Jeneane is a self confessed maverick, but perhaps it takes a maverick to change the world for the better. Jeneane, in her role as CEO, was looking for ways to help counter nursing burnout at the VNAHHS and help restore the caring in nursing. Faced with an escalating mountain of paperwork, visiting nurses at the VNAHHS were spending up to 50% of their time filling out reports and completing administrative tasks. Paperwork is a necessary duty, but it can and does contribute to burn out and lower levels of job satisfaction.

"I am a nurse and have personal experience trying to figure out how to accommodate family and social life with the demands of a nursing career. As regulations increase and paperwork to document compliance along with them, nursing has become an impossible job! Its no wonder 1 of 5 nurses plans to leave the profession within the next 12 months, and 1 of 3 of these same nurses is under 30. I want to change that statistic. I want to be able to allow nurses to get the chance to nurse, for all the reasons they became nurses in the first place. And, I doubt any nurse went to school to do paperwork for a living" said Jeneane.

Jeneane knew that there had to be a solution to the problem, and began investigating alternatives to the 'tried and true' pen and paper based methods of documentation. "My son, John is a physician's assistant who is an avid fan of the Palm OS. I discussed the VNA's challenges with him and he suggested a handheld solution would solve some of our nursing documentation and job satisfaction problems."

Jeneane quickly became intrigued with the potential of handheld computing, it seemed the devices were ideally suited to the needs of homecare. The more she looked the more she became convinced that mobile computing was the answer, however like many pathfinders before her, she discovered that she was charting undiscovered territory. The tools she needed to help her lighten nurses' burdens did not yet exist. Undeterred Jeneane set out to create a custom Palm OS software solution for homecare.

Jeneane has had a long standing interest in information technology, however she is not a software engineer. She needed to find some tools to help her simplify the design process. "I first experimented with Satellite Forms as a development platform for our applications. I found the software a little unstable and the tech support nearly absent. When I could reach the support people at Puma, they charged $35 per question. So, I had to look around some more. I then turned to Pendragon Forms and have been extremely satisfied ever since."

"We used the program's PC based version to create the initial forms but have recently installed the Internet version. This has solved some important issues for us. We needed multiuser access within the office for data query and analysis. Also, we need multiuser synchronization from the field, by that I mean multiuser synchronization that can be simultaneous if need be. The PC
version allows only one transmission at a time. We have too much traffic for that now.

We continue to work with Pendragon forms. The software is very stable, and through scripting you can customize it a great deal. The net version has many desirable features. And we have not had a single synchronization failure from the field.

All data resides on our own servers and is accessed through secured SSL. Our clinicians have password access, and access features are determined by VNAHHS. Our nurses can go to the website and view whatever their passwords allow them access to. Currently we are allowing for access to all forms for their discipline and their own historical data. Clinicians cannot modify a saved file, to protect the integrity of their original chart. However, they can input data either from the field via the handheld on via their PC on this website." Says Jeneane.

This ability to input data from the field or from their personal PCs at home has dramatically reduced the "windshield time" for the VNA nurses. VNA nurses are reporting a 50% reduction in time spent doing paperwork and a 5 fold decrease in reporting "turnaround" time.

"The VNA developed its first automated forms application for our high risk infant homecare program. The almost immediate acceptance and success of this effort led to more and more development. It has been very exciting ever since! Use of the PDA has proven to offer so much more than I had anticipated. We are using the device to improve not only documentation speed, accuracy, and clinician satisfaction, but also to provide point of service decision support. I am awed at the possibilities. Each week we find new ways to use the devices/software to improve patient care.

Now that our FreeForms project is well underway, I see the potential of using the software to advance the practice of nursing."

"My vision is that through use of affordable, intuitive hardware and software solutions- we can drive change in how we depict nursing interventions and reflect nursing knowledge through our documentation. Advancement will take time and means more than just the automation of traditional data collection instruments such as assessment forms. I hope to adopt and refine the nursing data dictionary, language, and coding mechanism as VNAHHS forms development evolves. I believe this is necessary to distinguish nursing from medicine, and necessary to assure proper compensation for nursing intervention and knowledge."

"Without a means of properly documenting what we do, in all its dimensions, we will not ever improve the appreciation (and reimbursement) of what nurses actually do. The nursing shortage is a wake up call!"

"Its hard to find the time to do all the things that seem possible. But, I am having a great time and appreciate all the chances I have been given recently to spread the word about the potential of handhelds in nursing." - Jeneane A. Brian

There are over 250 nurses/therapists working with the VNA, and by August 2001, more than 70 of them will be documenting their patient care on Palm OS enabled handheld devices using software applications developed by Jeneane and her team.

PDA cortex is pleased to honor Ms. Brian for her outstanding contribution to the advancement of nursing practice and mobile nursing informatics with the Mobile RN Award. Congratulations Jeneane, and thank you for all that you've done.