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Abstract

In this study, we described the smartphone work- and non-work-related activities; analysed the differences between smartphone use and nurses’ age, gender and working environment; and observed the influences that personal digital devices have on nurses’ performances. We conducted a cross-sectional and correlational study. A convenience sample of nurses was recruited composed of 256 nurses, mostly women (74.6%) under 30 years of age (59%). This study showed that the most frequent work-related smartphone activity was searching for work-related drug references. Smartphones also helped nurses reduce the work-related stress and improve unit cohesion and teamwork. Younger nurses and male nurses were more likely than female nurses to use their digital devices during healthcare activities. In addition, 42% of nurses reported that they were distracted by the use of smartphones. If smartphones are used properly, they are certainly helpful tools for improving patient safety and enabling communication among healthcare staff. Otherwise, smartphones can constitute an important source of distraction and endanger patient safety.

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... MHAs are a means of providing speedier nursing care that is available to everyone (2)(3)(4)7). However, in order to serve with the MHAs, the nurse must first accept the MSU and be willing to use it (12,13). This study aims to examine nurses' mobile health applications acceptance. ...
... As the total score of the scale increases, the level of acceptance of the mobile application also increases. Needs, (items 1-7), Behavioral Intentions (items [8][9][10][11][12][13], Attitudes about Usage (items [14][15][16][17][18][19], Perceived Benefits (items 20-24), Subjective Norms (items [25][26][27][28][29] and Performance Expectations (items 30-32) make up the six sub-scales. Cronbach's alpha coefficients for the subscales are: Needs subscale, 0.861; Subjective norms subscale, 0.810, Attitudes about usage subscale, 0.816; Behavioral intentions subscale, 0.899, Perceived benefits subscale, 0.851, Performance expectations subscale, 0.788 (15). ...
... "Needs subscale" refers to the needs that drive an individual to use and satisfy the necessity of resorting to a mobile app (13,14,19). Another study conducted with nurses reported that 42% of nurses use mobile apps to meet their needs (the most frequent work-related smartphone activity was searching for work-related drug references) -and found that smartphones also helped nurses reduce work-related stress and improve unit cohesion and teamwork (12). In the same study, nurses emphasized that if smartphones are used properly, they are certainly helpful tools for improving patient safety. ...
... They were not attentive to the patient " (Bautista & Lin, 2016). 42% of the nurses included in the study conducted by Pucciarelli report having been distracted from the use of their smartphone for personal purposes during their working activity (Pucciarelli et al., 2019). ...
... The positive aspects include: greater communication efficiency, reduction of time for research of clinical information, flexible access to information, reduction of the number of errors, improvement of elearning. In addition, the smartphone would seem to reduce work stress by allowing extra-work and leisure activities to be carried out during breaks, promoting greater job satisfaction (Pucciarelli et al., 2019;Sergeeva et al., 2016). In contrast, scrub nurses negatively viewed the use of mobile devices by nurses in circulation because it was considered an important source of distraction. ...
... However, the study only allowed to observe marginal effects following interruptions caused by the mobile phone during direct patient assistance activities. Several sources seem to agree that distractions and interruptions are closely related to the onset of medical errors (Alameddine et al., 2019;McBride & LeVasseur, 13AD;McBride et al., 2015b;Pucciarelli et al., 2019;Sergeeva et al., 2016). In the study conducted by Sergeeva et al. (2016), the authors identify the smartphone as a generator of stimuli capable of diverting the attention of the person from the priority activities and absorbing the cognitive resources useful for carrying out these activities. ...
Article
Aim To investigate the impact of smartphone distraction on the quality and safety of care provided by the nursing population during work. Background About 80% of nurses use the smartphone in the workplace both for personal purposes and as a useful support to improve the quality of care. Distraction from smartphones during care is a phenomenon that should be known and managed within each health service. Methods A systematic review of the literature was conducted using the PRISMA methodology. The sources included in the review study were subjected to a qualitative assessment using the GRADE method. Results Sixteen articles were included in the review. Studies included highlight the positive and negative consequences of using mobile devices during nursing practice. Findings identify the smartphone as a generator of stimuli capable of diverting the attention of the person from the priority activities and absorbing the cognitive resources useful for carrying out these activities. Some studies aimed to show the restriction policies and/or the strategies for reducing disruptions. This review highlights how the free and indiscriminate use of the smartphone can negatively affect patient safety and the nurse-patient relationship through the dehumanization and depersonalization of care. Conclusions Mobile technology can improve nurses' performance and the quality of care provided. However, the application of regulations and policies by healthcare facilities is desirable to avoid inappropriate use of these devices by nurses. The available data do not provide a precise estimate of the effect that distraction from smartphones has on the outcomes of nursing care.
... Currently, much of the literature focuses on medical doctors' use of smartphones [9][10][11][12]. However, more studies are needed to understand the perspectives of nurses -the largest group of healthcare professionals in a hospital [13] -since they tend to experience low support on using mobile devices [14,15] despite the potential benefits it could bring to enhance clinical work and improve patient care [16][17][18][19][20][21][22]. ...
... Considering that IT consumerization in healthcare organizations is a pertinent issue faced by several levels of hospital administrators [23], it is crucial to understand specific issues encountered by nurse administrators when their staff nurses use their smartphones for work purposes. To date, studies that present issues related to nurses' use of smartphones for work purposes (e.g., distraction, potential for medical errors, reduced quality of care, privacy and confidentiality issues, and nomophobia) were derived from surveys or interviews with bed-side nurses [20,22] or nursing students [15,[24][25][26][27]. Thus, there is a need for studies that focus on the perspectives of nurse administrators. More importantly, such studies from their point of view are needed because nurse administrators are in the best position to provide insights on how to appropriate implicit or explicit "bring your own device" (BYOD) policies for staff nurses given manpower and technological constraints in their area of assignment. ...
... The rationale of exploring this in this study is that certain issues might influence nurse administrators' support to staff nurses' use of smartphones for work purposes, which then influences staff nurses' perceived organizational support. Although previous works have presented several issues related to nurses' use of smartphones for work purposes (i.e., blanket ban of smartphones at work, reduced professionalism, and hospitals not providing smartphones and credits for nurses) [14][15][16][19][20][21][22], it is unknown whether these issues influence nurse administrators' support to nurses' use of smartphones for work purposes. For instance, if a hospital implements a blanket ban on smartphones, would a nurse administrator prohibit a staff nurse to use a smartphone if this is the only means possible to contact a physician given that there is no other hospital device to use? ...
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Background Studies show that nurses use their own smartphones for work purposes, and there are several organizational issues related to this. However, it is unclear what these organizational issues are in the Philippines and the influence they have on nurse administrators’ (ie, superiors) support to staff nurses’ (ie, subordinates) use of smartphones for work purposes. Objective Drawing from the Organizational Support Theory (OST), this study aimed to identify organizational issues that influence nurse administrators’ support to staff nurses’ use of smartphones for work purposes. Methods Between June and July 2017, 9 focus groups with 43 nurse administrators (ie, head nurses, nurse supervisors, and nurse managers) were conducted in 9 tertiary-level general hospitals in Metro Manila, the Philippines. Drawing from OST, issues were classified as those that encouraged or inhibited nurse administrators to support nurses’ use of smartphones for work purposes. Results Nurse administrators were encouraged to support nurses’ use of smartphones for work purposes when (1) personal smartphones are superior to workplace technologies, (2) personal smartphones resolve unit phone problems, and (3) policy is unrealistic to implement. Conversely, issues that inhibited nurse administrators to support nurses’ use of smartphones for work purposes include (1) smartphone use for nonwork purposes and (2) misinterpretation by patients. Conclusions Nurse administrators in the Philippines faced several organizational issues that encouraged or inhibited support to staff nurses’ use of smartphones for work purposes. Following OST, the extent of their support can influence staff nurses’ perceived organizational support on the use of smartphones for work purposes, Overall, the findings highlight the role and implication of organizational support in the context of smartphone consumerization in hospital settings, especially in developing countries.
... The results of the study show that the average score is higher for nursing coordinators than for nurses, male gender prevails, a figure that, compared with other studies conducted on a population of nurses and nursing students, highlights differences [18,19]. Other studies report conflicting data with respect to gender differences, with nomophobia more present in the female gender [19,20]. The results of a further study indicate a correlation between smartphone use and nomophobia, with a higher incidence in women than in men [17], while in another Italian study it was found that male participants (61.5%) believed that smartphones would improve coordination among care team members and also reported a reduction in the level of work-related stress through use smartphone [20]. ...
... Other studies report conflicting data with respect to gender differences, with nomophobia more present in the female gender [19,20]. The results of a further study indicate a correlation between smartphone use and nomophobia, with a higher incidence in women than in men [17], while in another Italian study it was found that male participants (61.5%) believed that smartphones would improve coordination among care team members and also reported a reduction in the level of work-related stress through use smartphone [20]. Subjects with mild nomophobia, of an almost negligible level, are numerically more present among nurses than coordinators, a worrying result and potentially having a negative impact on care performance. ...
Article
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(1) Background: Nomophobia is considered a digital and virtual contemporary society disorder and refers to discomfort, anxiety, nervousness, or distress caused by being out of contact with a cell phone or computer. The present study had a twofold objective: to evaluate the expert use of the Internet among Italian nurses by correlating it with socio-demographic characteristics, such as: sex, years of work experience, professional role, and level of nursing education; and to assess a possible increase in the levels of nomophobia among Italian nurses during COVID-19 compared to the pre-pandemic period. (2) Methods: An observational, cross-sectional, multicenter study was conducted from April to September 2020, such as during the First Wave of the COVID-19 outbreak. (3) Results: A total of 502 nurses were enrolled in the present study. Significantly differences were reported in the IAT (Internet Addiction Test) levels according to socio-demographic characteristics since males reported significantly higher IAT levels than females (p < 0.001). Nurses who worked more than 6 years reported significantly higher IAT levels (p = 0.031) than their younger colleagues. More nursing managers and coordinators reported significantly higher IAT levels than registered nurses (p < 0.001). This trend was repeated by considering the nursing educational level, as nurses who recorded more years of nursing educational level reported significantly higher IAT levels than the others (p = 0.003). Additionally, significant differences were reported according to all the socio-demographic characteristics considered and IAT subdimensions, namely: Salience, Excessive Use, Neglect Work, Anticipation, and Lack of Control. (4) Conclusions: The study revealed higher levels of Internet addiction in men than in women during the COVID-19 pandemic period, as well as a significant correlation between nomophobia, years of work experience, and the role of nursing coordinator/manager.
... Interruptions can also be related to hospitals, such as medical equipment failures and telephone / cellphone calls, although smartphones help nurses fulfill tasks according to guidelines and policies without abuse (Gill et al., 2012). Nevertheless, many studies have reported that use of phones / smartphones by nurses may contribute to interruptions of primary tasks, and discontinuation of clinical tasks with negative consequences to patient safety (McBride, 2015;Pucciarelli et al., 2019). Equipment failure is also reported as an interruption among healthcare providersespecially in operating rooms, where it is negatively associated with the functioning of the health team (Antoniadis et al., 2014). ...
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Aim: To discover the perceived level of nursing interruptions during care activities. The study evaluates the contributing factors of alarms, equipment failures, visitors, and telephone calls in predicting interruptions according to the site of nurses' work. It also examines the potential association of demographic factors of nurses with interruption levels. Design: A cross-sectional study. Methods: The study included nurses working at a tertiary hospital in Amman, the capital of Jordan. Data collections were carried out between May and July 2020. The analysis was performed using 257 valid questionnaires, compromising 128 male and 129 female respondents. The study used a nursing interruptions scale and an interruptions scale related to patients and hospitals. Results: Results indicated that the participating nurses generally experienced a high level of interruptions during nursing care activities. Visitors were found to be the main predictor of nursing interruptions on the surgical / medical floor; whereas equipment failure was found to be the main predictor of nursing interruptions in intensive care units. Finally, the demographic factors of marital status and educational level were associated with interruptions. Conclusion: Visitors and equipment failures are the main predictors of interruptions during nursing care activities. Our results provide a clear explanation for organizations, nurse managers, and clinicians of the factors behind nursing interruptions.
... 37 Interestingly, however, one study found that the use of smartphones in healthcare delivery was favored by nurses as a means to reduce work-related stress and enhance communication with colleagues and patient care. 38 Another limitation identified in our current review relates to patients not knowing how to use a smartphone and falsely believing that nurses were carrying smartphones for personal use, thus distracting them from patient care. 28 In keeping with distraction, when used for personal reasons in clinical settings, smartphones can lead to missing important patient information, which negatively affects patient care and patient safety. ...
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Advancements in information technology and computer science have resulted in the development of computerized healthcare information systems. Information technology can optimize patient care through providing immediate electronic education. The purpose of this mixed-methods systematic review was to synthesize evidence from studies exploring nurses and nursing students' attitudes and beliefs regarding the use of technology in patient care. Electronic databases Academic Search Complete, CINAHL, MEDLINE, Education Full Text, PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO, and ERIC were searched. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool. Convergent integrated synthesis was conducted. Eight studies were included. Technologies used in the reviewed studies include smartphones (n = 4) and Web-based information/educational resources (n = 4). Overall, nurses and nursing students' attitudes and beliefs regarding the use of smartphone applications were positive. When compared with other healthcare professionals, nurses were more likely to have access to Web-based resources and to appraise the importance of such resources in patient education. Nurses and nursing students are in a prime position to use technology in patient care and education. It is important therefore that nurses' positive attitudes toward technology be reinforced to increase the use and application of Web-based and smartphone technologies in clinical practice.
... Novel findings were that the mobile phone addiction levels of novice nurses who had adverse events were observed to be significantly higher than those without those type events across a one-year period. Likewise, Pucciarelli et al. (2018) reported And Poland (40.20%), but much lower than Greece (78.10%) . Additionally, this study shows higher scores of the burnout subscales than previous studies (Chen et al., 2019;Van Bogaert et al., 2010). ...
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Aim To explore the levels of mobile phone addiction and burnout and their relationships among novice nurses. Design A cross‐sectional investigation design. Methods Questionnaires were distributed to 400 novice nurses in five public hospitals in China. A total of 366 participants completed the survey. Data collected in 2020 were analysed by using descriptive statistics, an independent t test and Pearson's correlation analysis. Results The results showed that the frequency of nursing adverse events was associated with higher level of mobile phone addiction in novice nurses, and 52.46% of the participants (N = 366) presented a high level of occupational burnout. Moreover, the results indicated that there was a positive correlation between the novice nurses’ mobile phone addiction level and burnout (r = .33, p < .01). Conclusion The level of mobile phone addiction may affect nursing adverse events and nurses’ burnout. Education on novice nurses’ mobile phone use seems necessary to ensure patient safety and burnout prevention. Impact Findings of this study expanded important knowledge about mobile phone addiction and its potential influence on nursing safety and nurse burnout and may place significant implications to staff nurse management and in‐service education.
... Isso serve para garantir que a TICs em saúde não causem alienação e frustração. Nesse sentido, reitera-se a necessidade de que a comunicação virtual, por meios tecnológicos, venha para somar e não substituir o contato face a face e a presença física (37) . ...
Article
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Objetivo: Identificar evidências disponíveis na literatura científica acerca do uso de tecnologia da informação em saúde direcionada à comunicação efetiva para segurança do paciente. Método: Revisão integrativa da literatura nas bases de dados MEDLINE, LILACS e ScienceDirect. Foram incluídos 14 artigos originais e indexados em periódicos internacionais, nos idiomas português, inglês, espanhol e alemão, com recorte temporal de 2013 a 2018. Resultados: Os estudos abordam o desenvolvimento de tecnologias em saúde, como prontuários e formulários eletrônicos, bem como aplicativos para troca de mensagens. Estas permitem uma rápida comunicação interprofissional e otimizam o tempo de acesso e compartilhamento de informações. A agilidade e clareza nas informações determina ações mais seguras para o paciente. No entanto, é recomendado que essas tecnologias sejam associadas à interlocução verbal, a fim de propiciar relações humanizadas dentro das práticas assistenciais. Conclusão: O emprego das tecnologias de comunicação produz resultados de excelência na eficácia da segurança do paciente, em ambiente intra e extra-hospitalar, como em domicílio. Isto é evidenciado pela melhora no tempo-resposta de recebimento das informações ao utilizar a tecnologia disposta em smarthphones, tablets, notebooks e computadores, além de reduzir o uso de papel, mantendo dados padronizados, prevenindo perda de informações e otimizando o tempo. Dessa forma, conferindo melhor efetivação da comunicação inteprofissional e benefícios na saúde e segurança do paciente, de forma presencial ou remota.
... The complex process of integration of information and communications technology (ICT) into nursing practice impacts nurses' communication and relationships in patient care as well as their working condition, professional identities, and development [29]. This has led to an increasing interest into various aspects of nurses' ICT use, such as mobile phones in different care settings [30][31][32][33], social media [34,35], electronic records [36], Web-based guidelines [37,38], patient engagement technology [39], telehealth and telenursing [40], decision support [41], patient self-management [42], cybersecurity awareness [43], and multimedia Web-based simulation for competence development [44]. ...
Article
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Background: The nursing profession has undergone several changes in the past decades, and new challenges are to come in the future; patients are now cared for in their home, hospitals are more specialized, and primary care will have a key role. Health informatics is essential in all core competencies in nursing. From an educational perspective, it is of great importance that students are prepared for the new demands and needs of the patients. From a societal point of view, the society, health care included, is facing several challenges related to technological developments and digitization. Preparation for the next decade of nursing education and practice must be done, without the advantage of certainty. A training for not-yet-existing technologies where educators should not be limited by present practice paradigms is desirable. This study presents the design, method, and protocol for a study that investigates undergraduate nursing students' internet use, knowledge about electronic health (eHealth), and attitudes to technology and how experiences of eHealth are handled during the education in a multicenter study. Objective: The primary aim of this research project is to describe the design of a longitudinal study and a qualitative substudy consisting of the following aspects that explore students' knowledge about and relation to technology and eHealth: (1) what pre-existing knowledge and interest of this area the nursing students have and (2) how (and if) is it present in their education, (3) how do the students perceive this knowledge in their future career role, and (4) to what extent is the education capable of managing this knowledge? Methods: The study consists of two parts: a longitudinal study and a qualitative substudy. Students from the BSc in Nursing program from the Blekinge Institute of Technology, Karlskrona, Sweden, and from the Swedish Red Cross University College, Stockholm/Huddinge, Sweden, were included in this study. Results: The study is ongoing. Data analysis is currently underway, and the first results are expected to be published in 2019. Conclusions: This study presents the design of a longitudinal study and a qualitative substudy. The eHealth in Nursing Education eNursEd study will answer several important questions about nursing students' attitudes toward and use of information and communications technology in their private life, their education, and their emerging profession. Knowledge from this study will be used to compare different nursing programs and students' knowledge about and relation to technology and eHealth. Results will also be communicated back to nursing educators to improve the teaching of eHealth, health informatics, and technology. International registered report identifier (irrid): DERR1-10.2196/14643.
... The complex process of integration of information and communications technology (ICT) into nursing practice impacts nurses' communication and relationships in patient care as well as their working condition, professional identities, and development [29]. This has led to an increasing interest into various aspects of nurses' ICT use, such as mobile phones in different care settings [30][31][32][33], social media [34,35], electronic records [36], Web-based guidelines [37,38], patient engagement technology [39], telehealth and telenursing [40], decision support [41], patient self-management [42], cybersecurity awareness [43], and multimedia Web-based simulation for competence development [44]. ...
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BACKGROUND The nursing profession has undergone several changes the past decades and new challenges are to come in the future; patients are now cared for in their home, hospitals are more specialized, the primary care will have a key role. Health informatics is essential in all core competencies in nursing. From an educational perspective it is of great importance that students are prepared for new demands and needs of the patients. From a societal point of view, the society, healthcare included, is facing a number of challenges related to technological developments and digitization. Preparation for the next decade of nursing education/practice must be done, without the advantage of certainty. A training for not yet existing technologies where educators should not be limited by present practice paradigms is desirable. This paper presents the design, method and protocol for a study that investigate undergraduate nursing students’ internet use, knowledge about eHealth, attitudes to technology, and how experiences of eHealth are handled during the education, in a multi-center study. OBJECTIVE The primary aim of the research project is to describe the design of a longitudinal study and a qualitative sub-study consisting of following aspects: explore students’ knowledge about, and relation to technology and eHealth, i.e. 1) what pre-existing knowledge and interest of this area the nursing students have and 2) how (and if) is it present in their education, 3) how do the students perceive this knowledge in their future career role and, 4) to what extent is the education capable of managing this knowledge? METHODS The study consists of two parts: a longitudinal study and a qualitative sub-study. Students from the BSc in Nursing program from Blekinge Institute of Technology, Karlskrona, Sweden and from the Swedish Red Cross University College, Stockholm/Huddinge, Sweden were included in the present study. RESULTS The study is ongoing. Data analysis is currently underway and the first results are expected to be published in 2019. CONCLUSIONS This study presents the design of a longitudinal study and a qualitative sub-study. The eNursEd study will answer several important questions about nursing students attitudes towards, and use of ICT both in their private life, their education and their emerging profession. Knowledge from this study will be used to compare different nursing programs and students´ knowledge about and relation to technology and eHealth. Results will also be communicated back to nursing educators in order to improve teaching of eHealth, health informatics and technology.
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Aim Measuring the phenomenon of gambling and Internet addiction, with analysis of attitudes and psychophysical consequences among nurses working in different care settings. Methods An observational, cross sectional, multicenter study was conducted from April to September 2020. Participants’ socio-demographic information, the “Internet Addiction Test” (IAT) scale, and the “South Oaks Gambling Screen” (SOGS) were collected in order to assess the overuse of and whether an individual has a problematic relationship with gambling, respectively. Results 502 nurses were enrolled in the study. Significant correlations were found (p < .001) between the IAT score and gender, number of years of work experience, job role, educational qualification; and between the SOGS and gender, number of years of work experience, job role and regions of Italy. Conclusions The study highlighted an emerging social problem, and the results may be just the tip of the iceberg. Given the lack of knowledge of these phenomena and a high percentage of people who suffer from them but are afraid to admit it and get help, this study could also be useful in expanding knowledge and allow more professionals to get help and learn about possible treatments and cures for the resolution of these addictions.
Article
Background There has been an increase in the technological infrastructures of many health care organizations to support the practice of health care providers. However, many nurses are using their personal digital devices, such as smartphones, while at work for personal and professional purposes. Despite the proliferation of smartphone use in the health care setting, there is limited research on the clinical use of these devices by nurses. It is unclear as to what extent and for what reasons nurses are using their personal smartphones to support their practice. Objective This review aimed to understand the current breadth of research on nurses’ personal smartphone use in the workplace and to identify implications for research, practice, and education. Methods A scoping review using Arksey and O’Malley’s methodological framework was conducted, and the following databases were used in the literature search: CINAHL, PubMed, ProQuest Dissertations and Theses, Embase, MEDLINE, Nursing and Allied Health Database, Scopus, Web of Science, and Cochrane Reviews. Search terms used were Nurs* AND (personal digital technology OR smartphone OR cellphone OR mobile phone OR cellular phone). Inclusion criteria included research focused on nurses’ use of their own digital technologies, reported in English, and published between January 2010 and January 2020. Exclusion criteria were if the device or app was implemented for research purposes, if it was provided by the organization, if it focused on infection control, and if it was focused on nursing students or nursing education. Results A total of 22 out of 2606 articles met the inclusion criteria. Two main themes from the thematic analyses included personal smartphone use for patient care and implications of personal smartphone use. Nurses used their smartphones to locate information about medications, procedures, diagnoses, and laboratory tests. Downloaded apps were used by nurses to locate patient care–related information. Nurses reported improved communication among health team members and used their personal devices to communicate patient information via text messaging, calling, and picture and video functions. Nurses expressed insight into personal smartphone use and challenges related to distraction, information privacy, organizational policies, and patient perception. Conclusions Nurses view personal smartphones as an efficient method to gather patient care information and to communicate with the health care team. This review highlights knowledge gaps regarding nurses’ personal device use and information safety, patient care outcomes, and communication practices. This scoping review facilitates critical reflection on patient care practices within the digital context. We infer that nurses’ use of their personal devices to communicate among the health care team may demonstrate a technological “work-around” meant to reconcile health system demands for cost-efficiency with efforts to provide quality patient care. The current breadth of research is focused on acute care, with little research focus in other practices settings. Research initiatives are needed to explore personal device use across the continuum of health care settings.
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Background: Smartphones and other mobile devices are having and will continue to have an impact on health care delivery in acute settings in Australia and overseas. Nurses, unlike physicians, have been slow to adopt these technologies and the reasons for this may relate to the status of both these professions within the hospital setting. Objective: To explore nurses' perspectives on iPhone use within an acute care unit. We examined their experiences and views on how this device may improve communication and decision-making processes at the point of care. Methods: Two focus group discussions, using a semistructured interview, were conducted over the trial period. The discussions focused on the nurses' experiences regarding ease of use, features, and capabilities of the device. The focus groups were recorded, transcribed, and analyzed using semistructured interview questions as a guide. Results: The positive findings indicated that the iPhones were accessible and portable at point of care with patients, enhanced communication in the workplace, particularly among the nurses, and that this technology would evolve and be embraced by all nurses in the future. The negatives were the small screen size when undertaking bedside education for the patient and the invasive nature of the device. Another issue was the perception of being viewed as unprofessional when using the device in real time with the patients and their family. Conclusions: The use of iPhones by nurses in acute care settings has the potential to enhance patient care, especially through more effective communication among nurses, and other health care professionals. To ensure that the benefits of this technology is woven into the everyday practice of the nurse, it is important that leaders in these organizations develop the agenda or policy to ensure that this occurs.
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Background: High level of stress in intensive care unit nurses affects the quality of their nursing care. Therefore, this study aimed to determine the effects of a stress management program on the quality of nursing care of intensive care unit nurses. Materials and methods: This study is a randomized clinical trial that was conducted on 65 nurses. The samples were selected by stratified sampling of the nurses working in intensive care units 1, 2, 3 in Al-Zahra Hospital in Isfahan, Iran and were randomly assigned to two groups. The intervention group underwent an intervention, including 10 sessions of stress management that was held twice a week. In the control group, placebo sessions were held simultaneously. Data were gathered by demographic checklist and Quality Patient Care Scale before, immediately after, and 1 month after the intervention in both groups. Then, the data were analyzed by Student's t-test, Mann-Whitney, Chi-square, Fisher's exact test, and analysis of variance (ANOVA) through SPSS software version 18. Results: Mean scores of overall and dimensions of quality of care in the intervention group were significantly higher immediately after and 1 month after the intervention, compared to pre-intervention (P < 0.001). The results showed that the quality of care in the intervention group was significantly higher immediately after and 1 month after the intervention, compared to the control group (P < 0.001). Conclusions: As stress management is an effective method to improve the quality of care, the staffs are recommended to consider it in improvement of the quality of nursing care.
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Background: Approximately 35% of U.S. adults are obese, and this rate is expected to increase by almost 50% by 2030. New media such as smartphone applications (apps) provide a useful and low-cost way to disseminate weight control information. For many culturally distinctive population subgroups, however, there is currently an absence of research-tested smartphone apps for weight control. Methods: In this commentary, we highlight the need for culturally tailored smartphone apps for weight control and offer recommendations for further research by providing two specific examples: 1) the characteristic dietary patterns and absence of smartphone apps for weight loss for Hispanic Americans, in English and Spanish, and 2) and need for smartphone apps for weight loss for Brazilian Americans, including those who speak Portuguese. Results: Smartphone apps can be an effective intervention for improving diet and nutrition, encouraging physical activity, and reducing obesity, but few randomized controlled trials have been conducted of stand-alone smartphone apps for weight loss that focus primarily on self-monitoring of diet and physical activity. Further, there have been no published studies of apps for promoting healthy diet, better nutrition, increasing levels of physical activity, and weight loss among Hispanic Americans or Brazilian Americans. Conclusions: Low-cost, effective e-Health interventions (healthcare practices supported by electronic processes) are needed to promote physical activity, healthy eating, and weight control in culturally distinctive subgroups of the population. For weight loss, apps should be developed by use of evidence-based approaches that relate to behavioral theories. Additional public health research is needed to identify low-cost, effective strategies for weight loss for people who have varying levels of health literacy, and for non-English speakers. Culturally tailored e-Health interventions for weight control are more likely to address the needs of individuals and increase their motivation to engage in health promoting behaviors.
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Nurses function inside a particularly stressful occupation that requires the provision of continuous care to individuals who are often in great need. Stress has been shown to impair performance and specifically shown to impair nursing quality. However, we do not yet know how stress influences the cognitive performance of nurses, and hence, the present study investigated the associations between stress and cognitive performance in nurses using electroencephalography and administered cognitive assessments. Thirty-six nurses (34 women) of mean age 37.77 ± 11.40 years were recruited. Stress was examined using the Lifestyle Appraisal Questionnaire. Broad spectrum electroencephalogram activity at positions Fp1, Fp2, C3 and C4 was recorded for a 5-min baseline and active phase to physiologically assess cognitive performance. Additionally, the Mini-Mental State Exam and Cognistat were also used to measure cognitive performance. Assessed cognitive performance was not associated to stress, however, lifestyle factors, as well as a number of the examined cognitive electroencephalographic variables including changes in theta, alpha activity and gamma reactivity were. Definitively determining how stress affects the cognitive performance of nurses requires additional research; the present study forms a foundation from which future research can further expand the examination of stress exposure in nurses. Copyright © 2016 John Wiley & Sons, Ltd.
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Background and aims: Smartphone addiction, its association with smartphone use, and its predictors have not yet been studied in a European sample. This study investigated indicators of smartphone use, smartphone addiction, and their associations with demographic and health behaviour-related variables in young people. Methods: A convenience sample of 1,519 students from 127 Swiss vocational school classes participated in a survey assessing demographic and health-related characteristics as well as indicators of smartphone use and addiction. Smartphone addiction was assessed using a short version of the Smartphone Addiction Scale for Adolescents (SAS-SV). Logistic regression analyses were conducted to investigate demographic and health-related predictors of smartphone addiction. Results: Smartphone addiction occurred in 256 (16.9%) of the 1,519 students. Longer duration of smartphone use on a typical day, a shorter time period until first smartphone use in the morning, and reporting that social networking was the most personally relevant smartphone function were associated with smartphone addiction. Smartphone addiction was more prevalent in younger adolescents (15-16 years) compared with young adults (19 years and older), students with both parents born outside Switzerland, persons reporting lower physical activity, and those reporting higher stress. Alcohol and tobacco consumption were unrelated to smartphone addiction. Discussion: Different indicators of smartphone use are associated with smartphone addiction and subgroups of young people have a higher prevalence of smartphone addiction. Conclusions: The study provides the first insights into smartphone use, smartphone addiction, and predictors of smartphone addiction in young people from a European country, which should be extended in further studies.
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Smartphones and tablets have taken a central place in the lives of health care professionals. Their use has dramatically improved the communication and has become an important learning tool as the medical information can be assessed online at anytime. In critical care settings, use of smartphone facilitates quick passage of information through E-mail messaging and getting feedback from the concerned physician quickly, thereby reducing medical errors. However, in addition to the benefits offered, these devices have become a significant source of nosocomial infections, distraction for medical professionals and interfere with medical equipments. They may also put privacy and security of patients at stake. The benefits could be severely undermined if abuse and over use are not kept in check. This review article focuses on various applications of smartphones in healthcare practices, drawback of the use of these devices and the recommendations regarding the safe use of these devices.
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Psychologists typically rely on self-report data when quantifying mobile phone usage, despite little evidence of its validity. In this paper we explore the accuracy of using self-reported estimates when compared with actual smartphone use. We also include source code to process and visualise these data. We compared 23 participants' actual smartphone use over a two-week period with self-reported estimates and the Mobile Phone Problem Use Scale. Our results indicate that estimated time spent using a smartphone may be an adequate measure of use, unless a greater resolution of data are required. Estimates concerning the number of times an individual used their phone across a typical day did not correlate with actual smartphone use. Neither estimated duration nor number of uses correlated with the Mobile Phone Problem Use Scale. We conclude that estimated smartphone use should be interpreted with caution in psychological research.
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Mounting evidence shows that smartphone usage heavily disrupts our work life and social activities. Moreover, it is possible that overuse could resemble addictive tendencies. A key contributing factor to smartphone overuse seems to be usage of the messaging application WhatsApp. Although WhatsApp is one of the most commonly used communication applications on smartphones, research in this area is scarce. Given the huge societal debate on the impact of smartphone usage on our daily lives, the present study undertook a large-scale investigation in order to provide numbers on smartphone usage generally-and use of WhatsApp in particular, with the aim of providing a basis for a scientific debate. In a large sample of N = 2,418 users, we recorded WhatsApp behaviour over a 4 week period. Our data show that use of WhatsApp accounted for 19.83% (= 32.11 min) of all smartphone behaviour (compare: Facebook only 9.38% = 15.19 min). The mean of general daily smartphone usage was 161.95 min. Females used WhatsApp for significantly longer periods of time than males and younger age was associated with longer duration of WhatsApp use. While the personality trait Extraversion was positively associated with daily WhatsApp use, Conscientiousness showed an inverse correlation with the length of daily WhatsApp use. The numbers on smartphone usage in the present study show that the smartphone dominates our daily life. In particular WhatsApp is a driving force, here. Given the length of daily smartphone and WhatsApp usage, more studies need to be conducted to better understand smartphone usage.
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Individuals seeking treatment for addiction often experience barriers due to cost, lack of local treatment resources, or either school or work schedule conflicts. Text-messaging-based addiction treatment is inexpensive and has the potential to be widely accessible in real time. We conducted a comprehensive literature review identifying 11 published, randomized controlled trials (RCTs) evaluating text-messaging-based interventions for tobacco smoking, four studies for reducing alcohol consumption, one pilot study in former methamphetamine (MA) users, and one study based on qualitative interviews with cannabis users. Abstinence outcome results in RCTs of smokers willing to make a quit attempt have been positive overall in the short term and as far out as at six and 12 months. Studies aimed at reducing alcohol consumption have been promising. More data are needed to evaluate the feasibility, acceptability, and efficacy of this approach for other substance use problems.
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Personal mobile phones and other personal communication devices (smartphones and tablet computers) provide users with an ever-increasing number and diversity of non-work-related activities while at work. In hospitals, where the vigilance of health care workers is essential for patient care, the potential distraction of these devices could be hazardous to patients. The objective of this study was to determine the frequency of non-work-related use of personal mobile phones and other personal communication devices among hospital registered nurses. In March 2014, a previously validated 30-question survey was emailed to the 10,978 members of the Academy of Medical Surgical Nurses. There were 825 respondents who met the inclusion criteria. The use of a personal mobile phone or other personal communication device while working (excluding meal times and breaks) was reported by 78.1% (644/825) of respondents. Nurses reported regularly (sometimes, often, or always) sending personal emails and text messages (38.6%, 318/825), reading news (25.7%, 212/825), checking/posting on social networking sites (20.8%, 172/825), shopping (9.6%, 79/825), and playing games (6.5%, 54/825) while working. This study found that hospital nurses frequently use their personal mobile phones or other personal communication devices for non-work-related activities at work. The primary activity reported was to send personal emails and text messages to family and friends.
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Background The growth of digital technology has created challenges for safe and appropriate use of mobile or portable devices during work-integrated learning (WIL) in health care environments. Personal and professional use of technology has outpaced the development of policy or codes of practice for guiding its use at the workplace. There is a perceived risk that portable devices may distract from provision of patient or client care if used by health professionals or students during employment or WIL. Objective This study aimed to identify differences in behavior of undergraduate nurses in accessing information, using a portable or mobile device, when undertaking WIL compared to other non-work situations. MethodsA validated online survey was administered to students while on placement in a range of health care settings in two Australian states. ResultsThere were 84 respondents, with 56% (n=47) reporting access to a mobile or portable device. Differences in use of a mobile device away from, compared with during WIL, were observed for non-work related activities such as messaging (P
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The use of personal communication devices (such as basic cell phones, enhanced cell phones or smartphones, and tablet computers) in hospital units has risen dramatically in recent years. The use of these devices for personal and professional activities can be beneficial, but also has the potential to negatively affect patient care, as clinicians may become distracted by these devices. No validated questionnaire examining the impact of the use of these devices on patient care exists; thus, we aim to develop and validate an online questionnaire for surveying the views of registered nurses with experience of working in hospitals regarding the impact of the use of personal communication devices on hospital units. A 50-item, four-domain questionnaire on the views of registered nursing staff regarding the impact of personal communication devices on hospital units was developed based on a literature review and interviews with such nurses. A repeated measures pilot study was conducted to examine the psychometrics of a survey questionnaire and the feasibility of conducting a larger study. Psychometric testing of the questionnaire included examining internal consistency reliability and test-retest reliability in a sample of 50 registered nurses. The response rate for the repeated measures was 30%. Cronbach coefficient alpha was used to examine the internal consistency and reliability, and in three of the four question groups (utilization, impact, and opinions), the correlation was observed to be very high. This suggests that the questions were measuring a single underlying theme. The Cronbach alpha value for the questions in the performance group, describing the use of personal communication devices while working, was lower than those for the other question groups. These values may be an indication that the assumptions underlying the Cronbach alpha calculation may have been violated for this group of questions. A Spearman rho correlation was used to determine the test-retest reliability. There was a strong test-retest reliability between the two tests for the majority of the questions. The average test-retest percent of agreement for the Likert scale responses was 74% (range 43-100%). Accounting for responses within the 1 SD range on the Likert scale increased the agreement to 96% (range 87-100%). Missing data were in the range of 0 to 7%. The psychometrics of the questionnaire showed good to fair levels of internal consistency and test-retest reliability. The pilot study demonstrated that our questionnaire may be useful in exploring registered nurses' perceptions of the impact of personal electronic devices on hospital units in a larger study.
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With the use of highly mobile tools like tablet PCs in clinical settings, an effective disinfection method is a necessity. Since manufacturers do not allow cleaning methods that make use of anything but a dry fleece, other approaches have to be established to ensure patient safety and to minimize risks posed by microbiological contamination. The ability of isopropanol wipes to decontaminate iPads was evaluated prospectively in a observer blinded, comparative analysis of devices used in a clinical and a nonclinical setting. 10 new iPads were randomly deployed to members of the nursing staff of 10 clinical wards, to be used in a clinical setting over a period of 4 weeks. A pre-installed interactive disinfection application (deBac-app, PLRI MedAppLab, Germany) was used on a daily basis. Thereafter, the number and species of remaining microorganisms on the surface of the devices (13 locations; front and back) was evaluated using contact agar plates. Following this, the 10 iPads were disinfected and randomly deployed to medical informatics professionals who also used the devices for 4 weeks but were forbidden to use disinfecting agents. The quality of a single, standardized disinfection process was then determined by a final surface disinfection process of all devices in the infection control laboratory. No personal data were logged with the devices. The evaluation was performed observer blinded with respect to the clinical setting they were deployed in and personnel that used the devices. We discovered a 2.7-fold (Mann-Whitney U test, z=-3.402, P=.000670) lower bacterial load on the devices used in the clinical environment that underwent a standardized daily disinfection routine with isopropanol wipes following the instructions provided by "deBac-app". Under controlled conditions, an average reduction of the mainly Gram-positive normal skin microbiological load of 99.4% (Mann-Whitney U test, z=-3.1798, P=.001474) for the nonclinical group and 98.1% (Mann-Whitney U test, z=3.1808, P=.001469) for the clinical group was achieved using one complete disinfecting cycle. Normal use of tablet PCs leads to a remarkable amount of microbial surface contamination. Standardized surface disinfection with isopropanol wipes as guided by the application significantly reduces this microbial load. When performed regularly, the disinfection process helps with maintaining a low germ count during use. This should reduce the risk of subsequent nosocomial pathogen transmission. Unfortunately, applying a disinfection procedure such as the one we propose may lead to losing the manufacturer's warranty for the devices; this remains an unsolved issue.
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Aim: In this study, the prevalence and risk factors of Internet addiction in high school students was investigated. Material and method: This cross-sectional study was performed in the Mersin Province in 2012. The study sample consisted of students attending high school in the central district of Mersin. The data were summarized by descriptive statistics and compared by a binary logistic regression. Results: Our study population included 1156 students, among whom 609 (52.7%) were male. The mean age of the students was 16.1 ± 0.9 years. Seventy-nine percent of the students had a computer at home, and 64.0% had a home Internet connection. In this study, 175 (15.1%) students were defined as Internet addicts. Whereas the addiction rate was 9.3% in girls, it was 20.4% in boys (P < 0.001). In this study, Internet addiction was found to have an independent relationship with gender, grade level, having a hobby, duration of daily computer use, depression and negative self-perception. Conclusion: According to our study results, the prevalence of Internet addiction was high among high school students. We recommend preventing Internet addiction among adolescents by building a healthy living environment around them, controlling the computer and Internet use, promoting book reading and providing treatment to those with a psychological problem.
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Background: The majority of workers, regardless of age or occupational status, report engaging in personal Internet use in the workplace. There is little understanding of the impact that personal Internet use may have on patient care in acute clinical settings. Objective: The objective of this study was to investigate the volume of one form of personal Internet use-online social networking (Facebook)-generated by workstations in the emergency department (ED) in contrast to measures of clinical volume and severity. Methods: The research team analyzed anonymous network utilization records for 68 workstations located in the emergency medicine department within one academic medical center for 15 consecutive days (12/29/2009 to 1/12/2010). This data was compared to ED work index (EDWIN) data derived by the hospital information systems. Results: Health care workers spent an accumulated 4349 minutes (72.5 hours) browsing Facebook, staff cumulatively visited Facebook 9369 times and spent, on average, 12.0 minutes per hour browsing Facebook. There was a statistically significant difference in the time spent on Facebook according to time of day (19.8 minutes per hour versus 4.3 minutes per hour, P<.001). There was a significant, positive correlation between EDWIN scores and time spent on Facebook (r=.266, P<.001). Conclusions: Facebook use constituted a substantive percentage of staff time during the 15-day observation period. Facebook use increased with increased patient volume and severity within the ED.
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Introduction: Communication among healthcare providers continues to change, and 90% of healthcare providers are now carrying cellular phones. Compared with pagers, the rate and amount of information immediately available via cellular phones are far superior. Wireless devices such as smartphones are ideal in acute trauma settings as they can transfer patient information quickly in a coordinate manner to all the team members responsible for patient care. Subjects and methods: A questionnaire survey was distributed among all the trauma surgeons, surgery residents, and nurse practitioners who were a part of the trauma surgery team at a Level 1 trauma center. Answers to each question were recorded on a 5-point Likert scale. The completed survey questionnaires were analyzed using Statistical Package for Social Sciences software (SPSS version 17; SPSS, Inc., Chicago, IL). Results: The respondents had an overall positive experience with the usage of the third-generation (3G) smartphones, with 94% of respondents in favor of having wireless means of communication at a Level 1 trauma center. Of respondents, 78% found the device very user friendly, 98% stated that use of smartphones had improved the speed and quality of communication, 96% indicated that 3G smartphones were a useful teaching tool, 90% of the individuals felt there was improvement in the physician's response time to both routine and critical patients, and 88% of respondents were aware of the rules and regulations of the Health Insurance Portability and Accountability Act. Conclusions: Smartphones in an acute trauma setting are easy to use and improve the means of communication among the team members by providing accurate and reliable information in real time. Smartphones are effective in patient follow-up and as a teaching tool. Strict rules need to be used to govern the use of smartphones to secure the safety and secrecy of patient information.
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Although all professions are susceptible to work-related stress, the nursing profession has been identified as particularly stressful; indeed, oncology nursing is often described as being among the most stressful specialty areas. The current study tested the short-term effects of an innovative self-help stress management training for oncology nurses supported by mobile tools. The sample included 30 female oncology nurses with permanent status employed in six oncology hospitals in Milan, Italy. The stress inoculation training (SIT) methodology served as the basis of the training, with the innovative challenge being the use of mobile phones to support the stress management experience. To test the efficacy of the protocol, the study used a between-subjects design, comparing the experimental condition (SIT through mobile phones) with a control group (neutral video through mobile phones). The findings indicated psychological improvement of the experimental group in terms of anxiety state, anxiety trait reduction, and coping skills acquisition. This paper discusses implications for the implementation of this protocol in several contexts. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Smartphone use in health care work settings presents both opportunities and challenges. The benefits could be severely undermined if abuse and overuse are not kept in check. This practice-focused research paper examines the current panorama of health software applications. Findings from existing research are consolidated to elucidate the level and effects of distraction in health care work settings due to smartphone use. A conceptual framework for crafting guidelines to regulate the use of smartphones in health care work settings is then presented. Finally, specific guidelines are delineated to assist in creating policies for the use of smartphones in a health care workplace.
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This study evaluated the microbial contamination of health care workers' (HCWs) mobile phones. The study was conducted at a secondary referral hospital in July 2010. Samples were taken from all surfaces of the mobile phones using a sterile swab, and incubated on Brain Heart Infusion agar at 37.5°C for 24 hr. Any isolated microorganisms were grown aerobically on 5% sheep blood agar and eosin methylene-blue agar medium at 37.5°C for 24-48 hr. The Sceptor microdilution system was used to identify the microorganisms, together with conventional methods. The oxacillin disc diffusion test and double-disc synergy test were used to identify methicillin-resistant Staphylococcus aureus (MRSA) and expanded-spectrum beta-lactamase (ESBL)-producing Gram-negative bacilli, respectively. The mobile phones were also categorized according to whether the HCWs used them in the intensive care unit (ICU). Overall, 183 mobile phones were screened: 94 (51.4%) from nurses, 32 (17.5%) from laboratory workers, and 57 (31.1%) from health care staff. In total, 179 (97.8%) culture-positive specimens were isolated from the 183 mobile phones, including 17 (9.5%) MRSA and 20 (11.2%) ESBL-producing Escherichia coli, which can cause nosocomial infections. No statistical difference was observed in the recovery of MRSA (p = 0.3) and ESBL-producing E. coli (p = 0.6) between the HCW groups. Forty-four (24.6%) of the 179 specimens were isolated from mobile phones of ICU workers, including two MRSA and nine ESBL-producing E. coli. A significant (p = 0.02) difference was detected in the isolation of ESBL-producing E. coli between ICU workers and non-ICU workers. HCWs' mobile phones are potential vectors for transferring nosocomial pathogens between HCWs, patients, and the community.
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There has been a steady growth of research into interruption spanning two decades. The first observations indicating that interruptions appeared to be commonplace in busy clinical settings like the emergency department1–5 were soon followed by a potential link between interruptions and clinical error.6 We now know that the act of interruption is pervasive,7–9 perhaps universal, in clinical practice (and indeed most of life). Even apparently quiet and controlled spaces like the operating theatre are home to frequent interruption.10 11 There are now also robust studies demonstrating the sometimes negative impact of interruption on clinical work,12 and in the genesis of error.13–15 Interruption science is thus important in its own right. As importantly, it also provides us with a model for how we can approach the broader study of socio-technical systems in patient safety. The realisations that clinical work is complex, and that safety is an emergent property of local context, are all mirrored in the study of interruption. There is thus much to be learnt from the specific analysis of interruptions for the broader study of clinical work and patient safety. Studying interruptions is, however, challenging.16 17 It is still hard to predict the impact of interventions designed to minimise the effects of interruptions, or even to understand when such interventions are needed. Untangling this nuanced story could take a while, were it not for the work of researchers from other disciplines. Psychology, in particular, has a large corpus of research, often from controlled laboratory studies, that tease apart the mechanics of how interruption disrupts cognition.18 19 The field of human computer interaction (HCI) explores how interruption disrupts the way we interact with technology, how technology design can be interruptive (think pager or mobile phone) and, crucially, how technology can be designed …
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Social media applications such as Facebook and Twitter have been rapidly adopted by users of all ages, forcing us to change how we think about communication. Social communication is in transition from predominately telephone and face-to-face encounters to a digital public paradigm involving the use of social media. These applications offer numerous communication, information, and public relations benefits to individuals and organizations; however, they also pose new dilemmas for health care professionals and institutions. Research and media reports indicate that many pharmacy and medical students may lack good judgment when communicating and presenting themselves online in social media venues.1–3 Jain4 provided an excellent commentary on the complexity of social media issues pertinent to the individual health care provider. Incautious sharing of attitudes, behavior, and opinions with the online public can have deleterious effects on individuals. “E-professionalism” and online professional boundaries are important constructs for all to understand in order to safeguard their reputations and careers.5 A lack of recognition and comprehension of potential issues with social media is not the only hurdle; research has shown that some pharmacy students hold the attitude that information published via social media is irrelevant to the workplace and should not be used for judgments of professional ability or reputation, regardless of the type of information posted.3 Efforts are under way to educate pharmacy students on these issues, but it may take several years before those efforts succeed in preparing all pharmacy professionals to represent themselves appropriately in the online world.
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Interruptions have been implicated as a cause of clinical errors, yet, to our knowledge, no empirical studies of this relationship exist. We tested the hypothesis that interruptions during medication administration increase errors. We performed an observational study of nurses preparing and administering medications in 6 wards at 2 major teaching hospitals in Sydney, Australia. Procedural failures and interruptions were recorded during direct observation. Clinical errors were identified by comparing observational data with patients' medication charts. A volunteer sample of 98 nurses (representing a participation rate of 82%) were observed preparing and administering 4271 medications to 720 patients over 505 hours from September 2006 through March 2008. Associations between procedural failures (10 indicators; eg, aseptic technique) and clinical errors (12 indicators; eg, wrong dose) and interruptions, and between interruptions and potential severity of failures and errors, were the main outcome measures. Each interruption was associated with a 12.1% increase in procedural failures and a 12.7% increase in clinical errors. The association between interruptions and clinical errors was independent of hospital and nurse characteristics. Interruptions occurred in 53.1% of administrations (95% confidence interval [CI], 51.6%-54.6%). Of total drug administrations, 74.4% (n = 3177) had at least 1 procedural failure (95% CI, 73.1%-75.7%). Administrations with no interruptions (n = 2005) had a procedural failure rate of 69.6% (n = 1395; 95% CI, 67.6%-71.6%), which increased to 84.6% (n = 148; 95% CI, 79.2%-89.9%) with 3 interruptions. Overall, 25.0% (n = 1067; 95% CI, 23.7%-26.3%) of administrations had at least 1 clinical error. Those with no interruptions had a rate of 25.3% (n = 507; 95% CI, 23.4%-27.2%), whereas those with 3 interruptions had a rate of 38.9% (n = 68; 95% CI, 31.6%-46.1%). Nurse experience provided no protection against making a clinical error and was associated with higher procedural failure rates. Error severity increased with interruption frequency. Without interruption, the estimated risk of a major error was 2.3%; with 4 interruptions this risk doubled to 4.7% (95% CI, 2.9%-7.4%; P < .001). Among nurses at 2 hospitals, the occurrence and frequency of interruptions were significantly associated with the incidence of procedural failures and clinical errors.
Article
Introduction: In healthcare, smartphone is becoming an important tool among nursing population. With the smartphones, it was possible to implement new care models. However, if used incorrectly, it could be the cause of nurses' distraction and nosocomial infection. Aim: To analyze the various apps used by the nursing population and describe the smartphones' positive and negative aspects on health care by review the literature. Method: PubMed, CINAHL, SCOPUS e Web of Knowledge, Google Schoolar, databases were used to perform this study. The following keywords were used: ((nurse* NOT (student* OR physician*)) AND (smartphone* OR phone* OR mobile* OR cellphone) AND (app OR use* OR benefit OR distraction OR stress OR abuse OR work-related). Results: A total of 34 articles were included in the review. Medical calculation, heart measurement and chronic patient-nurse communication apps were described. While smartphones may cause distraction, nosocomial infection or interference with other medical devices, on the other hand they could improve the well-being, job satisfaction, productivity and decrease stress in nurse population. Conclusions: There are potential benefits of the smartphone use, but the smartphone misuse could have negative consequences on the quality care and patient' safety due to nurses' distraction and interruptions. For this reason, nurses should be careful when they use their smartphone for no work-related activities.
Article
This was an observational multicenter study of 50 registered nurses, randomly selected, on 5 surgical wards in 5 Italian hospitals. There were on average 5.6 interruptions per hour. Interruptions occurred more frequently during the afternoon shift (n = 1061; 52.8%), were caused mainly by the staff members (n = 978; 48.7%) during medication administration (n = 1075; 53.5%), and were managed directly by the nurses (n = 1639; 81.6%). The average duration of an interruption was 32.7 seconds (95% confidence interval, 30.7-34.7).
Article
Interrumption that occur during nursing practice are hazardous for patient safety, resulting in a heavy cognitive load for the health care professionals and increases the risk of making mistakes. An observational study was carried out in UU.OO operation of Neurosurgery and Vascular Surgery at a hospital in Liguria. The observation lasted one months, from July 1st, 2012 to August 1st, 2012. For data collection were used three form, one for each work shift, in which each health care professional had to report what activity was interrupted and why. A total of 7744 interruptium (in 5676 in Neurosurgery and 2068 Vascular Surgery). The major source of interruption was the bell, followed by the phone and relatives' questions. In general, activities interrupted were mainly made beds / hygiene care, administration and preparation of medication, handover and completion of the nursing documentation CONCLUSIONS: Interrumption will be an inevitable part of nursing practice, because of its very nature. It is therefore necessary to intervene on interruptions deemed avoidable and organizational variables that generate them, in order to increase patient safety and improve care activities.
Article
Mobile working refers to a practitioner's ability to access information systems and applications while 'on the move'. This relatively new concept has yielded a number of benefits, including the ability to access patients' electronic records in real time and a reduction in travelling time for clinicians, thereby improving efficiency within community nursing practice. For a change in practice to be successful, it is necessary to ensure that the proposals are discussed with the staff group implementing them and that appropriate help and support are provided during the period of transition. Maintaining engagement with community nursing teams may be challenging due to increasing workloads and limited resources, potentially affecting health professionals' ability to attend workshops and associated events. Considering the specific needs of the workforce requires consideration and planning, including provision of additional support for members of staff who may lack confidence in working with mobile devices.
Article
Abstract Internet addiction has become a serious behavioral health problem in Asia. However, there are no up-to-date country comparisons. The Asian Adolescent Risk Behavior Survey (AARBS) screens and compares the prevalence of Internet behaviors and addiction in adolescents in six Asian countries. A total of 5,366 adolescents aged 12-18 years were recruited from six Asian countries: China, Hong Kong, Japan, South Korea, Malaysia, and the Philippines. Participants completed a structured questionnaire on their Internet use in the 2012-2013 school year. Internet addiction was assessed using the Internet Addiction Test (IAT) and the Revised Chen Internet Addiction Scale (CIAS-R). The variations in Internet behaviors and addiction across countries were examined. The overall prevalence of smartphone ownership is 62%, ranging from 41% in China to 84% in South Korea. Moreover, participation in online gaming ranges from 11% in China to 39% in Japan. Hong Kong has the highest number of adolescents reporting daily or above Internet use (68%). Internet addiction is highest in the Philippines, according to both the IAT (5%) and the CIAS-R (21%). Internet addictive behavior is common among adolescents in Asian countries. Problematic Internet use is prevalent and characterized by risky cyberbehaviors.
Article
PurposeConsumer electronic devices such as smartphones, tablet computers, and e-book readers have become far more widely used in recent years. Many of these devices contain accessibility features such as large print and speech. Anecdotal experience suggests people with vision impairment frequently make use of these systems. Here we survey people with self-identified vision impairment to determine their use of this equipment.Method An internet-based survey was advertised to people with vision impairment by word of mouth, social media, and online. Respondents were asked demographic information, what devices they owned, what they used these devices for, and what accessibility features they used.ResultsOne hundred and thirty-two complete responses were received. Twenty-six percent of the sample reported that they had no vision and the remainder reported they had low vision. One hundred and seven people (81%) reported using a smartphone. Those with no vision were as likely to use a smartphone or tablet as those with low vision. Speech was found useful by 59% of smartphone users. Fifty-one percent of smartphone owners used the camera and screen as a magnifier. Forty-eight percent of the sample used a tablet computer, and 17% used an e-book reader. The most frequently cited reason for not using these devices included cost and lack of interest.Conclusions Smartphones, tablet computers, and e-book readers can be used by people with vision impairment. Speech is used by people with low vision as well as those with no vision. Many of our (self-selected) group used their smartphone camera and screen as a magnifier, and others used the camera flash as a spotlight.
Article
The objective of this study is to assess the efficacy of smartphone and its WhatsApp application as a communication method amongst the staff of plastic and reconstructive surgery section at tertiary care health facility. From January 2012 onwards, the authors used smartphones and its WhatsApp application as a communication method amongst their team for various aspects of patient management and as a tool for academic endorsements. During the period of this study, there were 116 episodes regarding patient management, which were handled, in a timely fashion by using this application. In addition opinion of rotating residents in the section was sought regarding the efficacy of this method of communication. Overall majority of residents were satisfied with this mode of communication. This new method of communication is an effective method for clinical and academic endorsements. The method is cheap and quick and easy to operate.
Article
Heart rate (HR) measurement is essential for children with abnormal heart beats. The purpose of this study was to determine whether HR measurement by smartphone applications (apps) could be a feasible alternative to an electrocardiography (ECG) monitor. A total of 40 children, median age of 4.3 years, were studied. Using four free smartphone apps, pulse rates were measured at the finger (or toe) and earlobe, and compared with baseline HRs measured by ECG monitors. Significant correlations between measured pulse rates and baseline HRs were found. Both correlation and accuracy rate were higher in the earlobe group than the finger/toe group. When HR was <120 beats per min (bpm), the accuracy rates were not different between the two different measuring sites for each app (median of 65 vs 76 %). The accuracy rates in the finger/toe group were significantly lower than those in the earlobe group for all apps when HR was ≥120 bpm (27 vs 65 %). There were differences among apps in their abilities to measure pulse rates. Taking children's pulse rate from the earlobe would be more accurate, especially for tachycardia. However, we do not recommend that smartphone apps should not be used for routine medical use or used as the sole form of HR measurement because the results of their accuracy are not good enough.
Article
Smartphone applications used in healthcare are emerging as an adjunct therapy to assist patients in self-management. Often, smartphone technology is not integrated into healthcare delivery and does not build the nurse-patient relationship, an essential mechanism to guide the patient toward health. In a pilot study using smartphones with teenagers with asthma, the application provided a method not only to share health information at the point-of-living, including health assessments, personalized health plans, and disease information, but also to allow text messaging communication between the teenager and his/her RN care coordinator. Twenty-five teenagers piloted the smartphone application and provided feedback about its use. Eighty-five percent of the teenagers responding to the end-of-pilot, semistructured interview indicated a positive change in the nurse-patient relationship. Teenagers perceived that they could ask more questions along with having improved access and quicker response times. The RN care coordinators perceived improved ability to contact teenagers and improved accuracy of assessment data. Although the pilot had several limitations, it demonstrates that smartphone technology and text messaging can further the nurse-patient relationship. For this to occur, nurses need to become involved in the development and integration of technology to focus applications on innovative ways to enhance communication in patient care.
Article
The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes in its research appendix a potential new diagnosis-Internet gaming disorder. This article outlines the debate surrounding non-substance addictions and the rationale for including this condition in the "Conditions for Further Study" chapter in DSM-5 Section III. It also describes the diagnostic criteria that DSM-5 recommends and methods to assess Internet gaming disorder. The paper details international research related to prevalence rates, demographic, psychiatric, and neurobiological risk factors, the natural course of the condition, and promising treatment approaches. The paper concludes by describing important issues for research to address prior to official recognition of this condition as a mental disorder.
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AIMS: Junior doctors write the majority of hospital prescriptions but many indicate they feel underprepared to assume this responsibility and around 10% of prescriptions contain errors. Medical smartphone apps are now widely used in clinical practice and present an opportunity to provide support to inexperienced prescribers. This study assesses the contemporary range of smartphone apps with prescribing or related content. METHODS: Six smartphone app stores were searched for apps aimed at the healthcare professional with drug, pharmacology or prescribing content. RESULTS: 306 apps were identified. 34% appeared to be for use within the clinical environment in order to aid prescribing, 14% out with the clinical setting, and 51% of apps were deemed appropriate for both clinical and non-clinical use. Apps with drug reference material, such as textbooks, manuals or medical apps with drug information were the commonest app found (51%), followed by apps offering drug or infusion rate dose calculation (26%). 68% of apps charged for download, with a mean price of £14.25 per app and a range of £0.62 - 101.90. CONCLUSIONS: A diverse range of pharmacology-themed apps are available and there is further potential for the development of contemporary apps to improve prescribing performance. Personalised app stores may help universities/healthcare organisations offer high-quality apps to students to aid in pharmacology education. Users of prescribing apps must be aware of the lack of information regarding the medical expertise of app developers; this will enable them to make informed choices about the use of such apps in their clinical practice.
Article
Research indicates that having electronic resources readily available increases learners' ability to make clinical decisions and confidence in patient care. This mixed-method, descriptive pilot study collected data about senior prelicensure nursing students using smartphones, a type of mobile electronic device (MED), in the clinical area. The smartphones contained nursing diagnosis, pharmacology, and laboratory information; an encyclopedia; and the MEDLINE database. Student (n = 7) data about smartphone use during a 10-week clinical rotation were collected via student-recorded usage logs and focus group recordings. Staff nurses' (n = 5) perceptions of students' use of smart-phones for clinical educational resources were collected by anonymous survey. Both the focus group transcript and staff surveys were evaluated and the themes summarized by content analysis. Positive results and barriers to use, such as cost and technological comfort levels, are discussed. The results may help nurse educators and administrators initiate further research of MEDs as a clinical resource.
Article
Abstract The purpose of this study is to explore the relationship between motives of smartphone use, social relation, and psychological well-being. The correlation analysis shows that the motives of smartphone use were positively related to bonding relations but negatively related to bridging relations. The hierarchical multiple regression analysis finds the associations among motives of smartphone use, social relations, perceived social support, and variables of psychological well-being. The results demonstrate that needs for caring for others were negatively related to loneliness and depression and positively related to self-esteem. However, the communication motives are not a significant predictor to determine self-esteem, loneliness, and depression. In addition, bonding and bridging social relations and social support significantly increase self-esteem and decrease loneliness and depression.
Article
It is commonly believed that for workers to browse the Internet for personal reasons during work hours is non‐productive. Contesting this belief, this study documents positive effects of workplace Internet leisure browsing (WILB) on employee productivity. It is argued that WILB is an unobtrusive interruption which enables restoration of mental capacity and fosters feelings of autonomy.
Article
This qualitative study was conducted to define and describe what constitutes and contributes to near miss occurrences in the health-care system and what is needed to ensure safer processes of care. Nine health-care organizations (13 sites total) including six academic health sciences centres (acute care, mental health and geriatric) and three community hospitals participated in this study. The final sample consisted of 37 focus groups (86 in the nursing staff only; 62 in the pharmacy staff only; and 99 in the mixed nursing and pharmacy focus groups respectively) and 120 interviews involving 144 health-care consumers. Data were collected using focus groups (health-care professionals) and key informant interviews (health-care consumers). A multi-level content analyses schema (transcription, coding, categorizing, internal consistency, thematic analysis and community validation) was used. Six themes emerged from the multi-level content analyses that combined focus group (health-care professionals) and key informant interview (health-care consumers) data. These themes are discussed under the three original research questions with supporting data derived from codes and categories. Study findings implicate changes for the health-care landscape relative to system, health policy, professional development and quality improvement.
Article
Using social media Web sites is among the most common activity of today's children and adolescents. Any Web site that allows social interaction is considered a social media site, including social networking sites such as Facebook, MySpace, and Twitter; gaming sites and virtual worlds such as Club Penguin, Second Life, and the Sims; video sites such as YouTube; and blogs. Such sites offer today's youth a portal for entertainment and communication and have grown exponentially in recent years. For this reason, it is important that parents become aware of the nature of social media sites, given that not all of them are healthy environments for children and adolescents. Pediatricians are in a unique position to help families understand these sites and to encourage healthy use and urge parents to monitor for potential problems with cyberbullying, "Facebook depression," sexting, and exposure to inappropriate content.
Article
Objectives: The purpose of this study was to clarify the contamination of mobile phones shared in hospital wards and its relationship with the consciousness and behavior of nurses about biological cleanliness. Methods: Samples from mobile phones were cultured to detect viable bacteria (n=110) and Staphylococcus aureus (n=54). A questionnaire survey was conducted on 110 nurses carrying mobile phones on the day of sampling. Results: Viable bacteria were detected on 79.1% of the mobile phones, whereas S. aureus was detected on 68.6%. All the nurses were aware of hand washing with water or alcohol after regular work, but 33.6% of the nurses were not conscious of hand washing with water or alcohol after using a mobile phone. There was a significant positive relationship between the frequency of using mobile phones and the number of hand washings with water or alcohol. A significant negative relationship was found between the detection of viable bacteria and the number of hand washings with alcohol. The results of logistic regression analysis showed that the detection of viable bacteria was related significantly with the number of hand washings with alcohol (Odds ratio, 0.350; 95%CI, 0.143-0.857) and that the detection of S. aureus was related significantly with the frequency of using mobile phones (Odds ratio, 0.183; 95%CI, 0.036-0.933). Conclusions: It is important to be conscious of the fact that mobile phones shared in hospital wards are easily contaminated. Because hand washing with water or alcohol prevents the contamination of the mobile phones, nurses should take standard precautions after using mobile phones.
Article
Use of communication devices in the hospital environment remains controversial. Electromagnetic interference (EMI) can affect different medical devices. Potential sources for EMI on ECG machines were systematically tested. Communication devices produce EMI on ECG machines. EMI impairs ECG interpretation. The communication devices tested were: a global system for mobile communication (GSM) receiver, a code division multiple access (CDMA) receiver, an analog phone, a wireless local area network, and an alpha-numeric pager. EMI was tested on 3 ECG machines: MAC 5000, MAC 1200, and ELI 100. The devices were tested at 2 and 1 meter, 50, 25, and 0 cm from the acquisition module. The ECGs were presented to a heterogeneous group of clinical providers, (medical students, residents, nurses, industry representatives from cardiac devices companies, and attending cardiologists) to evaluate the impact of EMI on ECG interpretation skills. EMI was detected on the MAC 5000 ECG machine when activated GSM, CDMA, and analog phones were placed on top of the acquisition module. No EMI was seen on the other ECG machines or when phones were at a longer distance or deactivated. EMI was incorrectly diagnosed in 18% of the cases. EMI was confused most frequently with atrial fibrillation or flutter (52%), ventricular arrhythmias (22%), and pacemaker dysfunction (26%). Medical students (p < 0.003) and non-cardiology residents (p = 0.05) demonstrated significantly worse performance on EMI interpretation. Digital and analog phones produce EMI on modern ECG machines when activated in direct contact to the acquisition module. EMI impairs ECG interpretation.
Article
Most hospital policies prohibiting the use of wireless devices cite reports of disruption of medical equipment by cellular telephones. There have been no studies to determine whether mobile telephones may have a beneficial impact on safety. At the 2003 meeting of the American Society of Anesthesiologists 7878 surveys were distributed to attendees. The five-question survey polled anesthesiologists regarding modes of communication used in the operating room/intensive care unit and experience with communications delays and medical errors. Survey reliability was verified using test-retest analysis and proportion agreement in a convenience sample of 17 anesthesiologists. Four-thousand-eighteen responses were received. The test-retest reliability of the survey instrument was excellent (Kappa = 0.75; 95% confidence interval, 0.56-0.94). Sixty-five percent of surveyed anesthesiologists reported using pagers as their primary mode of communications, whereas only 17% used cellular telephones. Forty-five percent of respondents who use pagers reported delays in communications compared with 31% of cellular telephone users. Cellular telephone use by anesthesiologists is associated with a reduction in the risk of medical error or injury resulting from communication delay (relative risk = 0.78; 95% confidence interval, 0.6234-0.9649). The small risks of electromagnetic interference between mobile telephones and medical devices should be weighed against the potential benefits of improved communication.
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