Mobile Technology Lessons Learned Along the Way

1. Mobile TechnologyLessons Learned Along the Way K Beard EdD GNP-BC NP-C ACNP-BC Hunter Bellevue School of Nursing

2. Discussion • Impetus behind mobile technology • Strategies used to implement mobile technology • Lessons learned when implementing technology

3. Medication Use • Any given wk - 4 out of 5 adults will use some type of medication (prescription, OTC, dietary supplements) • 1/3rd take 5 or more different medications • Sometimes preventable adverse drug events (ADE) occur in prescribing or taking the med • As a result Institute of Medicine (IOM) studied the prevalence of medication error • What do you think they found?

4. Deadly Medical Errors

5. Adverse Drug Events Injuries Due to Medication • 450,000preventable ADEs occur in hospitals each year • 800,000occur in long term care settings • 530,000Medicare patients experienced preventable ADEs in outpatient settings • Most likely to occur during the prescribing and administering stages • Hospital patient can expect at least one med error each day • As a result IOM studied the prevalence of medication error • How many individuals are injured or die every year from medication errors?

6. What Can We Do?????? • 1.3 million injured from ADE 1 person dies every day • Health care providers can’t keep up with all the information regarding medications • Use information technologies to reduce medication errors • Point of care reference information accessed from personal digital assistants

7. Complex fast paced environment threatens patient safety!!

8. Mobile Technology • Mobile technology - a platform whereby nurses can download nursing software and access informationat the point of care • Mobile technology can • Reduce errors • Improve care • Promote patient safety by increasing accuracy and efficiency

9. Promoting Excellence in Clinical Practice • Select a reference tool for point of care access (PDA & Software) • Have support readily available (software company) • Faculty point person • Acquire financing (cost efficient) • Educate faculty and students

10. Nursing Based Software • Contained drug content • Laboratory values • Disease Processes • Medical dictionary • Required for each student entering their first medical surgical clinical rotation • Made it a student fee so costs covered by scholarships or loan monies • Replaced several textbooks (nursing care plan text, medication drug guide, lab guide)

11. Evaluation of Program • Wanted to know who was using it • When they were using it • What were the likes/dislikes • Did it prevent medication errors?

12. Who’s using the software and when??? • 95 students completed survey • All used a variety of platforms (PDA, smartphone) • 96.7% used it for clinical • 58.7% used while studying • 46.7 used it during class • 43.5% used it to look up information for patients

13. Medication Administration Feature • Students using software to identify • Drug indications (88.6%) • Adverse effects of drugs (77.3%) • Medication contraindications (69.3%) • Generic names (64.8%) • Dose range (27.3%) • Dosage calculator (9.1%)

14. Error Reduction • 83.7% stated software never helped prevent an error • 16.2% reported that software prevented a clinical error • 6.5% reported it helped on more than 3 occasions • Error reduction was compared between levels 1 and 2 students- no significant difference

15. Lessons Learned • Multidisciplinary team needed (IT support, student financing, team leader) • Orientation before and several wks after initiation • Software that can be periodically updated • Cost saving benefit – less medication errors (Although some students felt the cost outweighed the benefit) • Negative comments from students stemmed from lack of modeling behavior by faculty • The importance of faculty modeling the behavior of using the PDA is an important aspect for students’ acceptance of the PDA/software

16. Questions????????

17. References Institute of Medicine. (2006). Preventing Medication Errors. Retrieved from http://www.iom.edu/~/media/Files/Report%20Files/2006/Preventing-Medication-Errors-Quality-Chasm-Series/medicationerrorsnew.pdf U. S. Department of Health & Human Services. Medication error report. (2009). Retrieved from http://www.fda.gov/Drugs/DrugSafety/MedicationErrors/ucm080629.htm Beard, K. V., Greenfield, S., Morote, S., Walter, R. (2011). Mobile technology: Lessons learned along the way. Nurse Educator 36(3), 103-106.