3. Hospital management should create a culture,
including a nurse vision statement, emphasizing the
benefits and value of nurses’ involvement in technology.
ment printing, copying, and electronic signatures
that maintain patient confidentiality) to support
ease of use.
Nurses and hospitals benefit from understanding
the value they will both receive from large-scale IS
implementations. Otherwise, nurses tend to focus on
their strength: patient care. According to a manager
working with a large health-care system in the northeastern U.S.: “Hospital management and IS departments must
make initiatives important for
nurses, as well as doctors. You have
to make this [technology imple-mentation] salient to the nurses by
promoting its effectiveness in
decreasing administrative workload and explain how what they
[the nurses] do or don’t do impacts transport
the whole care-delivery process. within hospital
But you [as part of management]
have to show how you are going to
support them in supporting the
organization... You just can’t dump
the technology there and expect
them to use it, especially if you are
replacing this chart they use to
carry around with a computer on a stick... They think
you are giving them more to do in attempts to make
the physicians’ jobs easier.” Thus, nurses should be
involved in physical device selection, development of
interface tools, and refinement of usage processes.
As long as nurses and registration personnel must
make trips back and forth to a desk or station to generate and retrieve paperwork or ID tags, they will have
a significant disincentive to use technologies supporting UA. Patient registration typically requires validating identification and insurance information, copying
- Food administration personnel (FAP)
make rounds to gather patient meal
requests or patients write meal
requests, reconcile physician-ordered
meal restrictions, prepare requests
based on food availability.
- Patient may or may not receive a
request, no real-time access to item
availability, and lengthy manual process
- FAP use UA devices on rounds and are able to
let patients know immediately, via real-time data
access, whether their requests are available and
meet physicians’ orders.
- Patients receive meals they ordered or an
explanation about why they can’t and faster meal
service, increasing delivery quality and
decreasing potential food spoilage by complying
with supply to demand, thereby reducing costs.
- Transport personnel use walkie-talkies - Transport personnel, access patient data, and send
to communicate with nursing stations requests, and related information via wireless
and a transport base about patient devices.
movement for records or transport - Patients are moved quicker, and wait times are
instructions; requests for patient reduced, thereby improving quality of care.
whereabouts are maintained manually.
- Long transport wait times due to
inefficient routing of transport
personnel and equipment.
Table 2. Tasks
amenable to UA.
documents or cards, printing wristband labels, and
securing signatures on documents. This time-consuming process can be expedited, while significantly reducing nurses’ frustrations, when supporting devices are
combined on a single mobile cart.
4. Hospital IS departments should support development or adaptation of wearable devices and multi-function mobile carts by manufacturers to support
6. Hospital management should extend UA to other
tasks that involve location, time, and identity or are
highly information-intensive and interdependent.
Table 2 provides examples of prospective processes
amenable to UA.
“Wearables,” such as handheld scanners and tablets
that can be clipped onto waist belts, free nurses’ hands
to hold a scanner, deliver medications, or aid a patient
in numerous ways. More streamlined designs for the
mobile carts might make the carts more maneuverable, more able to fit between beds, and—with additional shelves or desktop space—more conducive to
multiple uses. These innovations already are in place
in other industries. For example, aircraft mechanics
use similar configurations to fulfill their need for
mobility and access to critical information at the point
5. Documentation devices should be integrated to
mimic the workflow (scanning, label and docu-
7. Hospital management should incorporate software
and hardware necessary to support automated
patient and medication identification on the
mobile workstations to ensure nurses are charting
on the correct patient.
Manual charts typically are kept at patients’ bedsides or in boxes outside of their rooms, rather than
carried by nurses as they make rounds. Conversely, UA
technology is mobile, and a nurse has constant access
to patients’ records despite location. Safeguards must
be in place to ensure that nurses are charting on the
right person, not to mention sterilizing the necessary
hardware per intervention to prevent spreading infections as the nurse moves from one patient’s location to
the next or when the carts are passed to other nurses in