Promoting technology-enhanced learning for all: assessing staff competency and efficiency using mobile phones in clinical practice through simulation-based in-situ evaluation

Aims

Technology-enhanced learning, specifically the use of mobile devices by healthcare professionals, has transformed many aspects of clinical practice.¹

Some healthcare organisations are reluctant to advocate the staff use of mobile phones due to the risks associated with interference of medical equipment, infection control concerns and reported parental complaints.

In many healthcare trusts in the UK and Ireland, there is an overt discrepancy, as often medical staff are permitted access to their mobile phones in clinical practice, yet nursing staff and other healthcare professionals, are frequently restricted due to direction from senior management. Other projects to introduce specific medical smartphone applications, although shown to be an effective resource, have highlighted staff discomfort at using a ‘personal device’ in the workplace, uncertainty of the etiquette of mobile phone use and informal mobile phone policies in use on wards.²

Mobile devices provide a multitude of benefits for clinical staff including increased access to useful apps such as drug-dose calculators, and other validated point-of-care tools, which are of high educational value and have been shown to support better clinical decision making and improved patient outcomes.³ We suggest that granting all staff members equal access to digital technology endorses parity within the workplace and promotes more efficient digitally assisted clinical care.

Methods

We designed a survey assessing parental and staff perception on the use of mobile phones, using a five point Likert scale. Forty staff and forty  carers participated in the questionnaire.

Following this, we designed two clinical scenario’s assessing administrator and prescriber performance for healthcare professionals using low-fidelity simulation. We assessed length of time to complete task and degree of accuracy. Scenario 1 participants were prohibited from using mobile phones. Subsequently, participants were granted access to mobile phones for assistance in Scenario 2.

We collated prescribing and administration data in a ‘snap-shot’ audit, during a 12 hours shift on two paediatric wards.

Results

Thirty-eight out of 40 (95%) parents surveyed felt that healthcare professionals should be allowed to use mobile technology in a clinical environment. Similarly, of the 40 staff members surveyed, 39/40 (97%) felt access to mobile phones for clinical reasons was appropriate.

After highlighting the reasons staff were using mobile phones for example, for medical applications, 80% of parents changed to a positive perception of mobile phone use. Thirty-seven per cent of staff felt carers disliked use of mobile phones on the ward again highlighting the perceived negative view that staff members feel parents have.

We designed two in-situ simulated prescribing and drug administration scenarios and recruited medical, nursing and AHP staff members to take part in the evaluation (figure 1). For the drug administration scenario (performed by 10 nursing staff), all participants were quicker using a mobile phone for assistance. The average length of time was 1 min 22 s quicker. Task accuracy was maintained at 100% with and without mobile phone use.

Figure 1.

Staff took part in a simulated assessment of drug prescription using digital assistance on a smartphone.

For the prescriber scenario (performed by nine medics and one non-medical prescriber), again all participants were quicker using a mobile phone aide, with an average length of 1 min 26 s quicker. Accuracy of 100% was maintained in both cohorts.

Using the snap-shot 12 hours period of data collection, we estimated the number of perceived man-hours saved. The number of medications checked and administered by nursing staff was 110, giving a perceived time saving of 150 min. The number of medications prescribed was 29, giving a perceived time saving of 41 min. In total, this equated to 3 hours and 10 min saved in a 12 hours shift.

Conclusion

Despite previous anecdotal reports of parental concerns, this survey highlights the strong carer support for healthcare professionals appropriately using mobile phones in clinical areas within this Hospital. Staff members were similarly keen for the use of mobile technology to aid their practice. The survey also demonstrated how parental opinion can be influenced by appropriate information on use of mobile phones by healthcare workers and as such resources like parental leaflets or posters could help to waylay any remaining parental concerns.

Through the use of in-situ simulated clinical prescribing and administration scenarios, we have demonstrated an improvement in efficiency of performing clinical tasks with the assistance of mobile phones, ensuring accuracy was maintained.

The use of simulation technology can be used effectively as a Quality-Improvement aide as demonstrated here. We plan to negotiate with senior hospital management team, using this initiative as evidence, in a bid to demonstrate that the appropriate use of mobile phones in a clinical setting promotes well-informed, safety-conscious, technology-assisted clinical care.