Hand-Held Computers Speed University Of Florida's Home Nursing Visits

GAINESVILLE, Fla.---The University of Florida is one of five universities selected to test new software that can shorten the time nurses spend documenting patients' health conditions.

With the help of a hand-held, touch-screen computer running on software called the Nightingale Tracker -- named for the British nurse Florence Nightingale, hospital reformer and humanitarian -- UF nursing students document and track the condition of patients. The Nightingale Tracker makes home visits quicker and more efficient. Thanks to reduced paperwork, students found an extra 90 minutes or more each week.

The new software enables nurses and nursing students in the field to collect patient information and communicate with faculty members and consultants who are back in their offices. The data is sent over standard telephone lines or through cellular phone technology.

The Nightingale Tracker will enable real-time voice and data transmission via the Internet, and also can be used to browse the World Wide Web or to fax information. The software runs on a 3-pound, hand-held communication device called a personal digital assistant, comparable in size to a VCR tape.

FITNE Inc. (formerly the Fuld Institute of Technology in Nursing Education), an Ohio-based developer of interactive technology for health-care education, chose UF to test its software "because it has a strong commitment to community health nursing and a clear vision for the future of health care," said FITNE project manager Vicky Elfrink.

"The common thread among the universities chosen in the testing is their emphasis on providing students with learning opportunities in the community," Elfrink said. "Since a large part of nursing care is moving out of hospitals, we feel this kind of training is an investment in the future."

College of Nursing clinical assistant professor Joan Castleman, who heads the UF Nightingale Tracker field test, said it gives the students practical experience with technology they will use once they graduate.

Along with real-time communication, the software makes it easy to enter information into a clinical documentation record. It also is time-efficient in that nurses do not have to write long narratives on the patients' conditions.

"I have done admissions papers and had to fill out 17 documents," said Kathryn Pearce, a registered nurse pursuing a bachelor1s degree in nursing at UF. "The Tracker condenses the work so you don't have to handwrite anything."

A unique feature of the Nightingale Tracker is its use of the Omaha System, a clinical language developed for health-care providers practicing in community or home health settings. The language provides a framework for encoding and communicating patient data in a manner that helps providers make decisions about a patient's care.

UF just completed three months of software testing with 10 nursing students. The students were given questionnaires before, during and after the testing period.

Students kept journals describing their experiences. FITNE's Elfrink met with UF nursing students to get feedback. An upgraded version of the program will incorporate their suggestions.

Elfrink found students to be generally positive. The UF students found the prototype saved them time because they were able to e-mail their clinical reports to their instructor.

One shortcoming was that the computer1s operating system functioned slowly when large amounts of data were stored on it. In the second version of the software, which is being developed, this problem will be corrected by providing a server to store data, freeing up memory.

The new version will enable users to send and receive faxes, e-mail and use Internet technology in a faster and more efficient manner. The hand-held computer also will be lighter, weighing less than 2 pounds, with better speaker phone quality.

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