Welcome to Computers - Information on Laptop computers

A nurse wants to review her notes on how to run the cell-saver machine. With two taps of a stylus, she easily accesses the notes using the built-in memo program on her handheld computer, reviews the steps, and is confident she can set up and run the cell-saver correctly. Later that day, a coworker and classmate asks to borrow her pathophysiology textbook. The nurse makes a note in the to-do list program in her handheld computer as a reminder to loan the book to her colleague.

These days, many nurses use handheld computers, also known as personal digital assistants, to get organized and access information. These computers function as a calendar, telephone number list, and address book, but their use also can enhance nursing practice.

BUYING A HANDHELD COMPUTER

There are many choices available to a nurse who is shopping for a handheld computer. First, the nurse has to decide which type to purchase. Some handheld computers use the Palm OS operating system, while others operate a Microsoft Windows program. Both types have word processing and data analyzing programs and provide Internet access. There are a number of different manufacturers from which to choose.

Second, the nurse should decide how much money he or she wants to spend. A handheld unit that uses the Palm OS system and has 8 MB of memory and a black and white screen can be purchased for about $99; color versions with expandable memory cost approximately $199. A top of the line version with a digital camera can retail for $499. Handheld computers that use the Microsoft operating system usually are more expensive, but they often contain more memory and can run multiple applications simultaneously like a desktop computer does. A lower-end unit may cost approximately $199, while the top-of-the-line sells for around $699. Competition among companies and retail stores has resulted in customer rebates, and comparison shopping can help save money. The nurse also should contact his or her tax consultant to determine whether a handheld computer is tax-deductible as an occupational piece of equipment.

Manufacturers have made multiple brands of handheld computers compatible. If a nurse who owns a handheld computer wants to share notes with a coworker who owns a compatible handheld unit (ie, one that uses the same operating system), he or she can use the beam feature. The nurse accesses this feature from a drop down menu and taps the "beam" instruction while pointing the transmitting handheld computer's infrared port--located at the top of the computer--directly at the receiving unit's infrared port from a distance of 3 inches to 24 inches away. This action allows the transfer of files and programs between handheld units via infrared waves. The receiving handheld computer will ask whether to accept the beamed file or category and must receive a "yes" answer before it will accept the new information.

A desktop computer owner can buy a handheld computer that interfaces with his or her home computer. A battery charger/docking cradle is included with a handheld computer, and even neophyte users find setup can be easy. After the installation compact disk (CD) is placed in the desktop computer CD-ROM port, directions appear on the desktop computer's monitor.

PROTECTING THE HANDHELD COMPUTER

A handheld computer owner should register the purchase with the manufacturer to obtain a warranty and technical support. Many owners purchase a carrying case and screen protectors (ie, plastic covers for the handheld computer's glass). If a nurse accidentally pulls a ballpoint pen out of his or her pocket and uses it instead of a stylus, he or she will be glad to have a screen protector that prevents ink from reaching the glass and protects the screen from damage.

PROGRAMS FOR PERIOPERATIVE NURSES

A nurse who owns a handheld computer can find programs that enhance nursing practice from a number of software developers and retailers, many of whom have Internet sites. Most programs are available for both the Palm OS and Microsoft operating systems, although many programs require memory expansion cards. If a nurse wants reference programs, he or she should purchase a handheld computer that has an expansion slot for memory. The larger initial purchase price likely will prove worth the investment.

Online programs for health care workers number in the hundreds. Medical dictionaries and programs that interpret laboratory results or provide English-to-Spanish translation of medical terms are available. One program functions as a reference and review for nurses in RN first assistant training. Medication reference programs answer questions about dosages for adults and children and medication interactions, contraindications, and adverse reactions. Nurses can study simulator-based video modules on handheld computers to practice recognizing clinical conditions and making correct responses, thus adding to their learning experiences. (1)

Research programs can be used to record patients' status, care, and complications (2) and to track length of stay, procedure costs, and patient outcomes. (3) With more perioperative nurses doing research and using handheld computers, it is likely more programs will be developed. Some physician researchers have participated in program development. (3) Creative nurses could do the same.

OTHER NURSING APPLICATIONS

Programs allow a nurse to download patient information from the hospital computer system to a handheld computer, make patient care notes, and document vital signs, which then can be transferred to the hospital computer. This patient information also can be updated and beamed to staff members on the next shift. At present, these activities occur on patient care floors and in clinic settings. Visiting and home health nurses use handheld computers with modems and portable keyboards to "access schedules, patient charts and extensive medical references, and to fill out and submit nursing forms." (4)

SECURITY CONCERNS

Present use of handheld computers by many perioperative nurses does not require security because patient data is not entered into the computer. Handheld computers can meet security needs, however, including those that comply with Health Insurance Portability and Accountability Act requirements, (5) with the use of built-in password authentication, data encryption, and virtual private network (VPN) solutions that laptop computers and workstations currently use. (6) Virtual private network is a technology developed to maintain the privacy of businesses that use public telecommunication infrastructures for transporting data on the Internet. Security for handheld computers can involve multiple levels, including a power-on password that requires the correct password to be entered before the computer powers on, an alphanumeric password of the owner's choice to protect access, a fingerprint sensor, and VPN for additional security.

CONCLUSION

Handheld computers help nurses organize information and find the latest resources without leaving their patients' bedsides. A vast array of programs are available to help nurses do their jobs, and as use of handheld computers increases, more programs will become available. This exciting technology can be used to enhance nursing practice.

NOTES

(1.) "PDA Projects at Virginia Commonwealth University," Virginia Commonwealth University, http://www.at.vcu.edu /pops/pops_projects.html (accessed 11 Dec 2003).

(2.) "Pendragon forms case study. Wake Forest University Anesthesiology," Pendragon Software Corp, http://www.pen dragonsoftware.com/casestudy/cs-WakeForest .html (accessed 11 Dec 2003).

(3.) F P Giammattei, "Implementing a total joint registry using personal digital assistants. A proof of concept," Orthopaedic Nursing 22 (July/August 2003) 284-288.

(4.) J B Houck, "PDAs--stat--for busy nurses," Wireless NewsFactor, http://www .wirelessnewsfactor.com/perl/story/9943.html (accessed 11 Dec 2003).

(5.) "Remarks by Steve Ballmer, Pocket PC 2002 Launch, Oct 04, 2001," Microsoft, http: //www.microsoft.com/presspass/exec/steve/2001/1 0-04pocketpc2002.asp (accessed 11 Dec 2003).

(6.) "Palm continues to streamline business processes for health providers at point of care," http://pressroom.palm.com/Investor Relations/PubNewsStory.aspx?partner=Mzg0T IRFMU (accessed 14 Aug 2003).

Sharon E. Hohler, RN, BSN, CNOR, is a surgical nurse, orthopedics at St Francis Medical Center, Cape Girardeau, Mo.

Palm OS is a registered trademark of Palmsource, Inc, Sunnyvale, Calif. Microsoft Windows is a registered trademark of Microsoft Corp, Redmond, Wash.