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Calling on smartphones to enhance patient care

VanDusen, Krista A. BSN, RN

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doi: 10.1097/01.NURSE.0000525993.44109.f9
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WHEN CLINICAL NURSES have trouble reaching providers who aren't on the unit when a critical issue arises, can smartphones be the solution? This article outlines the advantages of this technology, pitfalls to avoid, and considerations for future applications.

Communication is key

Nurses communicate with multiple members of the healthcare team, often while maintaining heavy patient loads. Optimal communication procedures can help nurses use their time more efficiently to improve patient safety and outcomes.

Healthcare personnel are often in different locations when collaboration is needed. Maintaining safe patient care may require fast, accurate communication among mobile staff. Delays in communication have been identified by The Joint Commission as significant contributors to adverse events.1 The Joint Commission has made communication between healthcare workers a patient safety goal in an effort to reduce medical errors.1

Current communication technologies may provide one venue to improve healthcare team communication and workflow. Using smartphone-based technology has been proposed to improve the delivery of care in healthcare facilities.

Options abound

Nurses use many different methods of electronic communication in the clinical setting to coordinate patient care. These include e-mail, smartphone applications, and two-way or group texting options. The Joint Commission standards have been redefined, and they now allow texting of orders and patient information, if the clinician is compliant with a secure texting platform and maintains safety measures to ensure order accuracy.2 Texting lets members of the healthcare team communicate and collaborate effectively among several disciplines. These methods reduce response time in emergencies and increase the frequency of provider responses to nurses.3

When used appropriately, electronic devices can improve the organization of daily activities and administrative tasks. Applications allow users to set reminders for upcoming meetings or deadlines.4 They can also speed up patient data management, improve staff cooperation, and provide opportunities for more efficiency.5

Weighing the pros and cons

Along with benefits, electronic communication has some limitations in the clinical setting. For example, it can create additional interruptions that decrease clinicians' presence in other patient-care situations.6

Confidentiality is also a concern. Improved efficiency could be offset by communication difficulties and loss of reliability and confidentiality.7 Several studies have raised doubts about information security, inadequate technical skills, and poor staff interrelations. Nurses may perceive a worsening of interprofessional relationships due to an overreliance on text messaging and a subsequent lack of verbal communication.2,5,8

Smartphone applications should be carefully chosen for confidentiality as well as efficiency. Peer-reviewed software allows data encryption of stored patient information, remote wiping to destroy data in the event of loss or theft, secure encrypted data transmission over WiFi, and coordination with facility-specific standardized clinical communication tools.3 Additional studies to examine the clinical value of electronic communication systems are currently underway and should provide further information about the effectiveness of this technology.

Future considerations

Communication in the acute care setting is a complex process that occurs quickly in a rapidly changing environment. Ineffective communication is a key factor that increases the risk of errors. The engagement of all members of the healthcare team is needed to reduce medical errors through improved communication. As frontline providers who spend substantial time in direct care of their patients, nurses are a critical component of this team.

Facilities implementing smartphone technology need to identify measures to address information security, staff training, and team-building efforts to remediate concerns associated with the use of these electronic communication devices. Patient-care outcomes should be reliably measured to ensure that this technology meets the needs of patients and all members of the healthcare team.

Successful use of smartphone technology in the acute care setting requires healthcare facilities to develop communication protocols that address both the advantages and potential disadvantages of this technology with continued monitoring of efficacy and outcomes.


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2. Update: texting orders. Jt Comm Perspect. 2016;36(5):15.
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