The pilot study investigated the efficacy of a mobile application designed to facilitate critical thinking and clinical reasoning at the bedside, specifically related to nurse-sensitive quality indicators and core measures, or more specifically those healthcare acquired conditions we are all charged with managing and eliminating from our organizations. The mobile web application pilot provided resources in the navigation and management of one nurse-sensitive quality indicator Catheter Associated Urinary Tract Infection (CAUTI), and two core measures, Acute Myocardial Infarction & Stroke (AMI, STK).
Methods:
Use of mobile application devices were coupled with the use of Remote Management for rapid response within system and to all designated “partners” (i.e. nursing home, LTAC, etc.) via tele-monitor and/or teleconference with facility prior to patient transfer. Center to be staffed with 24/7 Acute Care APRN. Traveling/On call APRNs to respond either remotely or on site to view and review all patients requesting and /or requiring transfer to acute care.
Results:
The pilot included: one healthcare acquired condition (CAUTI), two core measures (AMI, STK), and a medication calculator. Early feedback from the participants prompted few changes in algorithms. An overwhelming interest indicated a need for adding more nursing sensitive indicator bundle and core measure algorithms. Seamless updates to the mobile web application are planned to remain current with the latest evidence-based practice recommendations established by regulators such as the Centers for Medicare and Medicaid Services (CMS) and The Joint Commission and national experts such as the Agency for Healthcare Research and Quality (AHRQ).
Conclusion:
Hospitals are increasingly developing policies and procedures to restrict the use of mobile devices in the clinical arena. Caution should be exercised before instituting policies that will limit point of care nurses from accessing valuable resources, devices, and methods required to optimize the acquisition, retrieval, and use of information in health to inform clinical decisions—the very purpose of informatics in healthcare. To date, seven additional core measure sets have been added, four additional nurse sensitive quality/safety indicators have been added, an icon was placed on nursing workstations for easy access to the point-of-care bedside mobile application, and continued collaboration with leadership on allowing cellular devices in patient care areas is on-going.