Audrey Snyder, RN, MSN, CEN, ACNP

Emergency nurses have to process large volumes of information on an hourly basis. Technological advances have impacted both the amount of information nurses can access, as well as the means of finding reference materials. To access this information quickly it needs to be portable and easy to use. Personal Digital Assistants (PDAs) can meet this need. A PDA is battery operated and small enough to fit into your hand or a scrub pocket, yet hold large amounts of data. Palm Operating System (OS) and Pocket PC OS are the most frequently used systems. Unfortunately, data cannot be shared between the two systems.

There are many health care applications available for the Palm OS and Pocket PC. Some applications can be downloaded for free, and some require a yearly user fee. Many programs have demonstration versions that allow you to try out the software prior to purchase.

The PDA comes with a calendar, address book, and memo pad. A pharmacology reference, a medical consult program, and medical calculation programs are the next priority. Pharmaceutical references can provide data on unfamiliar medications, cross-reference herbal products and medications, and identify common reactions. Medical programs can provide information about rare diseases quickly. Medical calculation programs can ease dosage calculations in pediatrics, and estimate due dates for pregnant patients. Each user should evaluate programs for their benefit in the current health care environment. The possibilities of accessing information at your fingertips are endless.

Current PDAs have some type of expansion slot that holds Compact Flash, memory sticks or memory cards, allowing for expandable memory, up to 254 MB. A minimum of 16 MB memory is desirable in a PDA. A PDA with 16 MB of memory and an expandable memory slot cost less than $200.00. In selecting a PDA, consider how you will use the PDA: As a personal organizer, reference tool, patient information manager, or for e-mail access. Consult your institution’s policies and the HIPAA (Health Insurance Portability and Accountability Act) regulations if patient information will be placed in the PDA.

At previous talks on the use of PDAs, nurses expressed concern about the amount of time it may take them to load the programs and begin using the PDA. A fellow emergency nurse who grew up not using computers spent a little more than an hour reading the material supplied with her PDA and setting up the desktop program on her home computer. She was using her PDA in the emergency department the next day.

If the battery dies you will temporarily lose all data in the PDA. Do not despair. Recharge the PDA and sync with your desktop, and the programs will be reloaded to the PDA. If you sync daily, only minimal data will be permanently lost.

Nursing conferences are a great place to network and learn about PDA programs emergency nurses are using in their clinical practice. Some free programs can be beamed, or transferred, between PDAs if they are on the same operating system.

Some PDAs can incorporate a phone, and many hospitals now allow digital wireless phones to be used in the hospital environment. Check your hospital’s policies and procedures regarding the use of digital phones and PDAs in the hospital environment. Our hospital has a policy that no electronic equipment can be used within five feet of medical equipment. Standing at the foot of the patient’s stretcher to use the PDA would comply with institution policy.

PDAs have the ability to increase the emergency nurse’s capacity to recall relevant information to support clinical practice.

Audrey Snyder is the clinical nurse specialist in the emergency department at the University of Virginia Health System. She is President of Mr. Jefferson’s ENA.