In the first step toward requiring all nursing students to carry personal digital assistants, the University of Rhode Island has bought 100 PDAs and given them to faculty and students in two classes to test-drive in their clinical practice.
PDAs are increasingly popular in nursing because they provide quick, easy access to health information at a patient’s bedside. Specialized software such as Epocrates allow nurses to tap into drug databases, find educational materials, even calculate intravenous drip rates.
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But PDAs have taken awhile to catch on, and until this fall, students and faculty at URI’s College of Nursing still were doing things the old-fashioned way: consulting textbooks.
Then the 100 Palm Tungsten E2 PDAs arrived. Half went to the faculty; the rest went to students in professor Laurie Lauzon Clabo’s graduate-level Clinical Nurse Leadership program and professor Mary Leveillee’s undergraduate psychiatric nursing course.
The PDAs are on loan to the students through the academic year; they’ll be allowed to keep them as long as they pass their classes and write an evaluation about how they used the PDAs.
If the pilot is deemed successful, next year all URI nursing students will be required to buy a PDA, putting the college at the forefront of adoption of this new technology. Several nursing schools, from Duke University to Rhode Island College, encourage the use of PDAs, but fewer require them. Among the exceptions is the University of Alabama Birmingham, which will mandate them starting this spring. A Palm Tungsten E2 costs about $200.
“We know that this is an added expense,” said Dayle Joseph, dean of the URI College of Nursing, “but we feel that students will use the PDAs in all of their clinical courses and graduate knowing that this is a necessary tool for all registered nurses.”
Just a couple of months into their PDA experiment, both Clabo and Leveillee – neither of whom had used PDAs before – are enthusiastic.
“I’m learning with my students, and it’s been exciting, because some of the students are phenomenal and learn to use it faster than I do,” said Leveillee. “There’s just a speed and convenience that goes with a PDA that, when translated to clinical practice, is going to be a great resource.”
Of course PDAs themselves are just hardware; what makes them useful is a program such as Epocrates, which they all installed.
“If a patient is going to be started on a new drug, [a nurse] can look up the drug and find out what’s the normal dose, what are the side effects, what other drugs might it interact with, the cost … and you can do that in a split second at the bedside,” Clabo said.
Epocrates routinely updates itself with the latest information on new and established drugs (say, clinical trial data that reveals potential heart risks or newly discovered drug interactions), Clabo added, and that makes it superior in daily practice to textbooks, which are outdated the day they’re printed.
In a learning environment, seeing those updates is in itself an important lesson, she said.
“The real message is for them to get the idea that knowledge changes constantly,” she said. “We’re in a time when knowledge is changing so quickly that relying on things like the old drug books is just no longer really acceptable.”
The school also encourages nurses to view themselves as health educators, and the PDAs make that easier, faculty and students said. At the bedside, they can show drug information to patients, answer any questions, and print out materials for them to take home.
Luz Marquez-Mocarsky, a nurse at Roger Williams Medical Center and a student in Clabo’s program, already had a PDA – a graduation gift last December – and considers it “my best friend.” When the nursing school gave PDAs to her entire class, she said, “I was so happy.”
“I use this as an educational tool at the hospital,” she said. “I go to my patients’ rooms, and that’s how I do my education. … I think every nurse should have one of these things.”
Clabo said Epocrates is the most commonly used program, “but there are thousands of applications that are useful for us.” Nurses also can download programs to analyze lab results, for example, or to estimate a patient’s cardiovascular risk.
“It can be used at point of care for every area of nursing, basically,” said Melissa Vandette, a nurse at Miriam Hospital and a student in Clabo’s program. “I think the biggest part of it is it’s a big timesaver. Time is of the essence when you’re treating patients and you’ve got people pulling at you from every direction.”
