Resources at the Point of Care: NP Students and PDAs

1. Resources at the Point of Care: NP Students and PDAs Deborah Booton-Hiser, PhD, ARNP University of Oklahoma College of Nursing Professor & Director Nurse Practitioner Program

2. PDA Information Today • Based on “today” but constantly advancing • Facilitate you to embrace more technology to enhance your educational journey AND your clinical practice • Begin or continue your journey with the POSSIBILITIES of PDAs • Handout with ALL the links! Monday the links will be electronically available to you on-line.

3. Critical Issues • Must have readily accessible information as you learn • Knowing is important but having immediate access to information is MOST critical • Quality documentation is essential to capture costs • Medication errors are at epidemic proportions • Knowledge is increasing at an exponential rate > defies memory capabilities • There is less time and more care to provide

4. PDA Use is a Viable Solution • Accessing CURRENT knowledge at POC • POC Rx referencing (dosing, contraindications, drug interactions, etc) • Extensive references “in the palm of your hand” • Automated updates to critical information • Quicker “e” consultation for resources and documentation • PDA generated prescriptions (readability) upon graduation • POC documentation incorporated in practice management upon graduation

5. Which ONE describes YOU • No PDA • PDA, barely touched • PDA, Love the games, address book and calendar • PDA, with pharmacotherapeutic resource and a bit of downloads • PDA, downloads, texts, and free/share ware • PDA, utilizing an integrated system in practice

6. Brand Operating system Issues of medical software compatibility are less Memory Screen (resolution, color) Camera MP3 Player WiFi, Bluetooth, BlackBerry wireless Internet access capabilities Phone/PDA combo Decisions Decisions – The plight of PDA purchases!

8. No 2 are alike - -Yet All are functional - - iPAC h2215 Blackberry Toshiba Cassiopeia RIM Tungston CLIE Treo 300 TRG Pro Zire 71 i705 Jornada Handera Axim

9. Considerations - - • What brand, operating system is the best “fit” with your use and needs – • What software will be utilized (OS, memory) • The cost of the PDA is only about 50% of the total expense – Remember there are accessories, peripherals, software, & wireless application protocols

11. Essential PDA Qualities • Screen • COLOR • Resolution • Memory (for Palm OS) • Built in PLUS • Expansion (SD Cards, Memory Sticks) • Size (weight 4-6 oz, bulk) • Battery life • +/-Processor speed (200-400 MHz) • +/-Interface • +/- Wireless access

12. Talk to many other PDAers Go to the Internet – manufacturers and reviewers PLAY with various PDAs Identify your NEEDS, wants, and BUDGET Identify the +’s & -’s of each PDA Decide which one FEELS right for YOU Make your best decision and buy “it” – This isn’t life or death Whatever you purchase now, it will NOT be your last PDA Strategies for Making the BEST choice

14. Limitless Software for PDAs Calculators Textbooks Trackers Prescribers Electronic Records References Coders & Billers Guides Clinical Guidelines

15. Software Considerations • Edition, development date • Author/Designer expertise • Evidence based • Funded by - - • Update capabilities • Interface capabilities • Navigationally intuitive • Readability • Cost

16. Software Considerations • Freeware ($0)/Shareware ($) • Commercial/Proprietary • Textbooks/Guidelines/Resources • Individual versus bundled references • Subscription & Renewal • Updates

17. Griffith’s Five Minute Clinical Consult Merck Manual Tabors Redbook Washington Manual ETC - - - - BENEFITS Reference @ POC Less reliant on memory Validation/Litigation Facilitates currency Remember – just like textbooks, these become dated & must be repurchased for newer editions Textbooks Modified for PDAs

18. Inter-relational data bases, Suites and Libraries • IRDB • Pharmacotherapeutic resources • Medical management resources • Suites & Libraries (multiple resources/databases) • Lexi-Comp • Handango’s Suites • Pocket Clinician Library • CONSIDERATIONS • May offer “auto updates” • May require annual renewal fees • MORE • Comprehensive • Expensive (secondary to more resources) • MEMORY required

20. Evidenced Based/Best Practice Resources • Nationally recognized treatment guidelines • NHLBI (Asthma, COPD, BMI, Obesity, Cholesterol) • CDC, etc. • Resources that are based on EBP/BP (by design & auto updates)

22. Medical References • Expands your horizon of differential dxs • Integrates contemporary health risks (ie. SARS, bioterroism agents (signs/symptoms/treatment/disposition) • Provides contemporary management recommendations • Based on IRDB, facilitates prescribing based on formulary plans

24. Pharmacology Resources, #1 Use • Growing field to choose • Quality programs are not free • What is the source of the data • Pharmaceutical manufactures? • Method for updating • Auto updates • General/Comprehensive resources • System, disease, age specific resources

25. A Sampling of PDA Drug References (a sampling) • ePocrates • Rx Clinical Drug Database –free • Rx Pro > $ • Lexi-comp • Lexi-Drugs • Lexi-Interact • Pharmacopoeia • Fact and Comparisons

26. Infectious Disease Antibiotic Resources (sampling) • Johns Hopkins Division of Infectious Diseases Antibiotic Guide (free) • Lexi-Infectious Diseases • Sanford Guide to Antimicrobial

29. Other Specialty Resources & RX Generating Programs (sampling) • Alternative Meds • Lexi-Natural Products • Lexi-Poisoning & Toxicology • MANY more specialty references (yes peds too!)

30. Medical Calculators • Minimal memory • Freeware/shareware • From accurate and useful to inaccurate and worthless • Beamable

35. Online PDA Resources • General resources provide a variety of benefits • PDA news/press releases (i.e. the recent purchase of Handspring by Palm) • Notification of new hardware/software • Wide array of products (purchase/free) • General and specialty resources • Reviews

38. Quickly Changing World: How to Keep Informed • Reviews • Manufacturers • New products • Patches, Repairs and Updates • Users • “Experts” • Cnet • PC resources • PDA websites

40. Foundation software • Documents to Go • HanDBAse

41. Readers • Isilo • TealInfo • Tealdoc

42. Making it all WORK • Download program from Internet to PC • File in PDA “space” • Unzipping • Synching

43. Market is Expanding • Increasing sophistication of the technology • Increasing software applications • Extending beyond the HCP and Health care settings • Extending into the homes and hands of our patients

44. NPs: • Seizing the opportunity to improve their clinical practice • Seizing the opportunity to improve the health of society • Embracing the opportunity to integrate technology • Beaming, WiFi’ing, tracking, scripting, calculating and coding with PDAs!