Evidence-based policy? The use of mobile phones in hospital

The Impact of Smartphone Addiction on Sleep Quality Among High School Students in Makkah, Saudi Arabia

Background Smartphones are Internet-accessible devices that everyone can use in any setting, and their popularity is growing. However, the pervasiveness of smartphone technology has raised concerns owing to its addictive effect among adolescents and its association with sleep quality and mental and physical health issues. Objectives This study aimed to determine the effect of smartphone addiction on sleep quality among secondary high schools in Makkah, Saudi Arabia. Methods The study was conducted on high school students in Makkah, Saudi Arabia, using an analytical cross-sectional design, from January 2023 to August 2023. The study used a multistage stratified random sampling technique to select participants. The data were collected from an online self-administered survey and analyzed using IBM SPSS Statistics for Windows (IBM Corp., Armonk, New York, United States). Results This study included 373 respondents. Among those, males represent two-thirds of the study population (66%), while females are 34%. The median age of the participants is 16 years old, and the interquartile range (IQR) is 6. Our results show that the median number of hours spent on mobile phones is six per day, and the IQR is 5. Furthermore, our findings reveal that the mean Smartphone Addiction Scale-Short Version (SAS-SV) score is 38.5 ± 10.8 out of 60, and the average global PSQI score is 6.63 ± 3.03 out of 21. The results show that the study participants have problems using smartphones longer than they intended, constantly checking them, and missing planned works due to smartphone use. There is a positive correlation between smartphone addiction and sleep quality (r = 0.261; p < 0.001), indicating that the respondents have worse sleep quality when smartphone addiction and the global PSQI increased. Conclusion Our study concluded that high school students in Makkah, Saudi Arabia, have high smartphone addiction. Moreover, high smartphone addiction is significantly associated with poor sleep quality. This study can help with the development of measures to improve better sleep quality among high school students.

Short message service usage may improve the public's self-health management: A community-based randomized controlled study

Background and Aims

The last decade has witnessed unprecedented growth in mobile phone use. It links millions of previously unconnected people. The ubiquity of mobile phones, which allows for use of the short message service (SMS), offers new and innovative opportunities for disease prevention and health education. SMS usage appears to be a feasible, popular, and effective way of improving health literacy. This study measured the effect of SMS health education on the improvement of health management in Shenzhen, China.

Methods

This was a community-based randomized controlled study. A total of 32 communities were randomly chosen out of 320, then about 200 participants were randomly sampled from each selected community. The subjects were equally divided into two groups at random. About half of the participants received health intervention messages via Internet-based SMS for almost a year. The data were analyzed by descriptive and inferential statistical methods.

Results

The proportion of participants involved in self-health management increased from 30.92% to 38.68% over the year (χ 2 = 42.49, p < 0.001) in the intervention group. People with marginal health literacy reported the highest increase (10.92%), while people with low health literacy reported the smallest (5.25%). The control group showed no difference in baseline and final health management proportions (28.02% and 29.64%, p > 0.05). No statistical difference in the prevalence of chronic disease (15.16% and 13.89%, p > 0.05) was found before and after the intervention in the intervention group. The prevalence in the intervention group was lower after the intervention than it was in the control group (17.33%, χ 2 = 14.45, p < 0.001).

Conclusions

SMS may be a powerful tool for improving the public's health literacy and health management because it is widely available, popular, affordable, and instant.

Policy recommendations on nurses' use of smartphones in the Philippines

BACKGROUND

One key technology that has a significant implication on how nurses communicate and share information is the mobile phone, particularly the smartphone. However, its use for clinical work should be regulated by policies to minimize risks and maximize benefits.

OBJECTIVE

To present policy recommendations on nurses' use of smartphones that are applicable in the context of clinical work in the Philippines.

MATERIALS AND METHOD

The policy recommendations were developed by synthesizing findings of a mixed-method research on nurses' use of smartphones in the Philippines conducted from January to July 2017.

RESULTS

The four policy recommendations are: (1) improving existing technologies to reduce smartphone usage, (2) providing adequate unit phones and service credits, (3) implementing realistic policies, and (4) educating nurses on the implications of using smartphones at work.

DISCUSSION AND CONCLUSION

Although these recommendations might not be ideal considering that smartphone use also presents drawbacks, a pragmatic decision to allow nurses to use it for communication and information seeking purposes can help enhance the quality of care given to patients and nurses' work productivity in settings with scarce manpower and technology. Nonetheless, hospitals should find these recommendations as a temporary solution, and they should strive to come up with a long-term solution of providing nurses with appropriate technologies to facilitate clinical work.

Questionnaire-based evaluation of mobile phone interference with medical-electrical equipment in Swedish hospitals

National recommendations in Sweden recommend a safety distance of 3 meter (m) between mobile phones and medical-electrical (ME) equipment in hospitals. A questionnaire was used to investigate how often mobile phones were reported to interfere with ME products in clinical practice across Sweden. The results confirmed that ME equipment can be affected by mobile phone use but, the risk of the patient's outcome being affected were minimal; no cases were identified which led to injury or death. In conclusion, the results support recommendations for a general safety distance of 0.5 m between mobile phones and ME equipment in care environments.

Residents’ use of mobile technologies: three challenges for graduate medical education

Introduction

The practice of medicine involves, among other things, managing ambiguity, interpreting context and making decisions in the face of uncertainty. These uncertainties, amplified for learners, can be negotiated in a variety of ways; however, the promise, efficiency and availability of mobile technologies and clinical decision supports make these tools an appealing way to manage ambiguity.

Mobile technologies are becoming increasingly prevalent in medical education and in the practice of medicine. Because of this, we explored how the use of mobile technologies is influencing residents’ experiences of graduate medical education.

Methods

We conducted an 18-month qualitative investigation to explore this issue. Our research was conceptually and theoretically framed in sociomaterial studies of professional learning. Specifically, our methods included logging of technology use and related reflexive writing by residents (n=10), interviews with residents (n=12) and interviews with faculty (n=6).

Results

We identified three challenges for graduate medical education related to mobile technology use: (1) efficiency versus critical thinking; (2) patient context versus evidence-based medicine and (3) home/work-life balance.

Discussion

In this digital age, decontextualised knowledge is readily available. Our data indicate that rather than access to accurate knowledge, the more pressing challenge for medical educators is managing how, when and why learners choose to access that information.

Remote Blood Glucose Monitoring in mHealth Scenarios: A Review

Glucose concentration in the blood stream is a critical vital parameter and an effective monitoring of this quantity is crucial for diabetes treatment and intensive care management. Effective bio-sensing technology and advanced signal processing are therefore of unquestioned importance for blood glucose monitoring. Nevertheless, collecting measurements only represents part of the process as another critical task involves delivering the collected measures to the treating specialists and caregivers. These include the clinical staff, the patient's significant other, his/her family members, and many other actors helping with the patient treatment that may be located far away from him/her. In all of these cases, a remote monitoring system, in charge of delivering the relevant information to the right player, becomes an important part of the sensing architecture. In this paper, we review how the remote monitoring architectures have evolved over time, paralleling the progress in the Information and Communication Technologies, and describe our experiences with the design of telemedicine systems for blood glucose monitoring in three medical applications. The paper ends summarizing the lessons learned through the experiences of the authors and discussing the challenges arising from a large-scale integration of sensors and actuators.

Sociotechnical analysis of nurses' use of personal mobile phones at work

BACKGROUND

Nurses' use of personal mobiles phones at work is a growing trend in healthcare organizations. Although recent studies have explored the positive and negative implications of nurses using personal mobile phones at work, none has yet analyzed the interactions of sociotechnical components (users, technology and policy) on nurses' use of personal mobile phones at work.

OBJECTIVES

Identify sociotechnical interactions by analyzing each sociotechnical component (users, technology and policy) that affects nurses' use of personal mobile phones at work.

METHODS

In-depth interviews were conducted with 30 nurses employed in 13 hospitals in the Philippines. The respondents include staff nurses (n=23), charge nurses (n=4), and nurse managers (n=3). Staff nurses were asked on their use of personal mobile phones at work, while charge and nurse managers were asked on their observations regarding staff nurses' use of personal mobile phones at work. Responses were analyzed qualitatively using sociotechnical analysis.

RESULTS

Sociotechnical analysis indicated that staff nurses used their personal mobile phones at work in various ways because its use helped in their nursing work, but inevitably altered a few of their routines. Although most hospitals had policies that prohibit the use of mobile phones, staff nurses justified their use of personal mobile phones by using it for work purposes and for the benefit of their patients. Staff nurses highlighted the absence of hospital-provided mobile phones as a key reason for using personal mobile phones at work. Charge nurses and nurse managers also influenced staff nurses' use of personal mobile phones at work.

CONCLUSIONS

Nurses could use their personal mobile phones at work for work purposes to enhance their clinical performance and improve patient care. Hospital administrators can leverage on nurses' use of personal mobile phones at work by formulating policies that consider both the benefits and potential drawbacks of mobile phone usage. Recommendations are made for the formulation of hospital policies to optimize the use of personal mobile phones of nurses at work.

Bacterial contamination of cell phones of medical students at King Abdulaziz University, Jeddah, Saudi Arabia

Cell phones are commonly used in healthcare settings for rapid communication within hospitals. Concerns have been increased about the use of these devices in hospitals, as they can be used everywhere, even in toilets. Therefore, they can be vehicles for transmitting pathogens to patients. This study aimed to examine the presence of pathogenic bacteria on the surfaces of cell phones that are used frequently by preclinical medical students. This cross-sectional study identified both pathogenic and nonpathogenic bacteria on cell phones of 105 medical students at King Abdulaziz University, Jeddah, Saudi Arabia, using standard microbiological methods. Out of 105 cell phones screened, 101 (96.2%) were contaminated with bacteria. Coagulase-negative staphylococci were the most abundant isolates (68%). Seventeen (16.2%) cell phones were found to harbor Staphylococcus aureus. Gram-positive bacilli were isolated from 20 (19%) samples. Viridans streptococci and Pantoea species were also isolated but at lower levels. Our findings indicate that cell phones can act as reservoirs of both pathogenic and nonpathogenic organisms. Therefore, full guidelines about restricting the use of cell phones in clinical environments, hand hygiene, and frequent decontamination of mobile devices are recommended at an early stage in medical schools, to limit the risk of cross-contamination and healthcare-associated infections caused by cell phones.

Lower Extremity Tissue Defect Caused by Mobile Phone Charger Explosion: A Case Report

As the usage of cell phones is markedly increasing worldwide, accidental injuries and even lethal damages caused by cellular phone explosions have been reported lately. Although, cell phone charger explosion related scalding and tissue loss is extremely rare, they generally cause severe damage to tissues and cause severe complications, ending up in hospitalization. We are presenting a case of 9-year old female patient who was admitted to our emergency service due to a phone charger explosion that resulted in a lower extremity tissue defect.

Interference of mobile phones and digitally enhanced cordless telecommunications mobile phones in renal scintigraphy

PURPOSE

The aim of the study was to assess the potential negative impact of cellular phones and digitally enhanced cordless telecommunication (DECT) devices on the quality of static and dynamic scintigraphy to avoid repeated testing in infant and teenage patients to protect them from unnecessary radiation exposure.

METHODS

The assessment was conducted by performing phantom measurements under real conditions. A functional renal-phantom acting as a pair of kidneys in dynamic scans was created. Data were collected using the setup of cellular phones and DECT phones placed in different positions in relation to a camera head to test the potential interference of cellular phones and DECT phones with the cameras.

RESULTS

Cellular phones reproducibly interfered with the oldest type of gamma camera, which, because of its single-head specification, is the device most often used for renal examinations. Curves indicating the renal function were considerably disrupted; cellular phones as well as DECT phones showed a disturbance concerning static acquisition.

CONCLUSIONS

Variable electromagnetic tolerance in different types of γ-cameras could be identified. Moreover, a straightforward, low-cost method of testing the susceptibility of equipment to interference caused by cellular phones and DECT phones was generated. Even though some departments use newer models of γ-cameras, which are less susceptible to electromagnetic interference, we recommend testing examination rooms to avoid any interference caused by cellular phones. The potential electromagnetic interference should be taken into account when the purchase of new sensitive medical equipment is being considered, not least because the technology of mobile communication is developing fast, which also means that different standards of wave bands will be issued in the future.

Contamination rates between smart cell phones and non-smart cell phones of healthcare workers

BACKGROUND

Healthcare workers' mobile phones are easily contaminated with pathogenic bacteria and could be vehicles of transmission. Smart phones are increasingly used in the hospital. The objective of this study was to compare the contamination rate of bacteria with pathogenic potential between smart phones and non-smart phones.

METHODS

We screened mobile phones of healthcare workers in three teaching hospitals in South Korea. The identification of cultivated micro-organisms and assessment of antibiotic susceptibility were performed.

RESULTS

One hundred fifteen (56.7%) participants used smart phones, and 88 (43.3%) used non-smart phones. Bacteria with pathogenic potential were isolated from 58 (28.6%) mobile phones, more often from smart phones than from non-smart phones (34.8% vs 20.5%, P=0.03). Multivariate analysis including various characteristics to determine risk factors revealed that only smart phones (vs non-smart phones) were a significant risk factor for contamination by bacteria with pathogenic potential (adjusted odds ratio [OR], 4.02; 95% confidence interval [CI], 1.43-11.31). Also, in a multivariate model including phone size, the smart phone was still a significant risk factor for the pathogen contamination (OR, 4.17; 95% CI, 1.07-16.33; P=0.04).

CONCLUSION

The smart phones of healthcare workers were contaminated with bacteria with pathogenic potential to a greater extent than were non-smart phones.

Informatics in radiology: Intuitive user interface for 3D image manipulation using augmented reality and a smartphone as a remote control

Although widely used as a pointing device on personal computers (PCs), the mouse was originally designed for control of two-dimensional (2D) cursor movement and is not suited to complex three-dimensional (3D) image manipulation. Augmented reality (AR) is a field of computer science that involves combining the physical world and an interactive 3D virtual world; it represents a new 3D user interface (UI) paradigm. A system for 3D and four-dimensional (4D) image manipulation has been developed that uses optical tracking AR integrated with a smartphone remote control. The smartphone is placed in a hard case (jacket) with a 2D printed fiducial marker for AR on the back. It is connected to a conventional PC with an embedded Web camera by means of WiFi. The touch screen UI of the smartphone is then used as a remote control for 3D and 4D image manipulation. Using this system, the radiologist can easily manipulate 3D and 4D images from computed tomography and magnetic resonance imaging in an AR environment with high-quality image resolution. Pilot assessment of this system suggests that radiologists will be able to manipulate 3D and 4D images in the reading room in the near future. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.324115086/-/DC1.

Bringing the artificial pancreas home: telemedicine aspects

The design and implementation of telemedicine systems able to support the artificial pancreas need careful choices to cope with technological requirements while preserving performance and decision support capabilities. This article addresses the issue of designing a general architecture for the telemedicine components of an artificial pancreas and illustrates a viable solution that is able to deal with different use cases and is amenable to support mobile-health implementations. The goal is to enforce interoperability among the components of the architecture and guarantee maximum flexibility for the ensuing implementations. Thus, the design stresses modularity and separation of concerns along with adoption of clearly defined protocols for interconnecting the necessary components. This accounts for the implementation of integrated telemedicine systems suitable as short-term monitoring devices for supporting validation of closed-loop algorithms as well as devices meant to provide a lifelong tighter control on the patient state once the artificial pancreas has become the preferred treatment for patients with diabetes.

Increasing clinical presence of mobile communication technology: avoiding the pitfalls

Mobile communication technologies are employed in many diverse areas of healthcare delivery to provide improved quality and efficiency of communication and facilitate increased rapidity of data or information transfer. Mobile phones enable healthcare professionals to possess a portable platform from which to provide many healthcare-related applications and are a popular means to directly communicate with colleagues and patients. As involvement of mobile communication technology in healthcare delivery continues to rapidly expand, there are also important considerations of relevance to patient safety and security as a result. Here, we review the previous evidence of reported clinical risks associated with mobile communication technology, such as electromagnetic interference, confidentiality and data security, distraction/noise, infection control, and cross contamination. In conclusion, although mobile phones provide much putative potential improvement to healthcare delivery, further evaluation and research are required to both inform and protect health professionals and users of such technology in the healthcare environment and provide the evidence base to support the provision of clear and comprehensive guidelines.

Perceptions and attitudes of hospital staff toward paging system and the use of mobile phones

OBJECTIVES

Our objective was to document the pattern of mobile phone usage by medical staff in a hospital setting, and to explore any perceived benefits (such as improved communications) associated with mobile phones.

METHODS

This cross-sectional survey was conducted in Waterford Regional Hospital, Ireland, where bleep is the official system of communication. All non-consultant hospital doctors, of medical disciplines only, were asked to participate. The questionnaire was designed to explore the pattern and different aspects of mobile phone usage.

RESULTS

At the time of study, there were sixty medical junior doctors, and the response rate was 100 percent. All participants used mobile phones while at work, and also for hospital-related work. For 98.3 percent the mobile phone was their main mode of communication while in the hospital. Sixty-two percent (n = 37) made 6-10 calls daily purely for work-related business, and this comprised of ≥ 80 percent of their daily usage of mobile phones. For 98 percent of participants, most phone calls were work-related. Regarding reasons for using mobile phones, all reported that using mobile phone is quicker for communication.

CONCLUSIONS

Mobile phone usage is very common among the medical personnel, and this is regarded as a more efficient means of communication for mobile staff than the hospital paging system.

Use of mobile phones by medical staff at Queen Elizabeth Hospital, Barbados: evidence for both benefit and harm

All members of medical staff, including students, were asked to participate in a self-administered questionnaire concerning patterns of mobile phone use and care. Participants' phones were cultured for micro-organisms. Healthcare professionals working in close proximity to sensitive equipment were surveyed concerning adverse events associated with mobile phones. Telephone operators were asked to monitor time elapsed as they attempted to contact medical staff by various methods. Of 266 medical staff and students at the time of the study, 116 completed questionnaires (response rate=44%). Almost all (98%) used mobile phones: 67% used their mobile phones for hospital-related matters; 47% reported using their phone while attending patients. Only 3% reported washing their hands after use and 53% reported never cleaning their phone. In total, 101 mobile phones were cultured for micro-organisms; 45% were culture-positive and 15% grew Gram-negative pathogens. The survey of staff working in close proximity to sensitive equipment revealed only one report of minor interference with life-saving equipment. Telephone operators were able to contact medical staff within 2 min most easily by mobile phone. Mobile phones were used widely by staff and were considered by most participants as a more efficient means of communication. However, microbial contamination is a risk associated with the infrequent cleaning of phones. Hospitals should develop policies to address the hygiene of mobile phones.

Interference by new-generation mobile phones on critical care medical equipment

Introduction

The aim of the study was to assess and classify incidents of electromagnetic interference (EMI) by second-generation and third-generation mobile phones on critical care medical equipment.

Methods

EMI was assessed with two General Packet Radio Service (GPRS) signals (900 MHz, 2 W, two different time-slot occupations) and one Universal Mobile Telecommunications System (UMTS) signal (1,947.2 MHz, 0.2 W), corresponding to maximal transmit performance of mobile phones in daily practice, generated under controlled conditions in the proximity of 61 medical devices. Incidents of EMI were classified in accordance with an adjusted critical care event scale.

Results

A total of 61 medical devices in 17 categories (27 different manufacturers) were tested and demonstrated 48 incidents in 26 devices (43%); 16 (33%) were classified as hazardous, 20 (42%) as significant and 12 (25%) as light. The GPRS-1 signal induced the most EMI incidents (41%), the GRPS-2 signal induced fewer (25%) and the UMTS signal induced the least (13%; P < 0.001). The median distance between antenna and medical device for EMI incidents was 3 cm (range 0.1 to 500 cm). One hazardous incident occurred beyond 100 cm (in a ventilator with GRPS-1 signal at 300 cm).

Conclusion

Critical care equipment is vulnerable to EMI by new-generation wireless telecommunication technologies with median distances of about 3 cm. The policy to keep mobile phones '1 meter' from the critical care bedside in combination with easily accessed areas of unrestricted use still seems warranted.

Bacterial contamination of anaesthetists' hands by personal mobile phone and fixed phone use in the operating theatre

Following hand disinfection, 40 anaesthetists working in the operating room (OR) were asked to use their personal in-hospital mobile phone for a short phone call. After use of the cell phone, bacterial contamination of the physicians' hands was found in 38/40 physicians (4/40 with human pathogen bacteria). After repeating the same investigation with fixed phones in the OR anteroom 33/40 physicians showed bacterial contamination (4/40 with human pathogen bacteria). The benefit of using mobile phones in the OR should be weighed against the risk for unperceived contamination. The use of mobile phones may have more serious hygiene consequences, because, unlike fixed phones, mobile phones are often used in the OR close to the patient.