Abstract
Purpose
Handheld computer technology provides a unique opportunity for health care professionals to access real time or near real time patient information and evidence-based resources at the point-of-care. The purpose of this study was to assess one physician’s experience using acute pain assessment software on a personal digital assistant (PDA) to assess patients on an acute pain management service (APMS).
Methods
Using a historical control and a “time and motion” study design, comparisons were made on acute pain assessment time and comprehensiveness when patient assessments are documented on a PDA vs the current paper-based method.
Results
The study physician (a PDA-user) reported feeling comfortable with the assessment software after five patient assessments. PDA assessments were more likely to contain documentation regarding pain and side effects (e.g., nausea, pruritus, hypotension) than the paper assessments. The median time of the “assessment only” component of the patient encounter was 53 sec longer using the PDA compared to paper (P < 0.00), however, the median “total encounter” (chart review, assessment, documentation) time was 74 sec shorter using the PDA vs paper (P < 0.00).
Discussion
The findings of this preliminary study suggest that the PDA is a reliable tool that meets the data management requirements within an APMS setting. This study found that patient assessments documented using acute pain software developed for use on a PDA were as efficient and content-rich as paper assessments. The PDA may even enhance the efficiency of the patient assessment process through the provision of more comprehensive digital data for research, clinical, and administrative needs.
Résumé
Objectif
Lordinateur nomade offre une chance unique aux professionnels de la santé d’accéder en temps réel ou presque à des renseignements sur le patient et à des ressources cliniques sur place. Notre objectif était d’estimer l’expérience d’un médecin qui utilise le logiciel d’évaluation de la douleur aiguë sur un assistant numérique personnel (ANP) pour examiner les patients d’un service de traitement de la douleur aiguë (STDA).
Méthode
Dans notre étude de type contrôle historique et tempsmouvement, nous avons comparé le temps et la représentativité de l’évaluation de la douleur aiguë pour des études de patients documentées sur ANP vs la méthode courante sur papier.
Résultats
Le médecin (un utilisateur d’ANP) s’est dit à l’aise avec le logiciel après cinq évaluations. Les examens avec l’ANP ont plus de chance de contenir de la documentation sur la douleur et les effets secondaires (comme les nausées, le prurit, l’hypotension) que celles sur papier. Le temps moyen de la partie ‘évaluation seule’ de la rencontre avec le patient a été plus longue de 53 sec avec l’ANP, comparé au papier (P < 0,00), mais le temps moyen de ‘l’entrevue complète’ (revue du dossier, évaluation, documentation) a été plus court de 74 sec avec l’ANP vs le papier (P < 0,00).
Discussion
Les résultats de cette étude préliminaire indiquent que l’ANP est un outil fiable qui répond aux exigences de gestion des données dans le cadre d’un STDA. Les évaluations de patients documentées à l’aide du logiciel sur la douleur aiguë, mis au point pour un usage sur ANP, ont été aussi efficaces et riches de contenu que les évaluations sur papier. L’ANP peut même améliorer le procédé d’évaluation du patient en fournissant plus de données numériques détaillées pour la recherche, les besoins cliniques et administratifs.
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Financial support: This paper is part of the research supported by grants from the Canadian Foundation for Innovation, the Ontario Innovation Trust, Queen’s University and Kingston General Hospital. Financial and/or in kind support has also been provided by the Claire Nelson Bequest Fund, Bickell Foundation, Health Evidence Application and Linkage Network, Purdue-Pharma, Cisco, Compaq and Smith Industries.
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VanDenKerkhof, E.G., Goldstein, D.H., Lane, J. et al. Using a personal digital assistant enhances gathering of patient data on an acute pain management service: a pilot study. Can J Anesth 50, 368–375 (2003). https://doi.org/10.1007/BF03021034
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DOI: https://doi.org/10.1007/BF03021034