Tech Talk

Mobile apps for nurses

By Karen Innocent, MS, RN, CMSRN, CRNP, ANP-BC

Healthcare has come a long way from the days research drug interactions while preparing to admin- when cell phones were banned from hospitals ister medications without taking valuable time to because of the interference with radiofrequency search for a drug reference book. Unlike a print cardiac monitors. Mobile phones are now used drug reference, many mobile reference apps provide for call systems, reference, and documentation. updates, including new drug indications, warnings, Although healthcare professionals have been using and newly marketed drugs. Updates usually are mobile computing devices for more than a decade, available with subscription programs or included in Hbeginning with the Palm brand of personal digital the purchase price of the software. Free references assistants, until recently there was little institutional usually have limited features and may not include support for using mobile clinical references. automatic updates. See Free mobile apps and where to More and more nurses are using clinical refer- get them for a selection of free POC apps. ences and other tools that are now available on (cell phones that have How do I choose a POC app? and computer-like functions, including running Not all apps are available for all mobile operating applications). Mobile clinical references are becom- systems. Most new mobile apps are being devel- ing a necessity to access oped for Apple’s iOS current and evidence- mobile operating sys- based information at tem, and can be found the point of care (POC). Downloading the free version in the iTunes App Store This article describes this (if available) is one way to online. Other online emerging technology and evaluate the quality of the sources for specific how it can be applied to data in an app. operating systems your practice. (Electronic include Android medical records and Market (http://www. other types of software android.com/market), integrated into a facility’s secure network are BlackBerry App World (http://appworld.blackberry. beyond the scope of this article.) com/webstore), and Palm App Catalog (http://www. .com). What are apps? Start by determining your specific needs, such Mobile applications (commonly called apps) are as the types of clinical problems that you encounter software programs for smartphones and other frequently. For example: handheld computing devices. Apps let you perform • Float RNs need to have a wide variety of refer- functions similar to those you’d do on a desktop or ence information at hand, including pathophysiol- laptop computer, such as looking up drug informa- ogy, drugs, and lab values related to the specialty tion. In healthcare, the most common mobile apps units where they may be assigned. downloaded are clinical references also known as • Nurses who routinely encounter patients who POC references, such as electronic drug manuals, can’t remember the names of their medications drug , tools to facilitate analysis of lab (but can describe the medication’s appearance) and diagnostic studies, and differential diagnosis would find a pill identifier useful. guides. • Most nurses can use a drug to help These references make accessing current informa- avoid serious errors with complex medication tion much easier for nurses. For example, you can infusion formulas.

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Copyright © 2010 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Tech Talk

Free mobile apps and where to get them

Supported handheld Where to App Functions Maker devices/platforms download it

Archimedes Medical calculator Skyscape Android, Blackberry, iPhone, iPod http://www. Touch, Palm OS 3.5 and up, Palm skyscape.com Pre classic (with classic application from MotionApps),

CheckRx Drug interactions The Medical Blackberry, iPhone, iPod Touch, http://www. Letter iPad, Palm OS 3.5 and up, skyscape.com classic (with classic application from MotionApps), Windows Mobile

Diagnosaurus Differential McGraw Hill Blackberry, iPhone, iPod Touch, http://www. diagnosis and Palm OS, Windows Mobile skyscape.com, or symptoms iTunes App Store ($0.99)

Epocrates Drug guide, pill Epocrates Android, Blackberry, iPhone, iPod http://www. identification, drug Touch, Palm Pre, Windows Mobile epocrates.com or interactions. iPhone iTunes App Store and Blackberry versions include MedMath

Epocrates Med Calculators, Epocrates Palm OS, Windows Mobile (some http://www. Tools (add-on conversion charts, Med Tools are included in Epocrates epocrates.com to Epocrates) and for Blackberry and iPhone) other references

MedWatch Drug alerts FDA/Center for Blackberry, Palm OS 3.5 and up, http://www. Drug Evaluation Windows Mobile skyscape.com and Research/ Office of Drug Safety

Shots 2010 Pediatric The Group on Android, Blackberry Storm, iPhone, http://www. immunization Immunization iPod Touch, Palm Pre, Windows immunizationed. schedule Education of Mobile org/ShotsOnline. the Society of aspx Teachers of Family Medicine

Check your device’s app store. Search major pub- mobile application websites, and publishers with lishers’ websites—Lexi-Comp, Lippincott Williams mobile references. & Wilkins, and McGraw Hill are traditional book If the application you’re interested in is avail- publishers that also have mobile apps. You also can able in free and paid versions, downloading the put the appropriate keywords (for example, “drug free version is one way to gauge how easy it is infusion calculator”) into a search engine. Be aware to use and to evaluate the quality of the data. that using a search engine casts a wide net—the (Remember that free versions often have limited keywords above will return links to universities’ features.) You can also search for online reviews recommended mobile references, general interest of the app to see what other users have to say

46 l Nursing2010CriticalCare l Volume 5, Number 5 www.nursing2010criticalcare.com

Copyright © 2010 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. about it. Another method is to consider buying Some prices and apps from a publisher or developer whose other operating systems products you trust. See Some smartphone prices and operating systems Prices vary depending on retailer, and are based on for a selection of what’s on the market. In addition smartphone purchase with a new wireless service contract. Apple’s iPhone is only available through to the standard voice packages for cell phone ser- AT&T; the others are available from various wireless vice, customers with smartphones must buy a data carriers. plan that provides Internet service. Before signing Apple iOS a cellular contract, be sure you understand the • iPhone 3GS, 8 GB, $99 contract terms and early cancellation charges—and • iPhone 4, 16 GB, $199 that the network’s coverage area and quality of • iPhone 4, 32 GB, $299 service will meet your needs. If you’re planning to Blackberry use your smartphone at the POC, research wire- • Pearl, $0 less coverage and reliability at your workplace or • World Edition, $99 workplaces. • Bold, $149 Android by Google Which institutions are embracing • My Touch, $49.99 POC apps? • Motorola Devour, $79.99 Although in the past, many healthcare profession- • Droid Incredible, $199 als were buying and using POC apps on their own, Palm OS academic medical centers are gradually seeing the • Palm Pixi Plus, $0 value of these apps for employees and students. • Palm Pre, $49 Among the universities and schools of nursing that • Palm Pre Plus, $149 require students to have smartphones or handheld Windows Mobile computing devices are Drexel University College • Kin One, $29.99 of Nursing and Health Professions in Philadelphia, • Kin Two, $49.99 Pa.; Northeastern Ohio University Colleges of • HTC Imagio, $99 Medicine and Pharmacy in Rootstown, Ohio; Ohio • HTC Touch Pro2, $199 State University College of Nursing in Columbus, Ohio; and the University of Virginia School of • Network overload. Apple’s exclusive contract Medicine in Charlottesville, Va. with AT&T has pointed up the problems when data usage exceeds network capacity. iPhone owners Future directions have discovered that network coverage is weak or As more of the healthcare professionals entering the nonexistent in some areas. workforce have been exposed to POC apps during As these issues are resolved and more health their education, it won’t be long before hospitals systems integrate POC apps into their information and health systems fully embrace the technology. technology infrastructure, the use of mobile devices But there are still some practical barriers to be will surge. In a few short years, smartphones will resolved: be as indispensible as the stethoscope. ❖ • Battery life. Nurses work a minimum of an 8-hour shift with many nurses routinely working RESOURCES 12-hour shifts. Mobile phones that are in constant Cassey MZ. Keeping up with existing and emerging technologies: an introduction to PDAs. Nurs Econ. 2007; use have to be charged in the middle of a shift, 25(2):121-123,135. and this downtime can be a disruption. Until Lu YC, Xiao Y, Mills ME, Soeken K, Vaidya V. Top Barriers device makers can increase battery life, health- and facilitators to nurses’ PDA adoption. AMIA Annu Symp care executives and informatics nurses seeking Proc. 2006:1016. to implement a POC app program need to find Karen Innocent is director of continuing education and conferences for solutions such as accessible charging stations or Wolters Kluwer Health in Ambler, Pa. backup devices. DOI-10.1097/01.CCN.0000387741.89111.e1 www.nursing2010criticalcare.com September l Nursing2010CriticalCare l 47

Copyright © 2010 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.