International Nursing: Use of a Commercially Available Smartphone Application to Solve Information Needs of Orthopedic Scrub Nurses

Majd H, Moradi A. Investigating a Newly Developed Educational Orthopedic Application for Medical Interns in a Before-after Quasi-clinical Trial Study

BACKGROUND

In COVID 19 era, the literature on e-learning, or particularly m-learning, has considerably increased focusing on the subject of medical knowledge transfer. Considering the importance of orthopedic knowledge for general practitioners and the inadequacy of the orthopedics internship duration in Mashhad University of Medical Sciences (MUMS), we have developed and investigated a smartphone orthopedic educational application named "Orthobox".

METHODS

In a quasi-clinical before-after trial study, we investigated the benefits of Orthobox application for medical interns attending MUMS orthopedic departments. A total of 120 students (64 and 56 students in control and case groups respectively) were recruited. The application consists of five main parts of medication, common order samples, common prescriptions, cast and splint types, and educational movies. Students who passed the course without getting access to the application (control group) and students who were also using application during the course (case group) were defined, and comparison was done between them objectively through final exam score comparison and subjectively through Visual Analogue Scale (VAS) questionnaire score comparison. Besides, using case group students' activity report provided by the application panel, correlational analysis was done on their amount of activity on each of the main parts of the application and the corresponding question exam and VAS score separately.

RESULTS

The case group of the study generally achieved higher final exam scores, mainly on Order question score (P value<0.001). Total VAS scores were also greater in case group (P value =0.001). It has also been identified that there is a notable positive trend between student's amount of usage of the application and their final exam scores through correlational analysis. This correlation was not significant about students' application visit numbers and VAS scores.

CONCLUSION

These results suggest that m-learning has got the potential to improve students' medical knowledge and skills by organizing must-to-learn content specified for intern students of orthopedics on one hand, and cause more satisfaction in students about their education on the other hand.

TRIAL REGISTRATION

This study was not registered because it is a quasi-clinical trial study.

LEVEL OF EVIDENCE

Level III (Evidence obtained from well-designed controlled trials without randomization (i.e. quasi-experimental).

Nurses' Use of Personal Smartphone Technology in the Workplace: Scoping Review

Background

There has been an increase in the technological infrastructures of many health care organizations to support the practice of health care providers. However, many nurses are using their personal digital devices, such as smartphones, while at work for personal and professional purposes. Despite the proliferation of smartphone use in the health care setting, there is limited research on the clinical use of these devices by nurses. It is unclear as to what extent and for what reasons nurses are using their personal smartphones to support their practice.

Objective

This review aimed to understand the current breadth of research on nurses’ personal smartphone use in the workplace and to identify implications for research, practice, and education.

Methods

A scoping review using Arksey and O’Malley’s methodological framework was conducted, and the following databases were used in the literature search: CINAHL, PubMed, ProQuest Dissertations and Theses, Embase, MEDLINE, Nursing and Allied Health Database, Scopus, Web of Science, and Cochrane Reviews. Search terms used were Nurs* AND (personal digital technology OR smartphone OR cellphone OR mobile phone OR cellular phone). Inclusion criteria included research focused on nurses’ use of their own digital technologies, reported in English, and published between January 2010 and January 2020. Exclusion criteria were if the device or app was implemented for research purposes, if it was provided by the organization, if it focused on infection control, and if it was focused on nursing students or nursing education.

Results

A total of 22 out of 2606 articles met the inclusion criteria. Two main themes from the thematic analyses included personal smartphone use for patient care and implications of personal smartphone use. Nurses used their smartphones to locate information about medications, procedures, diagnoses, and laboratory tests. Downloaded apps were used by nurses to locate patient care–related information. Nurses reported improved communication among health team members and used their personal devices to communicate patient information via text messaging, calling, and picture and video functions. Nurses expressed insight into personal smartphone use and challenges related to distraction, information privacy, organizational policies, and patient perception.

Conclusions

Nurses view personal smartphones as an efficient method to gather patient care information and to communicate with the health care team. This review highlights knowledge gaps regarding nurses’ personal device use and information safety, patient care outcomes, and communication practices. This scoping review facilitates critical reflection on patient care practices within the digital context. We infer that nurses’ use of their personal devices to communicate among the health care team may demonstrate a technological “work-around” meant to reconcile health system demands for cost-efficiency with efforts to provide quality patient care. The current breadth of research is focused on acute care, with little research focus in other practices settings. Research initiatives are needed to explore personal device use across the continuum of health care settings.