless. Using a cellphone in front of your patient is not professional. In my opinion, I think it has to do with the context in which your phone is used. For example, explaining to your patient why you are using it (i.e., look up drug information, diagnosis education, etc.) before you begin to use it would be polite, just so they do not think you are checking on how many likes you got on your last post. Additionally, the age of your patient as well as their culture should be considered. Many of the baby boomers might find it offensive if their nurse takes out their phone and begins to use it, as may some ethnicities who may find it disrespectful as well as unprofessional, if they do not understand what you are using your phone for.
The Pros
Enough of the cons, let's move on to the pros!
Statistics
According to Health News (2015), a recent survey by Spyglass Consulting Group found that at least 70% of hospital nurses use their cellphones for work related communications. Another survey by InCrowd found that 95% of 241 nurses owns a smartphone and 88% of them use it at work. Additionally, 52% use an app to find information related to treatment instead of asking a colleague, and 32% use it instead of asking a physician. What type of information? 73% look up drug info while at the bedside, and 72% look up diseases or disorders.
Support
The Institute of Medicine (2006) endorses the use of technology by healthcare providers to reduce the risk and the prevention of medication errors - and drug references are among the most used type of mobile apps. The Emergency Nurses Association (2013) stated in their position that nurses' access of mobile technology can provide information essential to their practice and has the potential to increase patient safety as well as emergency practice efficiency.
Interestingly, we can bring the Joint Commission into this! TJC reports that a failure to communicate properly is related to more than 60% of reported sentinel events. Nurses were reported to waste over 1 hour each shift tracking down providers regarding their patients, and texting provides a very efficient, fast, and quiet method to reach them (Journal of Nursing Education and Practice, 2014).
Apps
MedScape discusses a study published in the Journal for Nurse Practitioners (2014) concluded that apps enable clinicians to use evidence based guidelines for the treatment in care for their patients, as well as provide a greater chance in the identification of serious health issues during routine exams. According to Nurses who use apps as support tools are four to 44 times more successful in helping providers to diagnose chronic health issues.
There are hundreds of amazing nursing apps out there, but here is a 2014 list (taken verbatim) of the top 10 apps for nurses and nursing students, according to Capella University (and just look at who made number 10!!):
This simple app downloads a medication library to your phone. Great for students preparing for exams or nurses who need a quick reference point.
AVAILABILITY: iOS and Android; Free
This app turns the RN Pocket Guide by Informed Publishing into a digital information resource. Includes sections on CPR, Assessing, Cardiac, Respiratory, Neurological, Pediatrics, and more. A helpful resource for students studying for general or specialty coursework.
AVAILABILITY: iPhone, iPad, Android, Nook; price varies by $5-$10 depending upon device
PEPID - Drug and Clinical Resource
With different versions for different professions, including nurses, EMTs, physicians, students and more, this app provides detailed information for all elements of patient care. Students gain a credible and complete resource guide for coursework, lab exercises, and clinical practice.
AVAILABILITY: iOS, Android, Blackberry, and mobile browser compatible; student subscription starts at $195 for 1 year
Epocrates - Clinical Care Assistant
This app streamlines searches for information on prescription drugs, drug interactions, and a directory of providers. Nursing students can prevent mistakes on exams, and most importantly, provide proper treatment when they begin practicing.
AVAILABILITY: iOS and Android; free, with a $160 upgrade for disease and diagnostic access, or enterprise subscription
Medscape - Informational Resource
Published by WebMD, this top free app provides access to a medical directory, continuing education, medical news, and clinical reference library. The news aspect of this app helps students stay up-to-date in the industry.
AVAILABILITY: iOS and Android; free
WebMD - Access Full WebMD Resources
App version of WebMD website. Because Web MD is created primarily for the general public, nursing students can use the available resources on the app to practice describing care to patients with non-medical terminology.
AVAILABILITY: iOS and Android; free
Code Happy - Nursing Support System
Social network for nurses and students to find support from peers. It helps users gain and share perspective on a variety of nursing topics from residency rounds to passing exams.
AVAILABILITY: iOS and Android; free
A mobile version of one of the best medical dictionaries on the market. Includes photos, videos, audio pronunciations, and functionality to save favorite entries. This dictionary has 65,000 definitions to help nursing students study for tests.
AVAILABILITY: iOS, Android, Blackberry, and mobile browser compatible; $40 for 1-year subscription
AACN Bedside - Topical Reference Guides
The American Association of Critical Care Nurses created this app to provide a mobile marketplace for its popular laminated pocket cards. Pocket card topics include lab values, medication calculations, cardiac medications, and many more. Students can use this easily digestible information while studying on the go.
AVAILABILITY: iOS and Android; free with in-app purchases
allnurses.com app- Nursing Social Network
More than 900,000 members and peer-to-peer networking for nurses and nursing students. The app allows practicing nurses and students to find professional support and the latest nursing news. Offering the same tools as the website, the app allows users to post and read message threads, read/vote on polls, and search for topics.
AVAILABILITY: iOS and Android; free
Recommendations
Using smartphones at work is a fast, easy, and timesaving way to get the information you need to better care for your patient. Nurses should follow their hospital policy for use. Use passwords to protect your cell phone. Do not send patient identifiers through your cell phone to other providers unless it is encrypted. Consider ethics when using your smartphone. Do not comment, visit, or share any patient information on any social media site. Most of all, use your head - be smart when using that smartphone!
References
American Nurse Today. (2014). Evolution or revolution? Smartphone use in nursing practice. Retrieved from: http://www.americannursetoday.com/evolution-revolution-smartphone-use-nursing-practice/
Emergency Nurses' Association. (2014). Mobile electronic device use in the emergency setting. Retrieved from: https://www.ena.org/SiteCollectionDocuments/Position%20Statements/MobileElectronicDevice.pdf
Health News. (2015). Nurses and smartphones: A vital connection. Retrieved from: http://www.mhealthnews.com/news/nurses-and-smartphones-vital-connection
Institute of Medicine. (2006). Preventing medication errors. Retrieved from http://www.iom.edu/~/media/Files/Report%20Files/2006/Preventing-MedicationErrors-Quality-Chasm-Series/medicationerrorsnew.pdf
Journal of Nursing Education and Practice. (2014). Smartphones and computer tablets: Friend or foe? Retrieved from: http://tinyurl.com/p4m6p3c
MedScape. (2014) The effect of a mobile health decision support system on diagnosis and management of obesity, tobacco use and depression in adults and children. Retrieved from: http://www.medscape.com/viewarticle/834908
Occupational Health & Safety. 2012. Mobile phones in hospital settings: A serious threat to infection control practices. Retrieved from: https://ohsonline.com/articles/2012/03/01/mobile-phones-in-hospital-settings.aspx
