Last week someone asked me, ‘Why do nurses need apps?’ His question made me realize that the need for nurses to have apps to do their day-to-day work taking care of patients may not be obvious to the general public. I often tell nurses that it is our responsibility to inform others of our role and responsibilities, impact on patient care and overall value we bring to the health care industry. We are the subject matter experts and the champions for our profession. So, in the spirit of the message I often send to other nurses, I’d like to offer 5 reasons why nurses need apps to help support their delivery of high quality patient care.
Nurses need Apps to:
1. Individualize Patient Care
Nurses are the only care team members who are with the patient 24 hours per day, 7 days per week. As a result, nurses develop relationships with their patients and learn their preferences for care. The combination of a patient’s clinical care needs and personal care preferences together allow nurses to optimize their care to each patient as an individual person, rather than a diagnosis or condition. This seems simple and intuitive but it can be a challenge for nurses if they don’t have the right information about their patients.
Some patients will have specific preferences around taking meds or methods of feeding/eating. I cared for pediatric patients and the infant patients always had a specific pacifier and side to which he/she would sleep. For these pediatric patients, sleep and calmness were essential for their healing. Every patient has preferences that help build that relationship and feel like an individual person, rather than a diagnosis.
However, patients do not come in with a list of care preferences that can be captured on a form. Instead, nurses learn these care preferences through interacting with the patient. As nurses learn these preferences, they keep note of them but there is a lack of an effective mechanism by which to communicate these preferences between caregivers through the EHR. Thus, with the right mobile solution, we can support this information need and continue to support individualized patient care and allow nurses to feel confident that they know their patients.
2. Provide Consistent and Up to Date Information during Shift Report (e.g., nursing handoffs)
The information nurses need to know each of you as patient is communicated during the first 30 minutes of the nurse’s shift. If a nurse is assigned 6 patients on an acute care unit, this allows the nurse 5 minutes per patient to gather this information. As nurses, we trust our colleagues and listen to what we are told during shift report. The nurse who is starting his/her shift writes down on a piece of paper the information that the nurse communicates from his/her own piece of paper that started at the beginning of the previous shift. This process occurs wherever nurses can find space to talk. With just 5 minutes, there is a limit to how much can be shared as well as how well a nurse can capture that information in written form. The piece of paper is the highest valued tool that nurses use over the course of their day because it has everything they need to know about their patients on it.
Did you know that piece of paper is not part of the medical record? The piece of paper stays in their pockets and is a quick reference tool to support their own information needs over the course of the shift. It is flexible, portable, and overall useful to the nurse.
When I started my nursing career in 2000, cell phones were starting to become mainstream. The concept of a ‘smartphone’ did not exist. We managed with the lack of mobile technology. However, today we are in a different world. Our consumer-oriented world allows us to have access to use information from almost anywhere. For better or worse, we are becoming dependent on our supportive devices. Yet, when thinking about health care delivery, we have not yet been able to bring these vantage points to our nurses. With the right design, understanding of what nurses need, and when they need it, as well as the right devices, we have the ability to transform the care delivery process for the better.
3. Support their Daily roles as the Puzzle Masters of Care
Nurses need to coordinate and adjust all patient care activities in the midst of continuous inquiry. I remember my first year as a nurse when I would walk down the hall and the Unit Coordinator would look at me and say, “Tiffany, you are needed in rooms 3, 10, and 22, and you have a call from radiology on line 1, and the doctor for the patient in room 3, is on line 2. Also, this is the speech language pathologist for room 12 and she wants to know when the infant is scheduled to feed again.”
At times, I would chuckle because this just seemed so ridiculous that I was expected to handle all of this at the same time. Additionally, this never seemed to be ridiculous to the Unit Coordinator. This wasn’t a one-time event. This was my daily reality and this is the reality for nurses. Nurses are constantly faced with questions and inquiries from anyone to which they need to provide answers.
Patients and families will ask about the results of the labs taken that morning, the patient will ask when he/she can have pain medication again, and what the plan for him/her is for the day. The providers might ask if the patient has had his/her tests done, what he/she is allergic to, and when the family is coming in so they can have a conversation. Other members of the care team will ask when a good time to meet with the patient for treatment. All of these questions get filtered through the nurse.
We, as nurses, recognize and accept our role. However, this means that we need to be equipped with the ability to answer these questions as they are asked to us. Nurses get asked these questions at the bedside, in the hallway, at the nurses’ station and any other location within the hospital unit. This means that nurses need access to the answers from wherever they are located on the unit and through a tool that can be present wherever we are on the unit.
4. Allow nurses to spend more time caring for the patient.
‘Do I nurse the patient or nurse the computer?’ This is a common concern and unintended consequence of electronic health records (EHRs) among nurses who are providing direct patient care. Nurses know their patients need their attention. Nurses also know the information they gather from the patient is essential for assessing, planning, intervening, and evaluating the patient’s progress. Thus, the information must be available in the electronic chart. Yet, the interaction with the electronic chart within the computer is far more complex than the paper-based flow sheet that existed in the past. Additionally, nurses are often concerned that patients are wondering what they are doing on the computer, or worse, ignoring their patients.
If nurses could enter some of the essential data gathered at the bedside into a mobile app, the internal struggle could be reduced and also serve as an opportunity to enhance the nurse – patient relationship. By entering the data as it is being gathered, this near real time event would allow other members of the care team to interpret and adjust the plan of care in a timely manner. This would be an added advantage over the current method of batch charting every few hours when there are a few minutes available between nursing rounds. Lastly, all of these small wins throughout the day would have a large impact on the amount of time nurses stay late after their shift to catch up on charting.
5. Improve health status
With the right electronic tools (e.g., mobile apps) we can continue to improve the human health status for patients and the financial health status of our health care organizations. The use of apps for nurses designed to support their naturally occurring workflows and routines hold the opportunity to reduce unintended errors in communicating essential information. Over 70% of sentinel events (unintended events that should never happen to a patient) are a result of communication breakdowns at the time of handoff. Improving communication through consistent access to up to date patient information holds the potential to reduce unintended errors. Additionally by allowing nurses to access, enter and overall use information needed in real time at the point of care, their efficiency improves which in turn can lead to more timely interventions and transitions in care. All of these benefits hold the potential to improve the patient’s overall health status and patient experience. From a health care organization perspective, the improvements in safety, efficiency, timeliness, and patient experience all can lead to reductions in cost expenditures. Lastly, I will bring this back to the nurses. Nurses are saving lives every day. We need to find ways to reduce the burden of activities that are not directly serving patient care, so that nurses can focus as much of their attention as possible on the patient and ensure he/she is receiving the highest quality care.
These are just 5 reasons why nurses need apps. If you are a nurse reading this post, share your thoughts or share this with another nurse. Let me know your thoughts on why apps would improve your ability to provide quality patient care. Secondly, if you have been a patient or a family member of a patient, think about how apps would support nurses to improve your overall experience as a patient and also share your thoughts. We have a great opportunity to support nurses in their patient care delivery that wasn’t available several years ago. While the prior methods of managing information on the go (e.g., scrap paper, paper towels, post-it notes) have been used, we now have advanced technology and EHRs in health care organizations that can bring forward new ways of supporting nurses and other caregivers.
For more information on this topic or our solution to address these areas, please reach out to Nightingale Apps LLC at email@example.com