of key features is known as the form factor. Some smartphones have a physical keyboard that slides out, while others have a touch screen and no keyboard at all. Tablets share these considerations as well as an additional


consideration of size. Most of the largest tablets will not fit in a scrub pocket while some of the smaller ones are only 5 to 7 inches long and are almost as portable as a smartphone. Phablets fall into the smaller size group and also act as a cell phone.1


The


benefit of increased size is the improved viewing area, making text and images larger and sharper than on smaller devices. There are a variety of factors to consider with a smartphone or tablet, so remember to test a device in person before buying.8,9,15 Features: The display on most devices is full color and backlit;


where displays differ is in the resolution. The higher the reso- lution, the clearer the images will be. Some mobile devices can display in high definition, making them ideal for watching videos or looking at pictures. Some applications will not work with lower-resolution screens.8,9 Wireless devices come with rechargeable batteries and often


have a variety of charging options — wall chargers, car chargers and USB cables that can charge the PDA directly from a computer USB port. The length of use between recharges varies based on the type and speed of the unit’s processor and the type of appli- cation in use. Graphics-intensive applications, such as games or movies, tend to deplete the battery faster than text applications. Some devices may need to be recharged daily, or even throughout the day, for optimum use.8,9 Among other hardware considerations is availability of built-


in or attachable features, such as a keyboard, digital camera, voice recorder, media player, wireless communication device, USB port or global positioning system navigation unit. While some of these features were add-ons in the past, more and more devices offer them as built-in features. For example, clinicians may find keyboards useful for narrative charting; many different types and sizes of keyboards and keypads are available, some directly connectable to a device, but more often connectable via Bluetooth. Most devices now include a digital camera, which can prove useful for documenting injuries or wound healing. Of course, organizational policies, privacy rights and commonsense guidelines must always be adhered to when considering the use of pictures or videos of patients.16 Cost: The initial cost of a mobile device ranges from less


than a hundred dollars to over a thousand, depending on the features. When purchasing a smartphone or phablet with a new or renewal contract, this cost can often be greatly reduced or even eliminated. Be certain to review the monthly cost of any smartphone service, including overage charges per minute or per MB downloaded.


Mobile devices at the point of care Some healthcare systems are beginning to provide mobile devices to their staff or implementing BYOD programs to enhance the care of their patients. The use of specialized software appli- cations, often downloaded from the Internet, transforms the mobile device into a powerful clinical resource. With a touch of the stylus or swipe of a finger, clinicians can look up medi- cations, check drug compatibilities and perform complex drug dosing calculations. References on these devices can be used to evaluate lab results or review specific disease-related treatments and interventions.17,18


Many up-to-date medical and nursing


references and healthcare journal articles, are available for mobile devices, as discussed below. BYOD programs, which allow staff to use their own devices for


documentation in facility-provided EHRs, are spreading because of the federally mandated use of EHRs. This drive stems from the American Recovery & Reinvestment Act of 2009, which has resulted in the Centers for Medicare and Medicaid Services incentive program termed Meaningful Use. The purpose of the act is to improve patient outcomes by using technology in a meaningful way to improve the quality and safety of patient care. The program began by providing payment incentives for early adopters. Medicare-participating providers that didn’t adopt an EHR by 2015 face fines. Additional details are available at http://www.healthit.gov. In some cases, facility-specific clinical pathways and policy


and procedure manuals may be added to a mobile device. There are also applications that include electronic medical records that allow patient information and documentation to be transferred to and from the device. These are vendor specific and depend on your facility’s contract with that vendor. Based on content and use, specific medical software


fits into several categories. There are drug references, general nursing or medical references, specialty references, procedure guides and references, lab and diagnostic references, patient information or tracking applications, medical dictionaries, every sort of calculator, educational programs and other databases. Specialized reader applications allow the clini- cian to peruse articles, notes and journals downloaded from a variety of Internet sources. In addition, some programs allow the user to set up customized notes and databases and organize information. A survey of mobile health users indicates almost three-quarters of nurses use mobile devices to provide patient care.18


In nursing,


the number of students using mobile applications is growing. Some nursing schools now require students to use mobile devices equipped with software that allows them to access the most up- to-date medication information, including dosing information, drug interactions and lab tests.19 Medical applications for mobile devices come in all shapes


and sizes. Some apps are available for free due to either the generosity of the developer or advertising displayed during the use of the app. Most apps don’t cost much, often $15 or less. Some apps require a subscription fee to access some or all features. Subscription software applications usually charge an annual or semiannual fee for their service and offer regular updates for the apps.


2016 • Visit us at NURSE.com 41


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