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Contents - Winter 2009

Vol. 2 No. 1

PDAs for Caribbean Nurses

By Mary Walters

A Canadian program that distributes personal digital assistants (PDAs) to nurses in publically funded hospitals on five Caribbean islands is transforming how nurses gain access to health-care information and manage patient care.

The initiative provides groups of nurses and nursing students in Dominica, St. Kitts, St. Lucia, Barbados and the Dominican Republic with wireless access—and often their first computer access—to the latest nursing knowledge, diagnostic tools, treatment options and networking resources. In conjunction with the handheld units, the nurses are also able to feed data back to central computers, ultimately contributing to further improvements in the region’s patient care.

The program was conceived by a team of Canadian researchers led by Pammla Petrucka, an associate professor at the University of Saskatchewan’s College of Nursing Regina site, and is funded by the Government of Canada’s International Development Research Centre (IDRC).

As part of the research investigation, Petrucka and her research colleague Sandra Bassendowski work with collaborators from Canada and partners from the Caribbean and Mexico to implement the program and train its local technical and research team members, using a “train the trainer” model and established information and communication technologies.

The first phase of the initiative, launched in 2006, distributed PDAs to a portion of the nursing staff at four of the hospitals. This allowed comparisons of health-care capacity and knowledge transfer between those who had PDAs and those who did not. The second phase will evaluate key indicators after all nurses in each group are provided with the units.

A new Spanish component in this phase will extend the usefulness of the program in the Dominican Republic.

“The primary goal of the program is to improve care for patients with hypertension, diabetes, HIV and AIDS,” Petrucka says. “However, the introduction of the PDAs has a range of other potential demonstrable impacts—on nursing knowledge, nurses’ feelings of empowerment and staff retention, for example.”

Among the most immediate and visible benefits is the increased capacity of nurses to access appropriate health-care information in a timely manner. Before the first PDAs were introduced, the team invited nurses on each island to answer a standard clinical-care questionnaire. In one case, it took the group 45 minutes to respond—in part because they had to leave the hospital and go down the street to the local library to do their research. With a PDA and some training in its use, they are able to provide such answers almost instantaneously.

On each of the five islands, 40 to 50 PDAs will have been distributed to nursing staff by the end of the mixed-method study’s second phase. Each hand-held unit is pre-loaded with programs the participants have identified as important, including policy and procedure manuals, a medication handbook, laboratory diagnostics, a symptom-interpretation program, critical-thinking tools, and a medical calculator. Through the Internet, the units can also access international health-care databases and nursing discussion forums.

At each hospital, the PDAs are linked to a central desktop computer by means of a wireless infrastructure. This system was selected because of its seamlessness, and easy integration into the future healthinformation systems being considered within the region.

The impact of the PDAs is as dramatic to the nurses as it is to outsiders, Petrucka says. While some of the staff were reluctant to try the new technology when the program was first introduced, by the time the second phase began, everyone wanted the units. “In a setting where most people have no experience with computers at all,” Petrucka says, “these devices are like magical tools from outer space.”

Petrucka won an Association of Commonwealth Universities Titular Fellowship in 2006. She has also been named an Outstanding New Investigator by the Canadian Association of Nurse Researchers and received a humanitarian award from the University of Regina Alumni. Her ongoing research also includes several initiatives relating to the provision of health care to aboriginal communities in remote and rural parts of Canada, where digital technology also has enormous potential application.