Columbia SoN Selects Palm For Patient-care Initiative

Feb. 20, 2002 Palm, announced that the Columbia University School of Nursing (CUSN) has selected Palm handheld computers for an initiative designed to promote evidence-based, error-free patient care in nursing.

The initiative -- launched in response to the 2000 Institute of Medicine report on medical errors, which estimates that as many as 98,000 people die every year from medical errors that occur in-hospital as a result of bad systems -- builds on CUSN's leadership in Advanced Practice Nursing (APN) and expertise in informatics. Informatics is the use of information technology by nurses in caring for patients and in making patient-care decisions.

Information technology also is useful in the administration of healthcare facilities and the teaching of students to practice nursing. Beginning with its current Entry-To-Practice (ETP) students, CUSN provided students with Palm m500 handhelds to enable them to retrieve such things as medication information right at the point of care. ETP is a combined B.S./M.S. degree program for those with degrees in disciplines other than nursing who wish to become APNs. Columbia plans to integrate Informatics competencies throughout the curriculum, with the goal being to produce students competent in state-of-the-art informatics by the end of their studies. Competencies are leveled for the novice learner, the advanced beginner and for competent and proficient practitioners, starting with the basic nursing phase and progressing through master's and doctoral study.

Students Document Patient Care Using Nursing "Language" Students are expected to document all of their patient encounters so that they can begin building evidence from practice. To ensure the validity of the research, CUSN students monitor only those data elements that respond to nursing care. The program uses specific nursing taxonomy to categorize data, requiring students to document their activities using the nursing "language" they will use once they graduate.

"We're using the Palm m500 handheld for several reasons, including the Palm Universal Connector, which allows us to use the same cradle for synching
with desktop PCs, even if we move to future Palm handheld models," said Vice Dean and Dorothy M. Rogers Professor of Clinical Nursing Sarah Cook, who directs the project. "Another real plus was the handheld's expansion capability. Palm Expansion Cards enable our students to carry enormous amounts
of data easily.

"We're using databases provided by ePocrates, and students can access them right at the bedside to check treatment protocols or medication dosages, side
effects, and so on. There is also a new software program, developed at CUSN, that allows students to enter specific data about their patients (whose anonymity is protected) that identifies nursing diagnosis, and interventions and outcomes that can be measured."

The CUSN project benefits faculty and students alike. It allows faculty to track students' clinical experiences more closely than before. The detailed information they derive from student experience allows them to individualize future programs and to strive for error-free, evidence-based care and
structured nursing languages. In addition, the systematic gathering of data allows CUSN to develop a reliable database, which could be used for coding and
billing for APN services. At the same time, Palm handhelds make it easier for students to collect specific data about their experiences, a requirement for
professional credentialing.

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