Handheld Computer Devices to Support Clinical Decision-making in Acute Nursing Practice: Systematic Scoping Review. 2023

David Glanville, and Anastasia Hutchinson, and Damien Khaw
eLearning Department, Academic & Medical Division, Epworth HealthCare, Richmond, Australia.

Nursing care is increasingly supported by computerized information systems and decision support aids. Since the advent of handheld computer devices (HCDs), there has been limited exploration of their use in nursing practice. The study aimed to understand the professional and clinical impacts of the use of mobile health apps in nursing to assist clinical decision-making in acute care settings. The study also aimed to explore the scope of published research and identify key nomenclature with respect to research in this emerging field within nursing practice. This scoping review involved a tripartite search of electronic databases (CINAHL, Embase, MEDLINE, and Google Scholar) using preliminary, broad, and comprehensive search terms. The included studies were hand searched for additional citations. Two researchers independently screened the studies for inclusion and appraised quality using structured critical appraisal tools. Of the 2309 unique studies screened, 28 (1.21%) were included in the final analyses: randomized controlled trials (n=3, 11%) and quasi-experimental (n=9, 32%), observational (n=10, 36%), mixed methods (n=2, 7%), qualitative descriptive (n=2, 7%), and diagnostic accuracy (n=2, 7%) studies. Studies investigated the impact of HCDs on nursing decisions (n=12, 43%); the effectiveness, safety, and quality of care (n=9, 32%); and HCD usability, uptake, and acceptance (n=14, 50%) and were judged to contain moderate-to-high risk of bias. The terminology used to describe HCDs was heterogenous across studies, comprising 24 unique descriptors and 17 individual concepts that reflected 3 discrete technology platforms ("PDA technology," "Smartphone/tablet technology," and "Health care-specific technology"). Study findings varied, as did the range of decision-making modalities targeted by HCD interventions. Interventions varied according to the level of clinician versus algorithmic judgment: unstructured clinical judgment, structured clinical judgment, and computerized algorithmic judgment. The extant literature is varied but suggests that HCDs can be used effectively to support aspects of acute nursing care. However, there is a dearth of high-level evidence regarding this phenomenon and studies exploring the degree to which HCD implementation may affect acute nursing care delivery workflow. Additional targeted research using rigorous experimental designs is needed in this emerging field to determine the true potential of HCDs in optimizing acute nursing care.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000066491 Clinical Decision-Making Process of formulating a diagnosis based on medical history and physical or mental examinations, and/or choosing an appropriate intervention. Medical Decision-Making,Clinical Decision Making,Decision-Making, Clinical,Decision-Making, Medical,Medical Decision Making
D034201 Computers, Handheld A type of MICROCOMPUTER, sometimes called a personal digital assistant, that is very small and portable and fitting in a hand. They are convenient to use in clinical and other field situations for quick data management. They usually require docking with MICROCOMPUTERS for updates. Mobile Devices,Personal Digital Assistant,Computers, Palm-Top,Computers, Palmtop,PDA Computer,Palm Pilot,Pocket PC,Tablet Computers,Computer, Handheld,Computer, PDA,Computer, Palm-Top,Computer, Palmtop,Computer, Tablet,Computers, PDA,Computers, Palm Top,Computers, Tablet,Device, Mobile,Devices, Mobile,Digital Assistant, Personal,Handheld Computer,Handheld Computers,Mobile Device,PC, Pocket,PCs, Pocket,PDA Computers,Palm Pilots,Palm-Top Computer,Palm-Top Computers,Palmtop Computer,Palmtop Computers,Pilot, Palm,Pilots, Palm,Pocket PCs,Tablet Computer
D063731 Mobile Applications Computer programs or software installed on mobile electronic devices which support a wide range of functions and uses which include television, telephone, video, music, word processing, and Internet service. Mobile Apps,Smartphone Apps,Portable Electronic Applications,Portable Electronic Apps,Portable Software Applications,Portable Software Apps,App, Mobile,App, Portable Electronic,App, Portable Software,App, Smartphone,Application, Mobile,Application, Portable Electronic,Application, Portable Software,Applications, Mobile,Apps, Mobile,Apps, Smartphone,Electronic App, Portable,Electronic Application, Portable,Mobile App,Mobile Application,Portable Electronic App,Portable Electronic Application,Portable Software App,Portable Software Application,Smartphone App,Software App, Portable,Software Application, Portable

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