Bedside Manner Goes High Tech


This semester graduate students of Pace University’s School of Computer Science and Information Systems (CSIS) are learning the practical art of software engineering as they work to create physical assessment software for nursing students at Pace’s Lienhard School of Nursing (LSN) with “bedside” PDAs (Personal Digital Assistants).


Seven graduate students of CSIS have taken the LSN nursing students on as clients as they attempt to create a software medical system for entering patient data on a held device based on the Palm OS (Operating System) for Palm Pilots.


LSN was the first nursing school in the state of New York to use a handheld computer device called the Nightingale Tracker. The Tracker assists the student in creating patient care plans by using the Omaha System, which is a nationally recognized clinical vocabulary and classification system. At the point of care nursing students can enter patient data into the Tracker and transmit their data to their faculty advisors. Not all nursing students have access to this handheld device (larger than a Palm Pilot) because of its limited availability and cost.


As part of a yearlong course in software engineering that culminates in the masters degree in computer science, CSIS graduate students are attempting to create a physical assessment data entry system for symptoms, via an interactive graphical user interface presented on a Palm Pilot that is being developed for use in hospitals and clinical agencies by nursing students.


A typical software use-case scenario opens with the entry of a patient identification onto the Palm Pilot, followed by the presentation of the image of a body.  Nurses can point to different parts of the body and that will evoke pertinent pop-up menus, check boxes, and combo boxes (drop-down list of choices with a field for text entry).  Upon request, the PDAs will display a report summarizing the physical examination with respect to fifteen realms of symptomatology (e.g. ear; eye; throat and neck; hip and thigh; knee and leg; feet and ankles; abdominal; gastrointestinal; cardiovascular; etc.).  When the nursing student completes the exam, the record is saved.  The student will be able to electronically send the computerized record to their faculty and receive clinical feedback in real time, instead of waiting until the next day for possibly critical information.


Later, the collected records are uploaded from the Palm to a database.  This technology links the instructor and student more closely and provides the ability to provide timely feedback to increase critical thinking skill development for ultimately better patient care.