The Impact of Accessing Health Information at the Point of Care in Clinical Decision Making

Purpose:

The aim of the study was to investigate the impact that accessing health information at the point of care via MCDs had on the clinical decision making practice of medical practitioners and professional nurses in public hospitals and primary health care settings in the Eastern Cape Province. The information obtained was used to make recommendations to the Eastern Cape Department of Health  with regard to facilitating further expansion of the use of MCDs in practice.

Methods:

A quantitative, comparative descriptive design was used to conduct this study. The research population comprised all professional nurses and medical practitioners who participated in using the MCDs for accessing information at the point of care. The total research population was 125. No sampling process was implemented because all participants using the MCDs were included in this study. A structured self-administered questionnaire was developed assess the extent to which accessing information at the point of care impacted on the doctors and professional nurses’ ability to make informed clinical decisions. The questionnaire was adapted from questionnaires used in similar studies. The questionnaires were electronically distributed and field workers were also used to collect the necessary data in cases where the participants were slow in completing the online questionnaire. The completed hard copies of the questionnaires were captured onto the system by the PI and one of the field workers. A statistician was consulted with regard to data analysis and reporting. Descriptive and inferential statistics were used to analyse the data. A pilot study was conducted prior to the main study to ensure reliability and validity of the questionnaire and research process. Strategies to ensure reliability and validity were implemented throughout the study as well as strategies to ensure that a high standard of research ethics.

Results:

The overall response rate for this study was 82%. Generally the professional nurses appeared to have used the information provided on the mobile computing device more frequently than the medical practitioners for enhancing their clinical decision making at the point of care and they also found the information provided on the mobile computing device more useful for enhancing their clinical decision making at the point of care. A significant 98% of the registered nurses indicated that they found accessing e-Books in the mobile library easy to extremely easy while 80% of the medical practitioners indicated that they found accessing e-Books easy to extremely easy. Both medical practitioners and registered nurses either never or seldom experienced problems when using the mobile computing device. There were however, more medical practitioners than professional nurses that indicated that they had often experienced problems when using the mobile computing device. The professional nurses appeared to have used the information provided in the mobile library more frequently than the medical practitioners for enhancing their clinical decision making in making an accurate diagnosis, prescribing the correct medication dosage, managing the side effects of drugs, choosing laboratory tests, making referrals to the next level, reducing clinic visits and hospital admissions.

Conclusion:

Both the medical practitioners and professional nurses found the information provided on the mobile computing device to be very useful and easy to access. They indicated that having access to information at the point of care assisted them in many ways to make correct clinical decisions which impacted on the care that they provided to their patients.