"Bring your own device" to work tech trend helps nurses provide improved patient care

Main Category: Nursing / Midwifery
Also Included In: IT / Internet / E-mail
Article Date: 15 Aug 2013 - 2:00 PDT Current ratings for:
"Bring your own device" to work tech trend helps nurses provide improved patient care

Not long ago, hospital IT departments supplied and maintained the hardware and software that nurses used to perform work-related tasks. Then came the mobile revolution, when consumers increasingly began carrying smartphones and tablets to assist them in their personal lives as well as in business. As a direct result, many nurses today are following the trend known as BYOD - bring your own device.

"RNs have greater familiarity with their own devices and the more familiar they are, the greater the tendency there is for nurses to optimize the use of the device to its fullest capacity for improved patient care," says Judith Church, DHA, MSN, faculty member in the health care and health care informatics programs at American Sentinel University.

A recent survey by Fierce Mobile Healthcare found that 61 percent of hospitals and health systems responding said that half their employees use personal mobile devices for work. Fifty percent said this use was limited to email and calendar applications, but 36 percent said that employees were accessing patient data.

Another report, Point of Care Computing for Nursing 2012, examined the BYOD patterns of nurses and found that 69 percent of hospitals say their nursing staff is using personal devices at work.

The Pros and Cons of BYOD in Nursing
Church says that BYOD can increase productivity or job performance because people are more comfortable with their own device, have more control over the computing environment and enjoy an enhanced sense of work-life balance, to name a few benefits.

The nurses surveyed in the report specifically stated they use their own mobile devices to improve patient safety and reduce the risk of medical errors. They believe their personal devices enable them to fill in critical communication gaps with the technologies provided by the hospital - for example, allowing them to easily access clinical reference materials at the point of care or quickly communicate with other clinicians to coordinate care.

Yet, BYOD can put IT departments in the difficult position of having to provide support for all these personal devices.

For example, IT might have to build a platform that will ensure hospital software works on all four mobile operating systems (Apple, Android, Microsoft Windows and Blackberry). These diverse devices also create security and HIPAA issues associated with mobile technology.

"The drawback to BYOD in nursing is that it contributes to a non-standardization of a work arena's equipment," says Church. "Nurses should realize that IT policies exist for a reason to protect data integrity and security and should adhere to them at all times when participating in a BYOD initiative."

Using BYOD to Improve Nursing Workflows
Integrating BYOD with nursing call systems can improve both staff and patient satisfaction. Call systems based on overhead paging or lights that can only be seen from the nursing station may soon become obsolete in favor of newer systems that can wirelessly transmit alerts right to a nurse's smartphone when the patient pushes a button.

Alerts can take the form of text messages, emails, pages or phone calls. In some cases, patients may be able to send a specific type of alert - a request for bathroom assistance or pain medicine, for example - that are then routed to the appropriate staff person.

"BYOD can play a significant role in nursing to improve workflows," says Church. "The individual device and user prowess will contribute to optimal standardization of devices across the physical and electronic work environment."

Church points out that BYOD is a trend that will continue in health care because of its financial implications.

"The BYOD trend will thrive in nursing because health care organizations save money when the employee purchases the device. Since nurses are most familiar with their own devices, they will work more effectively and efficiently. Equipment - no matter what it is - is only as effective as its setup and use," adds Church.

It's clear that health care must find ways to reap the benefits of mobile technologies, while reducing the risks and protecting patient data.

"BYOD initiatives should be expanded to include nurses as well as physicians in order to increase nurse productivity and improve patient care and satisfaction," adds Church.

For more information about American Sentinel University's MSN, nursing informatics specialization, please visit http://www.americansentinel.edu/health-care/m-s-nursing/m-s-nursing-nursing-informatics.

Article adapted by Medical News Today from original press release. Source:

American Sentinel University

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Prisons and partner organisations must do more to provide health and social care to growing population of older prisoners, UK

Main Category: Public Health
Article Date: 14 Aug 2013 - 2:00 PDT Current ratings for:
Prisons and partner organisations must do more to provide health and social care to growing population of older prisoners, UK

More needs to be done in prisons to look after a growing population of older male prisoners, according to research by The University of Manchester.

The findings, just published by the National Institute for Health Research (NIHR) Journals Library in Health Services and Delivery Research, showed 44% of prisons do not have a policy on the care and management of older prisoners and there was a lack of integration between health and social care services.

Planning for an older prisoner's release from jail was also frequently non-existent leading to their health and social care needs not being met once they were out in the community - unless they lived in probation-approved premises immediately on release.

Professor Jenny Shaw, from the Offender Health Research Network based at the Institute of Brain Behaviour and Mental Health at The University of Manchester, said specialised assessments were required for older patients because they have more complex health and social care needs than their younger counterparts and those of a similar age living in the community.

Earlier studies have shown approximately 85% of older prisoners having had one or more major illness with the most frequently reported health conditions being cardiovascular diseases, arthritis, back problems, respiratory diseases and depression. They are also at greater risk of becoming isolated and are less likely to have social support, putting them at a greater risk of developing mental health difficulties.

The Manchester research, led by Professor Shaw, looked at serving male prisoners over age 60 at all prisons in England and Wales.

It found some positive improvements including that the number of prisons appointing a member of staff to act as an Older Prisoner Lead had increased in recent years. But these staff did not all appear to be fully active in their roles in tailoring and improving services for older prisoners.

The study also found the Department of Health's recommendation to provide older prisoners with a specific health and social care assessment when they arrived at prison was largely unmet.

Professor Shaw said: "There seems to be ambiguity regarding the responsibility for older prisoners' social care. We also found that the geographical organisation of social services can result in the responsible social service being located a considerable distance from where prisoners are being held. In such instances, local social services do not co-ordinate their care."

"Older prisoners have on average almost three unmet health and social care needs on entry to prison and the most frequent unmet need was in relation to knowing where to get information about their care. We are now calling for a series of improvements to be made."

Suggested improvements include housing older prisoners near to where they will live when they are released to improve the co-ordination of their care and a thorough health and social care entry assessment for all older prisoners which is then reviewed throughout their sentence. Guidelines also set out how to systematically address these health needs during a prisoner's sentence and will now be piloted at a number of prisons in England.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Health and social care services for older male adults in prison: the identification of current service provision and piloting of an assessment and care planning model

Health Services and Delivery Research - DOI: 10.3310/hsdr01050

Senior J, Forsyth K, Walsh E, O'Hara K, Stevenson C, Hayes A, Short V, Webb R, Challis D, Fazel S, Burns A, Shaw J

The University of Manchester

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Tumor suppressor may provide clues for improved treatment for neuroblastoma

Main Category: Neurology / Neuroscience
Also Included In: Cancer / Oncology;  Stem Cell Research
Article Date: 14 Aug 2013 - 0:00 PDT Current ratings for:
Tumor suppressor may provide clues for improved treatment for neuroblastoma

Loss of a gene required for stem cells in the brain to turn into neurons may underlie the most severe forms of neuroblastoma, a deadly childhood cancer of the nervous system, according to a Ludwig Cancer Research study. Published in Developmental Cell, the findings also provide clues about how to improve the treatment of this often-incurable tumor.

Neuroblastoma can appear in nervous tissue in the abdomen, chest and spine, among other regions of the body, and can spawn body-wracking metastasis. The most severe tumors respond poorly to treatment, and the disease accounts for 15 percent of cancer deaths in children.

Johan Holmberg, PhD, at the Ludwig Institute for Cancer Research Stockholm took a close look at the role of the CHD5 tumor suppressor during normal nervous system development. Previous studies had shown that the gene CHD5 is often inactivated in the most severe forms of neuroblastoma, but little was known about its function in healthy tissue or how it operates. The study, which was conducted in close collaboration with colleagues at Trinity College, Dublin, Ireland, addressed these two key issues.

The researchers found that CHD5 is required for the cellular transition from a stem cell to a mature neuron. In one experiment, the researchers knocked down the CHD5 gene by injecting a small RNA into the brains of fetal mice while in the womb.

"The result was a complete absence of neurons," says Ludwig researcher Holmberg who is based at the Karolinska Institutet. "Instead of becoming neurons, the cells with CHD5 knocked down stayed in a limbo-like state between an actively-dividing stem cell and a mature nerve cell. It was a very robust effect," added Holmberg.

The researchers also dissected how CHD5 operates, showing that it sticks to certain modifications of histone proteins. These modifications help control how genes are turned on and off. In the absence of CHD5, key stem cell genes are not turned off, and genes required for neuronal maturation are not turned on. The findings highlight how the failure of a cell to properly mature into its terminal state can underlie cancer, a relatively understudied area of research.

"It is necessary for cells in the healthy nervous tissue to be able to go from stem cells to neurons," explains Holmberg. "If you lose this capacity, these cells become locked in an immature state, which might yield quite dangerous tumor cells, especially in combination with additional cancer-promoting cellular events."

The research could also lead to new ways to treat neuroblastoma, perhaps using currently approved drugs. One component of neuroblastoma treatment is retinoic acid, a drug that can drive neuronal maturation. Holmberg and his colleagues found that knocking down the expression of CHD5 in more benign neuroblastoma cells blocked their capacity to mature in response to retinoic acid treatment. "These cells were completely insensitive to treatment, no matter how much we gave them, mirroring the same unresponsiveness to retinoic acid in the more malignant CHD5-negative neuroblastoma cells," says Holmberg.

The results of these cell-based experiments are consistent with clinical findings that retinoic acid is often unsuccessful in patients with severe forms of the disease. Holmberg reasons that if CHD5 could be re-activated in such hard-to-treat patients, it might increase responsiveness to retinoic acid. The findings may also have relevance for other types of tumors. For instance, CHD5 is often inactivated in glioblastoma multiforme, the most common and most aggressive form of brain cancer in adults.

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Funding for this research came in part from Science Foundation Ireland; the Health Research Board; the Swedish Cancer Society, the Swedish Research Council, the Lilian Sagen and Curt Eriksson Research Foundation; DBRM; the Swedish Childhood Cancer Foundation; the Danish National Research Foundation; the Lundbeck Foundation; and the Novo Nordisk Foundation.

CHD5 Is Required for Neurogenesis and Has a Dual Role in Facilitating Gene Expression and Polycomb Gene Repression

Developmental Cell, Volume 26, Issue 3, 223-236, 12 August 2013. 10.1016/j.devcel.2013.07.008

Ludwig Institute for Cancer Research

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