The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

THE USE OF A PERSONAL DIGITAL ASSISTANT (PDA) FOR ONGOING DATA COLLECTION SAVES SIGNIFCANT TIME IN A LARGE, URBAN, TERTIARY CARE FACILITY

Russell T. Reid, BBA, RCP, RRT, CPFT Mike Scotton, BA, RCP, RRT, Carolinas Medical Center, Charlotte, NC

Background:
The Department of Respiratory Care at Carolinas Medical Center, an 843 bed tertiary care center, is involved in multiple projects requiring the collection, organization and analysis of large data sets focused on improving patient care and patient outcomes. A clinical specialist assigned to our Pulmonary Best Practices project, which is a multidisciplinary approach to comprehensive management of the mechanically ventilated patient, is required to collect data on a daily basis for as many as 20 mechanically ventilated patients. The data set for this project includes 51 elements including the status of mouth care, clinical rotational therapy, hours of rotational therapy per day, nutritional needs assessment, weaning status, number of hours out of bed, number of hours sitting up, temperature, sedation protocol status, use of paralytics, respiratory treatments and additional data that is shared among the disciplines involved. This data was being collected manually on a data collection tool and then entered into a Microsoft Access database. The data was being captured twice; once on paper and again in the database. In order to eliminate the manual collection of data at the bedside it was necessary to initially capture this data electronically. The device selected needed to be portable, possess sufficient battery life, be safe to use in the clinical setting, be reliable and durable.

Method: We chose to use a Visor Prism Personal Digital Assistant (Handspring Corporation), which uses a Palm Operating System (Version 3.5), equipped with a color screen and 24 megabytes of Random Access Memory (RAM). In order to transfer data directly into a secure, encrypted Microsoft Access database we chose a product called Pendragon Forms (Pendragon Software Corporation) which allows the creation of a data collection interface on the PDA and allows transfer of data during a "Hot Sync" into the Microsoft Access database using an Open Database Connectivity (ODBC) connection. The database can then be used to produce reports which can be used to analyze practice patterns, identify opportunities for improvement and provide a repository for historical data comparison. Implementation of the system required approximately 5 hours of development time for the PDA system interface.

RESULTS: Prior to implementation of the electronic data capture system the clinical specialist was spending an average of 6.0 hours a day performing data collection and entry, which meant that it was easy to fall behind. After implementation of the electronic data collection system this was reduced to an average of 3.0 hours per day for a savings the equivalent of .37 FTE annually. Total cost to implement the bedside data collection system was $546.12 as shown in Table 1. 

Item Cost
Handspring Visor Prism  $279.65
16 MB Memory Module $49.99
Pendragon Forms Software $101.48
PDA Interface Development Time $115.00


Table 1. Cost of hardware and software for an electronic bedside data collection system.

Experience: One of the authors has a degree in Information Systems and experience with respiratory care database management systems (RCDMS). Both authors have many years of experience with data collection for quality assurance, process improvement and research purposes.

Conclusions:
The use of a PDA for ongoing data collection resulted in a labor savings of the equivalent of .37 FTE. This meant that the system paid for itself in approximately two weeks. Additionally, the clinical specialist is able to take the PDA on rounds which allows immediate access to patient information which is valuable during bedside discussions with the team. 

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