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PubMedDate not supplied

Use of electronic self-monitoring for food and fluid intake: A pilot study.

In this small pilot study, the authors examined the use of a personal digital assistant (PDA) to electronically self-monitor the dietary and fluid intake of individuals receiving hemodialysis. The purpose of this study was to describe intake patterns of fluid, sodium, potassium, phosphorus, protein, and calories over a 3-month period as recorded using a PDA. Mean weekly intake values were plotted on line graphs to examine trends of intake. The patients' mean weekly intakes of sodium, potassium, phosphorus, and fluid were dynamic and fluctuating. Protein and caloric intakes were significantly below the recommendations of the K/DOQI guidelines. Standard methods to assess intake may not adequately capture intake patterns on a daily basis.

Aged↗
PubMed2005

Angina on the Palm: randomized controlled pilot trial of Palm PDA software for referrals for cardiac testing.

OBJECTIVE: Personal digital assistants (PDAs) are popular with physicians: in 2003, 33% of Canadian doctors reported using them in their practices. We do not know, however, whether using a PDA changes the behaviour of practising physicians. We studied the effectiveness of a PDA software application to help family physicians diagnose angina among patients with chest pain. DESIGN: Prospective randomized controlled pilot trial using a cluster design. SETTING: Primary care practices in the Toronto area. PARTICIPANTS: Eighteen family physicians belonging to the North Toronto Primary Care Research Network (Nortren) or recruited from a local hospital. INTERVENTIONS: We randomized physicians to receive a Palm PDA (which included the angina diagnosis software) or to continue conventional care. Physicians prospectively recorded the process of care for patients aged 30 to 75 presenting with suspected angina, over 7 months. MAIN OUTCOME MEASURES: Did the process of care for patients with suspected angina improve when their physicians had PDAs and software? The primary outcomes we looked at were frequency of cardiac stress test orders for suspected angina, and the appropriateness of referral for cardiac stress testing at presentation and for nuclear cardiology testing after cardiac stress testing. Secondary outcome was referrals to cardiologists. RESULTS: The software led to more overall use of cardiac stress testing (81% vs 50%). The absolute increase was 31% (P = .007, 95% confidence interval [CI] 8% to 58%). There was a trend toward more appropriate use of stress testing (48.6% with the PDA vs 28.6% control), an increase of 20% (P = .284, 95% CI -11.54% to 51.4%). There was also a trend toward more appropriate use of nuclear cardiology following cardiac stress testing (63.0% vs 45.5%), an absolute increase of 17.5% (P =.400, 95% CI -13.9% to 48.9%). Referrals to cardiologists did not increase (38.2% with the PDA vs 40.9%, P =.869). CONCLUSION: A PDA-based software application can lead to improved care for patients with suspected angina seen in family practices; this finding requires confirmation in a larger study.

Adult↗
PubMed2005

Can hand-held computers improve adherence to guidelines? A (Palm) Pilot study of family doctors in British Columbia.

OBJECTIVE: To examine whether Palm Prevention, a free software tool for Palm OS personal digital assistants (PDAs) that provides quick access to preventive guidelines in a patient-specific manner at the point of care, improved adherence to five preventive measures in primary care. DESIGN: Prospective intervention pilot study. SETTING: Vancouver, BC, and surrounding area. PARTICIPANTS: Eight general practitioners. INTERVENTIONS: Each physician used Palm Prevention for five preventive measures during routine preventive health visits with 10 patients (n = 80). Charts of consenting patients were reviewed for documentation of recommended maneuvers. MAIN OUTCOME MEASURES: Rates of adherence to five evidence-based guidelines selected from the Canadian and American task forces on preventive care and incorporated into Palm Prevention. RESULTS: Intervention and control physicians were similar in their familiarity with and use of PDAs, and they recruited similar patients for the study. Intervention and control groups had similar rates of screening for hypertension. Intervention improved adherence to the remaining four guidelines: cervical cancer screening increased 22% (only absolute increases are reported); hyperlipidemia screening increased 30%; colorectal cancer screening increased 27%; and prophylaxis with acetylsalicylic acid in high-risk patients increased 38%. Participants were surveyed after the study; all reported that they found the software helpful and would continue using Palm Prevention. Usage statistics showed that study participants used the tool outside the trial: users entered between 28 and 68 unique patients into the program during the 2-month intervention. CONCLUSION: This pilot study suggests PDAs are useful in improving preventive care and facilitating translation of knowledge into practice. This was particularly apparent with newer guidelines.

British Columbia↗
PubMed2006

Integration of technology in a clinical research setting.

The use of wireless technology to collect and retrieve relevant patient data has been in use on many nursing units for the past decade. The technology continues to advance as it relates to patient data collection devices. The utilization of computers (in the form of a wireless tablet) is used in the General Clinical Research Unit (GCRC) at Howard University Hospital. The wireless technology is used for the compilation and retrieval of pertinent research data.

Clinical Nursing Research↗
PubMed2006

Family nurse practitioner students utilization of Personal Digital Assistants (PDAs): implications for practice.

Personal Digital Assistants (PDAs) are a readily accessible source of information to aid in the delivery of patient care. A pilot group of five Family Nurse Practitioner students used PDAs to organize data and access information relevant to patient care. Utilization of the PDAs in the clinical setting provided practice guidelines, textbook information and protocols that were readily accessible. The PDA made it possible for students to utilize preexisting knowledge with additional learning resources. The PDAs were purchased with funds provided from a United States Department of Health and Human Services, Health Resources and Services Administration (HRSA) grant.

Attitude of Health Personnel↗
PubMed2006

Expanding the scope of health information systems. Challenges and developments.

OBJECTIVES: To identify current challenges and developments in health information systems. METHODS: Reports on HIS, eHealth and process support were analyzed, core problems and challenges were identified. RESULTS AND CONCLUSION: Health information systems are extending their scope towards regional networks and health IT infrastructures. Integration, interoperability and interaction design are still today's core problems. Additional problems arise through the integration of genetic information into the health care process. There are noticeable trends towards solutions for these problems.

Computational Biology↗
PubMed2006

A deployable framework for mobile telemedicine applications.

In recent years, the shortage of medical specialists and access to medical information has necessitated a growing interest for cost effective and efficient telemedicine tools for healthcare delivery. Mobile telemedicine applications are aimed at meeting the mobility requirements of patients and doctors by integrating wireless communications for different health care services and education.Although, telemedicine holds great promises in enhancing health care delivery in rural area and developing countries, only a few applications exist because of poor frameworks for their deployments. This paper, aims at providing a deployable framework for Mobile Telemedicine Applications for Tropical Diseases (MTATD).MTATD presented here, provides access to a telemedicine unit via hand held devices over a PSTN/GSM and the Internet for a collaborative health care delivery and education between patients and care providers.

Computer Communication Networks↗
PubMed2006

Preliminary analysis for the development of a PDA-based decision support system for the screening and management of obesity.

This preliminary study toward the development of a Mobile Decision Support System for Advanced Practice Nursing (MODS-APN) for the management of obesity compared APN students' current electronic clinical log (CL-APN) documentation to an obesity clinical practice guideline (CPG) and examined the extent to which concepts related to the screening and management of obesity could be represented with standardized terminologies. The data that were documented by APN students with the CL-APN were retrieved using the Structured Query Language (SQL) and were compared to the CPG using a scoring tool developed for this study. Only 1.4 % of the encounters had obesity as an assessment diagnosis and about 40 % of those encounters did not have any plans of care related to the CPG's main treatment recommendations. Fifty-six concepts related to the screening and management of obesity were extracted from the CPG and were mapped to 36 terms using standardized terminologies.

Computers, Handheld↗
PubMed2006

The fusion of gerontology and technology in nursing education: History and demonstration of the Gerontological Informatics Reasoning Project--GRIP.

Phase I of our Gerontological Reasoning Informatics Project (GRIP) began in the summer of 2002 when all 37 senior undergraduate nursing students in our accelerated BSN nursing program were given PDAs. These students were oriented to use a digitalized geriatric nursing assessment tool embedded into their PDA in a variety of geriatric clinical agencies. This informatics project was developed to make geriatric nursing more technology oriented and focused on seven modules of geriatric assessment: intellect (I), nutrition (N), self-concept (S), physical activity (P), interpersonal functioning (I), restful sleep (R), and elimination (E)--INSPIRE. Through phase II and now phase III, the GRIP Project has become a major collaboration between the College of Nursing & Health Professions and College of Information Science and Technology at Drexel University. The digitalized geriatric nursing health assessment tool has undergone a second round of reliability and validity testing and is now used to conduct a 20 minute comprehensive geriatric health assessment on the PDA, making our undergraduate gerontology course the most high tech clinical course in our nursing curriculum.

Aged↗
PubMed2006

Mobile computing in a New Zealand Bachelor of Nursing Programme.

Mobile computing is rapidly becoming a reality in New Zealand health care settings. Personal Digital Assistants (PDAs) are the most frequently used of these mobile technologies, giving nurses access to clinical learning resources, including drug references, medical encyclopaedias and diagnostic information. The implementation of mobile computing at Waikato Institute of Technology (Wintec) will ensure graduates of our Bachelor of Nursing Programme are able to meet health care service demands for knowledge in contemporary information technologies as well as the information technology requirements defined by the Nursing Council of New Zealand and the Health Practitioners Competency Assurance Act 2003 for registration as a nurse in New Zealand. This opinion paper presents strategies for the implementation of mobile computing as a core element of the curriculum for the Bachelor of Nursing Programme at Wintec in Hamilton, New Zealand.

Computers, Handheld↗
PubMed2006

Usefulness of a personal digital assistant-based advanced practice nursing student clinical log: Faculty stakeholder exemplars.

The number of health sciences educational programs that are integrating personal digital assistants (PDAs) into their curricula is on the rise. In this paper, we report an evaluation of the usefulness of a PDA-based advanced practice nursing (APN) student clinical log through faculty stakeholder exemplars in three areas: pediatric asthma care; procedures of Acute Care Nurse Practitioner (NP) students; and diagnostic and screening procedures of Women's Health NP students. We generated descriptive data through routine queries and through custom SQL queries at the request of a specific faculty member who wished to examine a particular aspect of an educational program. In addition, we discussed the potential implications of the data with the respective faculty members. The exemplars provide evidence that faculty stakeholders found the APN student clinical log to be useful for a variety of purposes including monitoring of student performance, benchmarking, and quality of care assessments.

Computers, Handheld↗