Five Tips for Creating Bedside Nursing Apps

Bedside nursing apps are gaining popularity. In the past year, the Zielony Nursing Institute at Cleveland Clinic has piloted numerous apps – self-contained programs downloaded on mobile devices to fulfill a specific purpose. These range from apps used by PCNAs to take vital signs to ones used by clinical nurse specialists to track their duties and apps to facilitate rounding.

“It’s what nurses are coming to expect,” says Beth Meese, BSN, BBA, RN, Administrative Director of Technology and Innovation for the Clinical Solutions Center at Cleveland Clinic. “We live in a mobile-driven consumer world. While we have an EMR [electronic medical record] that’s computer based, it doesn’t offer the mobility we expect in our personal lives.”

Advice for app development

Meese has worked alongside Danielle Dick, BSN, RN, on several app development projects. Dick is a Program Manager in Cleveland Clinic’s Office of Nursing Informatics. The two offer several tips for creating bedside nursing apps:

1. Find the value proposition first. “Why are you spending time creating apps for nurses?” asks Meese. “There are always efficiency and patient safety components. But you also have to look at the value proposition.” For example, purchasing mobile devices costs money. However, it may allow you to reduce the number of workstation-on-wheels required on a unit.
2. Get input from the users. “You need to get ideas from bedside nurses,” urges Dick. “The people that know the clinical workflow in and out – that truly understand what it will be like to use the app on the floor – have to be involved from the beginning.” For instance, nurses can offer insight on what mobile devices to select: Does it need to fit in their pocket? Is it easy to keep clean and safe?
3. Work in the trenches. To best understand how the app should work, developers should spend some time on the nursing unit prior to development and during the pilot. When Cleveland Clinic trialed an app for PCNAs to take vital signs on a medical-surgical unit at one of its regional hospitals last summer, a member of both the Clinical Solutions Center and the Office of Nursing Informatics was onsite. “The developer got the PCNA’s feedback and immediately made changes to the app,” says Dick.
4. Factor in extra time for training. It may not be as simple as educating nurses on the app itself. Cleveland Clinic created its rounding app on the Windows 8 operating system. When the app was piloted on a medical-surgical unit on the healthcare system’s main campus last fall, developers discovered they had to train nurses on the Windows 8 platform before teaching them how to use the app.
5. Make sure the app is compatible with your EMR system. “We try not to create something so custom that if the application itself goes down, the task couldn’t be done just as well in EPIC [Cleveland Clinic’s EMR system],” says Meese. Apps developed by Cleveland Clinic are driven off cascading flow sheets derived from EPIC.

The future of bedside apps

Dick and Meese agree that bedside apps are here to stay. “It all leads back to better patient care,” says Meese. “If we can do something better, cheaper, faster and safer, then we should. That’s why some of these apps will catch on.”