Eryn M. Godwin

The purpose of this work is to obtain a set of best practices for the design of mental health smartphone applications (MHSAs) for an adolescent user base. The authors carried out a systematic literature review combined with a bibliographic coupling analysis to identify relevant literature, and then a thematic analysis of the literature to identify core principles. These efforts led to a framework of nine general principles for the creation and design of MHSAs. The nine core principles identified were: Using evidence-based treatments, encouraging intrinsic motivation in users, using extrinsic behavior triggers, providing professional support, enabling social support, engaging users during the development process, using user-centered design principles, including a parental mode, and protecting patients’ privacy.

Electronic Medical Records (EMRs) have an issue that is not being addressed: poor usability. Clinicians use EMRs daily to check patient charts, order medications, and communicate with patients (Paul, 2015). However, doctors and nurses struggle every day with EMR usability issues, such as an unnecessary number of clicks to complete a medication entry, lack of customization, and visual clutter, to name a few. These issues can lead to potential medical errors, nurse frustration, patient or employee harm, and clinician burnout. While the literature provides a few suggestions to improve usability, little change has been made to the two primary EMR providers (Cerner and Epic).Additionally, the current literature lacks attention on EMR usability with pediatric nurses, instead focusing on doctors, fellows, or residents. Due to the abundant usability issues with EMRs, clinicians are dissatisfied with the program, experiencing symptoms of burnout, and struggling to use these systems. The goal of this thesis is to the answer the question of will a redesign of Cerner’s EMR (PowerChart), increase usability and ease-of-use for pediatric nurses? This research will be done by first, engaging nurses to pinpoint the primary usability issues in PowerChart, second, redesigning the system, and finally, conducting usability reviews on both PowerChart and the redesigned EMR to examine the effect of a redesign on usability for pediatric nurses.

ABSTRACT: Although smartphone use in the workplace by physicians has been well documented, such use by nurses warrants further examination. In particular, there is a lack of research regarding the effects of smartphone use on nursing efficiency and workflow satisfaction. Our organization developed a pilot program to introduce the use of hospital-issued smartphones by direct care nurses in the pediatric ICU (PICU) and a satellite ED and created an implementation team to carry this out. Our research team thought it important to measure and evaluate nursing efficiency and workflow both before and after these phones were issued. The original plan included three primary measures: pre- and postimplementation surveys (both units), time-on-task studies (both units), and interruption observations (PICU only). Because of technical difficulties, the PICU pilot arm was abandoned after the smartphones were introduced. The ED arm completed the postimplementation time-on-task studies and the postimplementation survey nine months after implementation. The postimplementation survey results showed that nurses preferred other methods of communication over smartphones, and smartphones were scored lower than all other forms of communication for ease of integration into the workflow. Time-on-task results indicated texting was faster with smartphones than it was when using T9 texting (predictive texting) with the wireless Ascom phones in the PICU. Making calls with the smartphone took ED nurses significantly longer, and many preferred their traditional communication methods. Further research is needed to determine whether smartphones can be optimized to enhance nursing workflow, increase efficiency, and improve patient outcomes. This article provides vital information for nurses and others considering a transition to the use of smartphones or similar devices in the workplace.