A. Brian, BSN, MBA, CEO, VNAHHS, recipient of the Mobile RN
A Brian, "walking the talk"
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."
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.