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Reading illegible handwriting. Walking
to another hospital wing to enter notes. Lugging heavy
books around. Re-entering information again and again.
Technology that fits in the palm of your hand is rendering
such ordeals things of the past.
Arlene Keeling, director of the acute care nurse practitioner
program at the University of Virginia School of Nursing,
noted her students' lab coats bulging with pocket-sized
textbooks on pharmacology, diagnosis and treatment.
But a friend using a personal digital assistant inspired
her to find a better way to tote around information.
"This was 1997," Keeling said. "I contacted
Palm Computing and asked if they would supply some of
our students with PDAs."
Palm agreed, and the university alumni association
supplied matching funds to equip the faculty.
By downloading various applications from the Web, students
suddenly could have the latest drug information in their
hands, instead of heavy textbooks that could be up to
two years out of date.
"In PDAs, you can download yesterday's New England
Journal of Medicine and get abstracts," Keeling
said.
Accessing the latest information would be especially
important for nurse practitioners in family medicine
in rural areas who might not have all the necessary
textbooks at their disposal.
Information in a digital device is far more malleable
than words in a book, and these devices can supply all
sorts of useful bits of medical data gathered online.
Contraindications, dosages, interactions with other
drugs-even herbal ones-are a pen tap away. Load the
device with assorted handy software such as a creatinine
clearance calculator. Can't recall something about the
new ACLS guidelines? Bring them up with a Pocket PC
device or one running the Palm operating system.
By "beaming" programs and data between compatible
PDAs, Keeling said, nurses share knowledge even more
widely.
The University of Virginia School of Nursing requires
that graduate students purchase one of these devices
when they enter the pharmacology course, rather than
buy the textbook.
"Most of the information they can download for
free from the Internet," Keeling said.
Although the pharmacological textbook hasn't disappeared,
students are much more likely to share the textbooks
and check them out from the library than buy them, Keeling
said.
Keeling said that a study the school performed with
unboundmedicine.com two years ago found that the longer
a PDA was used, the more it was integrated into clinical
practice. "The biggest result was [that] the time
saved was significantly related to their use of the
PDA," she said.
But for nurses, not just any old PDA will do. "The
basic PDA doesn't work," Keeling said. "You
need to pay $200 to $300 to get one with adequate memory,
or have the ability to expand memory."
With fewer people going into medicine, the doctor shortage
has enhanced the use of physician extenders, such as
nurse practitioners. One such NP is Raquel Vaughan at
Stern Cardiovascular Center, a group of 14 cardiologists
and nine NPs in Memphis, Tenn. Board-certified both
as family practice and acute care nurse practitioner,
Vaughan now carries her first computer-an HP iPAQ Pocket
PC that Stern purchased for her four months ago.
"What they have elected to do at this center is
to begin slowly purchasing this equipment, identifying
NPs and physicians to begin piloting the program to
transform our paper records over to electronic records,"
Vaughan said.
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