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Great job!  Question 1 response Michelle Harper

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Great job!  Question 1 response Michelle Harper

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This topic addresses using smart phone technology applications in nursing. I have included information on 6 different apps that are helpful to nurses.

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Using Smart Phones to Deliver Better Patient Care

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Does your current nursing role allow the use of smartphones in the work place? If so, what applications do you use the help improve patient care? If not, do you think it would help or distract you in your role if they allowed smartphones to assist with patient care?

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What application discussed in the paper would help you most in your role? Have you ever used one of these applications as a nurse or one similar?

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Nurses Report on Personal Use of Social Media in the Work Place

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Nurses Report on Personal Use of Social Media in the Work Place

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Citation:

Piscotty, R., Martindell, E. & Karim, M. (2016). Nurses' self-reported social media and mobile device use in the work setting. Online Journal of Nursing Informatics (OJNI), 20(1), Available at http://www.himss.org/ojni

Abstract

Studies have examined social media's effect on healthcare privacy and boundary violations, but there is a notable gap in the literature about whether or not nurses are using social media during work hours. The purpose of this descriptive secondary analysis study was to examine the self-reported use of social media by nurses, via personal mobile devices or otherwise, in the work setting. This study is a step toward identifying social media use in the workplace. A convenience sample ( N= 140) of registered nurses from a public school of nursing in southeast Michigan in the fall of 2011 was used. The results support widespread use of mobile devices for checking messages, missed calls, and social media by nurses during working hours. The use of social media in healthcare settings is evident and likely to stay (Ying Mai & Sandbee, 2014). There are possible benefits for both nurses and patients, so long as the risks are effectively addressed.

Introduction

Digital technology has become ubiquitous in our lives. It impacts our daily schedules, activities, and interactions with others. For example, it's sometimes easy to forget a time before smart phone use when one had to wait for a letter to arrive in the mail with important news. The computer age and the advent of the Internet have drastically reduced the time needed for many activities, such as library research and personal communications. Social media is one digital tool that has greatly impacted our lives and our entire culture (Grimmelmann, 2009). Young adults raised with access to online social environments have different socialization expectations, freely sharing personal details and opinions (Peters, 2011). Instant sharing with prompt support or response has become an expectation of many professionals (Steinwart, 2009). Instant sharing is enabled by mobile devices that grant access to social media from any location with Internet connectivity (Faguy, 2009).

The nursing profession can benefit from digital technology in the workplace, including social media and mobile devices (Piscotty et al., 2013; Simpson, 2014). In addition to their professional education and training, nurses are expected to bring skills and knowledge acquired through life experience to the work environment. Many recently graduated nurses grew up in a culture of social media, a culture of instant access to information and reliance on digital technology (Steinwart, 2009). Younger nurses were encouraged to use Internet programs and education-related social media sites during high school and college and now come to the workplace expecting to continue that practice (Altes, 2009). Social media use could therefore be classified as an unexplored cultural behavior that impacts patient care (Piscotty et al., 2013; Simpson, 2014).

The healthcare industry has accelerated the implementation of healthcare information technology such as electronic health record (EHR) systems due to government incentives and future penalties from Medicare and Medicaid (Centers for Medicare and Medicaid Services, 2015). These advancements have paved the way for web content for patients and email communication between patients and providers (Lober & Flowers, 2011). However, healthcare organizations have been slow to allow the use of social media sites and mobile devices by nurses in the workplace (Piscotty et al., 2013; Simpson, 2014). There has been little research into the use of these technologies by nurses during work hours. It is time to address how the cultural and social changes brought about by social media can best be incorporated into nursing practice.

Purpose

The purpose of this descriptive secondary data analysis study is to examine the self-reported use of social media by nurses in the workplace. Understanding nurses' use of social media sites at work will aid in identifying issues and implications for nursing practice. Therefore, the following research question guided this study: What is the prevalence of social media use by nurses during work hours?

Conceptual Framework

Donabedian's (1969) model of healthcare quality evaluation guides this study. It is most useful in directing design of contemporary nursing interventions and in evaluating their importance and contribution to safety and quality in healthcare (Gardner, Gardner, & O'Connell, 2014). The model allows for the examination of quality through the assessment of three main components of the healthcare system: structure, process, and outcomes. Structure includes the instruments of care and the healthcare organization. In the workplace environment, access to social media by mobile devices is considered a component of structure. Process is concerned with the actual delivery of nursing care. In this case, social media use may affect characteristics of nursing care delivery such as whether care was delivered or not delivered, as well as the quality of delivery. Outcomes are defined as the end results of care that was delivered. Theoretically, if social media is available (structure) and used (process), then there may be an impact on the end results of care (outcome). However, the focus of this study is on the presence and use of social media and mobile devices in the work setting rather than on the outcomes of presence and use.

Background

Social media is a "constellation of internet-based tools that help users connect, collaborate, and communicate with each other in real time" (Ressler & Glazer, 2010, p. 1). The presence of social media allows communication among those with similar (or dissimilar) interests and creates networks or groups with unlimited numbers of people accessing, sharing, and manipulating data. Regardless of the classification of a social media site as personal (e.g., blog) or professional (e.g., LinkedIn), the functionality remains the same. Mobile devices with Internet access range from desktop computer terminals to pocket-sized cell phones.

Social media has received limited favorable attention from the healthcare industry. According to the National Council of State Boards of Nursing (NCSBN, 2011), care providers are accessing organizational and institutional websites for professional collaboration, communication with patients and families, and education of both the public and healthcare workers. Sharp (2010) reports that social networking can be used to recruit patients and staff, as well as to advertise and strengthen brand loyalty.

A few studies have acknowledged the usefulness of mobile devices in healthcare settings as means of accessing reference information and patient data. However, social media sites were not explored. According to Naditz (2010), there are over 5,000 health applications, or apps, for mobile devices and smartphones. Whether or not any of them include social media aspects was not stated in the Naditz paper. There was an extensive study done by Wu, Li and Fu (2011) concerning the importance of using mobile devices for patient care, but the authors did not discuss social media sites. A study by Wittmann-Price, Kennedy and Godwin (2012) focused on nursing students' smart phone use as a means of accessing pharmacology information, nursing diagnoses, and lab information. Findings were positive, but again, no discussion of social media was present.

Fisher and Clayton (2012) studied social media outlets, such as email, texting, mobile apps, blogs, and websites. Their findings showed patient interest in using social media to obtain information from their healthcare providers. In addition, the authors reported that of participants who were not currently using social media, 41.6% indicated they would learn to use these tools if they provided access to healthcare information and patient-provider communication (Fisher & Clayton, 2012).

Ying and Sanghee (2014) conducted an online survey to examine the characteristics of nurses that use and do not use social media. The authors reported no major differences in characteristics between users and non-users. The study did not examine the use of social media during work hours. The majority of the study participants were advanced practice nurses with an average of 23 years of experience. Registered nurses (RNs) without an advanced degree made up just 36.83% of the sample. The majority of nurses (93.41%) responded that they did use social media, and indicated a strong preference for using social networking sites (90.33%) and podcasts (76.24%). The authors noted that their findings are more representative of advanced practice nurses, and any generalization to the entire nursing population should be made with caution.

A study by Lambert, Barry and Stokes (2012) discussed the use of social media as a means of instantaneous communication and information sharing in healthcare settings. Social media outlets discussed included Facebook, MySpace, Twitter, YouTube, Skype, LinkedIn, blogs, and email. Lambert et al.'s (2012) main focus was the possible legal implications of potential violations of privacy. The authors introduced questions such as: Are emails truly private? Are doctor to patient communications via Facebook truly confidential? Can Skype be used to assess and diagnose? Derouen (2012) also discussed privacy and the appropriateness of social media use by nursing staff.

For the present study, no research specifically addressing social media use and its relevance to nursing care as an interruption or distraction could be located. Still, employers have categorized personal devices and social media sites in the workplace as inappropriate behaviors (Piscotty et al., 2013; Simpson, 2014). These policies are preemptive, and not based on actual evidence of the use of social media in nursing practice.

Social media is here to stay. New technologies, such as smart phones, can open doors for innovative nursing care and positive changes in healthcare delivery (Putzer & Park, 2011). However, employers in many industries are creating policies to direct behavior (Arnold, 2009). Yet, there is little knowledge regarding current nursing practice as it relates to personal social media use during working hours. Prior studies have not addressed whether nurses are bringing personal mobile devices into patient care areas or if they are accessing social media sites during working hours.

Methods
Study Design and Sample
The study used a descriptive design derived from a secondary analysis of data collected as part of a larger qualitative and quantitative investigation on the use of social media by nurses in the workplace. A convenience sample of students enrolled in an RN to BSN completion program at a public school of nursing in southeast Michigan was used. All of the participants were RNs. There were no inclusion or exclusion criteria. The total number of participants who started the survey was N = 140. The response rate to the questions of interest in this study varied from n = 140 to n = 130 as a response was not required for each question. Missing data for the questions of interest and demographics ranged from a minimum of six and a maximum of 10 participants. Cases were excluded pairwise for missing data.
Instrument
The questions analyzed in this study were part of a larger 60-question survey. These questions pertained to the use of social media in the work setting. Demographic information was also collected. The survey was administered within the context of using social media during working hours. The survey was modified from a social media survey developed by a Professor of nursing in South Korea with a specialization in nursing informatics (Lee, 2011). Permission was granted from Professor Lee to use the survey and make modifications. The survey was translated and edited for an English-speaking audience. Three faculty experts modified and further developed the survey, which was determined to have face validity. The faculty's expertise was in nursing education, informatics, and nursing quality and safety. Face validity was determined by consensus among the faculty experts in regard to the survey. The survey was also reviewed by a small group ( n = 5) of practicing registered nurses that worked in acute care settings to ensure readability and face validity of the questions.
Procedure
The primary data were obtained between September and November of 2011 using an online survey created in the Qualtrics (Provo, UT) survey software. The survey was available to the sample via email invitation and course websites. The email described the purpose of the study and time frame for completion and linked to the survey. The online survey contained a description of the study and directions on how to complete the survey. The RN to BSN academic adviser provided student email addresses for contact. The survey was open for four weeks and reminder emails were sent to participants twice per week during the study period. Qualtrics generated a report of responses for each question at the end of the survey period. Institutional Review Board approval was obtained prior to the initiation of the study. Participation was voluntary and anonymous unless the individual chose to submit an email address for a gift card drawing. The data collected were not associated with student email addresses or any other identifying information.
Statistical Analysis
Data were analyzed using SPSS 21 (Armonk, NY: IBM Corp). Nurses' access of social media during work hours as well as social media use with patients was examined using descriptive statistics, particularly frequencies. The frequency for each question was calculated to determine percentages pertinent to specific social media use by nurses during work hours.

Results
Demographic Characteristics
The sample consisted of a total of N = 140 RNs that started the survey. Response rates ranged from n = 140 to n = 130. The mean age of the sample was 34.98 years (SD = 8.11) and the mean years worked as an RN was 6.10 years (SD = 5.82). The majority of the respondents were female ( n = 121, 93.1%) and worked in an acute care setting ( n = 121, 93.1%) as a staff nurse ( n = 109, 83.8%). A large number of the nurses who responded worked the day shift ( n = 67, 51.5%), worked full time ( n = 105, 80.8%), and worked as a staff nurse ( n = 109, 83.2%). The majority of the nurses reported being a member of a social media site ( n = 125, 89.3%)
Prevalence of Social Media Use by Nurses during Work Hours
Table 1 presents the results of nurses' social media use during work hours. When the participants were asked how many hours they had spent on social media sites that day, the majority ( n = 83, 61.9%) reported they had spent less than 1 hour on social media sites while 23.9% ( n = 32) reported spending more than 1 hour on the sites. The majority of the participants ( n = 121, 90.3%) reported that they had witnessed other RNs using social media sites during a work shift. Half of the participants (n = 68, 50.7%) reported using a social media site during a work shift. The majority of the participants ( n = 90, 67.2%) reported checking their mobile device (i.e., cellular phone) to identify missed calls or text messages more than 2 times per shift, with 21.6% ( n = 29) checking more than 10 times.

When participants were asked if they had connected with discharged patients via social networking sites, the majority ( n = 124, 92.5%) reported they had not, while 7.5% ( n = 10) indicated they had connected with discharged patients. The majority of the participants ( n = 128, 95.5%) reported that they had never connected with patients currently under their care via social networking sites. When asked if a current or former patient had ever tried to contact the participant via social networking sites, the majority ( n = 115, 85.8%) responded no, but 14.2% ( n = 19) reported yes. The majority of the participants ( n = 118, 88.1%) reported that a current or former patient's family had not tried to connect with them via social networking sites.

Discussion

This study's findings indicate that use of social media and mobile devices is prevalent in the healthcare workplace. About half (50.7%) of the respondents indicated they had accessed a social media site during a work shift; further, more than 90% of the nurses reported witnessing a peer access a social media site during a work shift. Since social media enables connecting with others, we asked the respondents if they had connected with patients via social media sites. Some nurses stated they had connected with patients via social networking (7.5%) or that patients had sought them out (14.2%). The purpose of the networking was not discussed, and whether the communication was purely social or related to healthcare is not known. A majority (91.1%) of the participants reported checking a mobile device for missed calls and/or text messages.
Implications and Best Practices
The findings raise questions that could be relevant to patient care interruptions, safety, communication, and possible HIPAA violations. Understanding interruptions and their impact on patient care and nursing effectiveness is important. Concerns in the literature about the use of mobile devices have been mostly negative. The urge to answer personal phone calls or respond to messages is a potential interruption of care (Piscotty et al., 2013; Shattell, 2010). Interrupted nursing care has been correlated with increased complexity of the decision-making process (Hedberg & Larsson, 2004). Hopkinson (2011) observed that the nursing culture places a priority on answering incoming care-related phone calls and considers personal calls an interruption to nursing care. One could reason that social media messages similarly contribute to interruptions and possibly errors.

Additionally, patient perception of mobile device use by nurses may factor into how patients feel about their healthcare delivery and their trust in their practitioners. Cleanliness becomes a concern when mobile devices are used throughout the hospital environment. The literature suggests that personal devices carried in pockets have the potential to contaminate patients via the carrying of infection to and from the patient care arena (Badr, Badr, & Ali, 2012; Angadi, Misra, Gupta, Jadhav & Sardar, 2014).

There are possible advantageous uses for social media and mobile devices in the healthcare setting, and they are worthy of further study. For example, mobile devices can provide instant access to information that could be helpful for interpreting patient lab values or radiology results. In addition, when administering medications, mobile devices could provide convenient drug interaction or patient allergy information, as well as proper dosage and timing. Patient records could be easily viewed at the bedside without the need for cumbersome and often malfunctioning computers-on-wheels. Critical values could be sent to all involved in a patient's care, immediately, without the need for numerous telephone calls or tracking down team members.

Mobile devices can also enhance communication speed, thereby enhancing patient safety. Putzer and Park (2011) point out that social media and mobile devices enable convenient and instant access to reference information, evidence-based practice guidelines, and drug information. These data can be promptly applied to patient care for faster and perhaps more effective nursing interventions. Lober and Flowers (2011) assert that support groups for patients with various health conditions are available to even the most distant or immobile patient through website access.

Ying Mai & Sandbee (2014) suggested that RNs can use social media within the healthcare community to connect with other professionals. This idea can also be transferred to facilitating communication within a healthcare setting between nurses. Staffing issues within a unit could be easily negotiated between RNs via social media. Creation of an online meeting place such as a blog, bulletin board, or private group on a social media site could be used to foster unit communications. New job positions could also be effortlessly communicated via social media within a healthcare institution and easily filled.

Concerns about digital technology in the healthcare workplace are common in the literature. Most concerns involve patient confidentiality and privacy. For example, the unfettered ability to publish permits collaboration and professional development but also raises concerns about the handling of personal information and "off-the-record" comments; in addition, information or data entered into a website are susceptible to manipulation and copying (Anderson & Puckrin, 2011; Grimmelmann, 2009). Employers can monitor or block access to websites deemed inappropriate for the work environment (Arnold, 2009), but these restrictions only apply to employer-owned devices (Piscotty et al., 2013). Personal devices brought from home are not affected (Piscotty et al., 2013; HIPPA Collaborative of Wisconsin, 2010).

The security of communications in a networking environment is different from previous provider communication formats. As an individual's comfort with friends in a social network increases, there is a tendency to freely share personal details and information (Spector, 2010). The speed of interaction within social media may erode more cautious behaviors such as re-reading before sending or posting (Anderson & Puckrin, 2011). This behavior can result in posting information, comments, or photos that, on second thought, should have been withheld. The nature of a social media network as an informally connected group presents another unique issue (Murphy, 2011). Each member has the ability to share with unknown individuals. This erodes the security of communication as comments are passed out of context to linked individuals who may make incorrect interpretations before passing data further into the network.

The American Nurses Association (ANA) and the NCSBN have touched on privacy issues in their guidelines for the use of social media by nurses (NCSBN, 2011). The image one creates on a social network site remains visible not only to friends, but also to employers, potential patients, and past patients. Privacy laws - and liability - exist even on personal social media sites. Even innocuous comments by healthcare providers as "friends" may be regarded as medical advice (Lie, 2011). No longer does the end of the shift necessarily terminate contact or accessibility of the healthcare team to the patients. Patients wishing to further a relationship with a care provider now have a resource to gather personal information or even approach individuals privately (Stokowski, 2011).
Limitations
A limitation of this study is that it did not seek to discover a link between social media and mobile device use; rather it simply demonstrates that these tools were used. Additional research is necessary to explore how social media sites are used in health settings and if there is opportunity for providers and patients to improve health outcomes. This study did not determine how nurses' social media use affects patient care quality and safety. The sample was limited to RNs in an RN to BSN program at one school of nursing. The stigma of smart phone use in the healthcare setting may be a cause of underreporting by respondents of this survey. This may have contributed to the higher numbers of those being seen using social media (90.3%) vs. those who said they have accessed such sites (50.7%) during work hours. A further limitation of this study is the exponential growth of social media over the past few years. The data in the present study were collected in 2011, and since then, social media sites have further developed and grown in number. Although this is a limitation, it is important to note that 89.3% ( n = 125) of the respondents reported being a member of a social media site and 85.8% ( n = 115) reported they used social media sites "today," indicating a high frequency of use even in 2011. This is consistent with the study conducted by Ying and Sanghee (2104) that 93.4% of nurses reported using social media.
Future Research
Several aspects of social media and mobile device use in healthcare require further exploration. This study indicates that nurses frequently use social media in the workplace, but it is still not well understood if that use is relevant to patient care. The similar studies discussed imply a rise in social media use in healthcare and discuss the pros and cons of such media. Social media in healthcare remains largely uncharted territory, with most hospitals slow to recognize and implement social media, despite initial positive research (Wu, Li & Fu, 2011). Further research is needed to examine the relationship of social media and mobile device usage with patient and organizational outcomes. Finally, additional inquiry should determine exactly when and how nurses are accessing social media sites during work hours.

Conclusion

Registered nurse use of social media and mobile devices in the healthcare setting is evident and is likely to stay (Ying Mai & Sandbee, 2014). With the rise in the development of social media sites relevant to healthcare comes the rise in the RN's desire to use these tools. Social media sites such as LinkedIn, Facebook, ResearchGate, and Twitter are all being used as mediums to disseminate evidence-based information. Thus, the presence (structure) and use (process) of social media and mobile devices by nurses were supported by the findings of this study and lend credence that outcomes as described by Donabedian as the end results of care may be affected. The possible benefits for providers and patients are great, so long as the risks to patient safety and privacy are addressed. An example of a benefit to providers is that there is instant access to current evidence that can be used at the point of care to support clinical reasoning and appropriate clinical decision making. Instant access to pertinent information may result in timely care and improved patient outcomes.

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Author Bios

Ronald J. Piscotty Jr., PhD, RN-BC , is an Assistant Professor at the University Of Maryland School of Nursing in Baltimore, MD. Dr. Piscotty has expertise in health systems and nursing informatics. Dr. Piscotty's focus on research is to examine the impact of technology on nursing practice.

Ellen Martindell MSN, RN, is currently working in the health insurance industry. Ellen has worked in large health care systems for 35 years in various roles. Ellen has an extensive background in training staff in the intensive care, outpatient clinic, and laboratory settings. Ellen has had ample opportunities to observe and work with staff and patients using various electronic devices.

Matthew Karim, RN, BSN, CCRN, is a staff nurse in the Cardiothoracic ICU at Munson Medical Center in Michigan. Matts' responsibilities include post-operative management of patients who undergo open-heart, lung, esophagectomy, and aortic dissection procedures. Matt has one year of experience in nursing and is the co-chair of his unit's governing body as well as a mentor to new graduates.

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social media; nursing informatics; work; quality; safety

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Nurses' Self-Reported Use of Social Media and Mobile Devices in the Work Setting

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Piscotty, R., Martindell, E. & Karim, M. (2016). Nurses' self-reported social media and mobile device use in the work setting. Online Journal of Nursing Informatics (OJNI), 20(1), Available at http://www.himss.org/ojni Studies have examined social media's effect on healthcare privacy and boundary violations, but there is a notable gap in the literature about whether or not nurses are using social media during work hours.

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Ethics Concerning Smart Phone Use in Nursing

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Ethics Concerning Smart Phone Use in Nursing

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Despite hospital policy restrictions, 67 percent of hospitals interviewed in a Spyglass Consulting Group study reported that staff nurses use personal smartphones for clinical communications and workflow. As a result, 88 percent of hospitals were concerned with some type of HIPAA-related security risk.

The study revealed that nurses sent patient data using smartphones, although it was much more common with doctors. Six to 14 percent of nurses sent text messages, used app-based messaging or used picture messaging to send patient-related clinical information to their colleagues.

Although smartphones can be beneficial to healthcare facilities, the risks are clear. The possibility of security breaches and compromised patient data can undermine the connectivity and safety of healthcare environments. Solutions can help minimize these threats.

Positive Aspects of Smartphone Usage

A survey of a large hospital corporation in London found that 53.2 percent of nurses considered their smartphone "very useful" or "useful" for helping with clinical duties. Two-thirds of nurses owning medical apps use them as part of their clinical practice.

According to the survey, more than 90,000 mobile health apps are available. By 2017, 3.4 billion people worldwide will own a smartphone and half will be using mobile health apps. Most of these apps target lay users to promote healthy living or assist with disease conditions, but an increasing number of apps are designed for healthcare providers in clinical environments. Mobile health apps allow providers convenient access to health-related content to facilitate decision-making.

Smartphones can also improve communication in nursing, which some believe has been neglected. "Despite advancements in mobile devices and unified communications, hospital IT has underinvested in technologies and processes to support nurses at point of care," said Gregg Malkary, managing director of Spyglass Consulting Group. "Nearly 42 percent of hospitals interviewed are still reliant on pagers, noisy overhead paging systems and landline phones for communications and care coordination."

"Hospital IT has an imperative to evaluate and deploy innovative mobile technologies and unified communications solutions to support collaborative team-based care to help enhance communications, streamline productivity, improve care quality, and increase clinician satisfaction," the Spyglass Consulting Group study concluded. Half of hospitals interviewed planned to invest in or evaluate enterprise-class smartphone solutions over the next 18 months.

Ethical Implications of Smartphone Usage

If the majority of nurses use personal smartphones for clinical communications and workflow, then nurses could be violating federal laws (specifically, HIPAA), hospital security policies and the American Nurses Association's Code of Ethics, according to American Nurse Today.

"If they're sending protected health information (PHI) on their smartphones in a way that can be linked to a specific patient, they're also violating state nurse practice acts," American Nurse Today reports. "Sending PHI could lead to loss of employment, financial fines, jail sentences, and loss of one's nursing license."

Working Nurse warns that the security and protection of sensitive data "takes on a whole new meaning when dealing with sensitive patient medical information. A single breach would potentially compromise thousands of patients' data, leaving them vulnerable to a medical identity theft." Research states the following: employee-owned devices are compromised at more than twice the rate of devices owned by corporations; 40 percent of Americans don't have password protection on their mobile devices; and 51 percent use public Wi-Fi hotspots, which are vulnerable to data breaches.

According to a 2015 study from the Ponemon Institute, criminal attacks are the leading cause of healthcare data breaches - a first in the five years of the study's history. Criminal attacks increased by 125 percent in the previous five years, which researchers attribute to two critical facts that cybercriminals recognize. First, healthcare organizations manage a treasure trove of financially lucrative personal information. Second, they do not have the resources, processes and technologies to prevent and detect attacks and adequately protect healthcare data.

In a separate study, the Ponemon Institute found that data breaches in healthcare are the most expensive to remediate, and the cost is rising. The study of 350 companies in 11 countries across 16 industries showed that the average cost of a healthcare breach is $363 per personally identifiable record exposed. In contrast, the average cost of a data breach across all industries is $154.

Solutions

In hospitals that have a "bring your own device" policy, nurses must carefully follow the rules, even if it includes restrictions on how they use their device or whether their device can be confiscated or erased if a breach occurs. Even if the policy doesn't outline certain best practices, nurses should be aware of and abide by these standards.

Strong passwords are a must, and multiple layers of authentication are ideal. Nurses should also install mobile security, because "your smartphone is as much a computer as your laptop or desktop at home," Working Nurse says. Users should also exercise caution around unsecured wireless networks and unencrypted apps. Nurses should limit use to encrypted networks with passwords and firewalls. They should also be aware of the 75 percent of apps that don't encrypt data, the 86 percent that lack basic security mechanisms and the 97 percent that contain some type of privacy issue.

Whether nurses and other healthcare professionals use their own smartphone or a provided device, hospital policies for smartphone use must be based on federal and state regulations. These rules can help healthcare providers prevent exchanging secure data on unsecure devices, apps and networks. Hospitals should also have legal and cybersecurity professionals provide accountability and review.

Enhancing Patient Safety and Care

Clinical and ethical implications of smartphone use present obstacles for nurses and other healthcare professionals. Although the devices have much to offer for the quality of patient care, precautions must be taken to ensure sensitive data remains safe and secure.

Alvernia University's online nursing programs assist students in learning how to best use smart technology to improve patient outcomes, while respecting patient privacy and confidentiality. The RN to BSN Completion Program and the Post-Master's Doctor of Nursing Practice (DNP) Clinical Leadership Program take place in a flexible online learning environment that allows students to maintain their work and personal schedule.

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Ethical Issues in Nursing: The Impact of Smartphones on Patient Care - Alvernia University Online

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Despite hospital policy restrictions, 67 percent of hospitals interviewed in a Spyglass Consulting Group study reported that staff nurses use personal smartphones for clinical communications and workflow. As a result, 88 percent of hospitals were concerned with some type of HIPAA-related security risk.

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A Nurse Developed an App to Help Other Nurses

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A Nurse Developed an App to Help Other Nurses

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TigerText - For safe and secure healthcare communication

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TigerText - For safe and secure healthcare communication

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TigerText Secure Text Messaging App for the Enterprise

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TigerText simplifies and secures enterprise messaging, accelerates workflows, and gives you back control over your communications.

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This is a review of the app Resuscitation! by EM Gladiators. This app allows the clinician to work clinical cases in the ED