Using mobile technology to record patient observations: impact on care management and clinical practice.

PhD researcher: Shannon Costello

End of project summary

In Wales, new technology (CareFlow Vitals) available on iPads was implemented into the hospitals of one health board to be used to record patient vital signs at the bedside. This study aimed to uncover the acceptability and usefulness of these devices according to the healthcare professionals using them on the hospital wards. Through observations, interviews, and survey methods, a range of healthcare professionals (doctors, nurses, allied health professionals and healthcare support workers), explained how they used the devices, the reason(s) for using them, and gave their views on the benefits and disadvantages of using the devices in clinical practice.

Main messages

• Overall and on the basis of those participating in the study, the response towards CareFlow Vitals on iPads was mixed. Some professional groups participating in the study (nurses, health care support workers, critical care outreach practitioners) preferred using the mobile devices and software in practice whereas other groups (such as physiotherapists) preferred the use of pen and paper. The data suggested that the experience of healthcare professionals had a significant effect on whether the participants preferred the use of CareFlow Vitals compared to pen and paper records. In particular, those who were midway into their career preferred the use of CareFlow Vitals in their clinical practice.
   
• At the time of the study, logins for the CareFlow Vitals software were not available for all members of staff, notably agency staff. This created issues of password sharing as those inputting data from observations (typically healthcare support workers and nurses) needed to log into the devices.
   
• Perceived benefits included improved patient safety, potentially identifying deterioration sooner leading to faster treatment decisions, and saving clinicians’ time which enabled them to perform other clinical tasks. There were, however, concerns that patients had reduced contact time with doctors as the vital signs data could be accessed remotely.
   
• At the time of the study, the full potential of using CareFlow Vitals had yet to be realised. The Welsh Nursing Care Record (an electronic patient record system) complements CareFlow Vitals and to reduce the use of paper, both need to be implemented.