How Patients Perceive Caring at the Dawn of a Technological Revolution

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How Patients Perceive Caring at the Dawn of a
Technological Revolution

• Research Proposal

Created by J. Bourque, A. Bourre, B. DelGuidise,
F. Duffy S. Fitzgerald, A. Labonte, A. Mitchell,
J. Ubhi, E. Walker
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• Personal Digital Assistants (PDAs) have evolved
  from a novelty item to a potentially significant
  tool in the field of nursing.

Have been used by nurses to

• Store patient records

• Store assessment data

• Store diagnostic manuals

• Store drug manuals

• Store Med/Surg text books

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Literature Review

• Limited research regarding the use of PDAs by
  nurses in the clinical setting
• Many opinion based articles that outline the
  advantages and disadvantages of using PDAs in
  nursing
• Two main themes nurses perceptions, use by
  undergraduate nursing students

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A study of personal digital assistance to
enhance undergraduate clinical nursing
education. Miller, et al (2005)

• Comparative group design of second degree
  students using PDAs vs. students not using PDAs
• Looked at how PDAs affected information seeking
  behaviours and clinical performance
• Showed that those with PDAs made use of them
  reducing the amount of time needed with text
  books, placed greater value on the credibility of
  the PDA
• Supports PDAs as an effective learning tool

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Medication Error Reduction and the Use of PDA
Technology Greenfield (2007)

• Non-randomized quazi-experimental study
• Determine whether the use of PDAs reduces the
  incidents of medication errors in clinical
  testing and providing more efficient nursing care
• Control group used text references/experimental
  group used PDAs alone
• Findings found that the use of a PDA decreased
  the number of errors and increased the efficiency
  in a case study scenario

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Adopting a Personal Digital Assistant System
Application of Lewins Change Theory Lee (2006)

• Descriptive exploratory qualitative approach with
  in depth interviews
• Revealed four adaptive stages
• Unfreezing stage
• Moving stage
• Refreezing stage
• Anticipatory stage
• Nurses are adaptive professionals and PDAs are a
  valuable tool for their practice

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Data Gaps

• Many gaps due to the lack of research in the area
  of nursing and the role of the PDA, and most
  importantly how patients perceive the care
  associated with them
• The lack of research has prevented the
  implementation of PDAs into the main stream
  nursing profession

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Research Question Hypothesis
The patients will perceive greater satisfaction
with their care from nurses who utilize PDAs, due
to their ability to access accurate and up to
date information, provide effective teaching via
multi media applications, and spend more time
with the patient at the bedside.

• Do patients perceive a difference in the care
  given by nurses who do not use a PDA vs. nurses
  who do?

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Objective

• Determine if the use of PDAs hinders or enhances
  the quality of care provided by nurses

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Design

• Non-Randomized quasi-experimental approach
• Used to make relationships clear, to explain why
  an occurrence has taken place and to observe
  causal relationships
• The patient will not know what is being tested
  and the nurse will not know how they are being
  evaluated

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Sample

• Two samples
• Self selected nurses
• Self selected patients
• Poster will be hung on all the acute care units
• Participation is voluntary without remuneration
• Goal is to recruit 50 acute care nurses

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Inclusion Criteria

• RNs
• Must be a full time RN

• Patients
• Must speak English at an 8th grade level
• Be over the age of 18
• Be admitted for at least 24hours

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Exclusion

• Patients
• Being cognitively or sensory impaired

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Hardware/Software

• Tungsten E2 by Palm
• Nursing Central
• Ultimate Anatomy Organ Systems Flash Cards

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Implementation

• 11 week period (4-3-4)
• Nurses will ask patients if they would like to
  participate and provide patients with
  questionnaires
• Nurses will never see the blank or completed
  questionnaires

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Proposed Budget A
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Proposed Budget B
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Data Collection

• Validate the Amended Caring Assessment Tool
• Patients fill out the 5 point Likert type scale
  based on their perceived satisfaction

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Data Analysis

• Results will be run through a statistical program
  and results compared to see if there is a
  statistical difference between the control group
  and experimental group

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Implications for Research

• Benefit the advancement in scientific knowledge
  in many ways
• Contribution to recent literature
• Replication
• Implementation of PDAs

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Implications to Nursing

• The results from this study will
• Enhance/Hinder
• Resolve apprehensions
• Promote peer education

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References

• Duffy, J.R., Hoskins, L., Skifert, R.F. (2007).
  Dimensions of Caring Psychometric Evaluation of
  the Caring Assessment Tool Electronic version.
  Advances in Nursing Science. 30(3), 235-245.
• Enger, J.C. (2001). PDAs A hands-down winner
  Electronic version. Nurse Practitioner.
• Greenfield, S. (2007). Medication Error
  Reduction and the use of PDA technology
  Electronic version. Journal of Nursing
  Education. 46(3), 127-132.
• Hardwick, M.E, Pulido, P.A., Adelson, W.S.
  (2007). The use of handheld technology in
  nursing research and practice Electronic
  version. Orthopaedic Nursing. 26(4), 251-255.
• Krauskopf, P.B. (2004). Accuracy and efficiency
  as outcomes of clinical scenarios by novice nurse
  practitioners using personal digital assistants.
  Ph.D. dissertation. Virginia University. United
  States, Virginia.
• Lee, T. (2006). Adopting a personal digital
  assistant system application of Lewins change
  theory Electronic version. Journal of Advanced
  Nursing. 55(4), 487-496.
• Lee, T., Lin, K., Lin, J. (2007). Development
  and testing of an evaluation scale of personal
  digital assistants Electronic version.
  Computers Informatics Nursing. 25(3), 171-179.
• Miller, J., Shaw-Kokot, J.R., Arnold, M.S.,
  Boggin, T., Crowell, K.E., Allegri, F., Blue,
  J.H. Berrier, S.B. (2005). A study of
  personal digital assistants to enhance
  undergraduate clinical nursing education
  Electronic version. Journal of Nursing
  Education. 44(1), 19-26.