Valuable
Decision Making Apps for NP Learning
ELLEN
D. JONES
Mr. Jones is a 55 year
old male who presents for a 15 minute office visit for a “complaint of fatigue
and frequent urination.” Mr. Jones has not been seen in the office for 18
months. He stated he usually was seen in a convenient urgent care on the road
while traveling as an Executive Salesman. He stated that he was in a hurry because
he had a plane to catch in 4 hours. He said his wife told him he had a UTI and
needed antibiotics.
V.S. from the CNA: Temp 98.F; BP 150/90; P 72; R 18; BMI 30;
UA negative for WBC, Blood, or Nitrites
The NP Student has 15
minutes to determine the appropriate history including Family; ROS; Physical
Exam; Labs; Assessment; Plan; and Follow up. The clock is ticking. Mr. Jones is
getting irritable with the questions because he has a plane to catch and a
simple UTI. He only came in because his wife stated he needed antibiotics.
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T |
he
NP student reaches for her iPad. Seem all too familiar? NP students are aware
that software, reference books, and healthcare applications software (Apps) are
readily available and affordable to assist in patient decisions. Software
providers, healthcare organizations, specialty groups, and entrepreneurs are
creating Iphone/Ipad/Android and point of care digital Apps and releasing them
quickly to the public. Since there is little industry control regarding the
release of software Apps that is similar to the critique found in evidenced
based textbooks, journal manuscripts, and online software such as Up to Date
and Dynamed, it can be difficult to recommend Apps that are safe for use in
healthcare decisions. Reliable sources in healthcare are often very expensive
and may be available to NP students at discounted rates or available from their
university or practice site; but, they are attached with cumbersome logins and
passcodes. Apps are downloadable to the
individual hardware unit making them easy to access and are often offered free
of charge or inexpensively, making them very attractive for the NP student
user.
Select Apps that have been designed based on
quality healthcare information. Was the App produced from a quality healthcare
organization? Has the App been endorsed by reputable healthcare organizations?
It can be difficult to determine the development of an App. The best practice
is to be directed to an App from the Official Website of the organization. For
example, if you go to the US Department of Health and Human Services, Agency
for Healthcare Quality and Research Official Website at http://www.ahrq.gov/clinic/ppipix.htm and
select the Electronic Preventive Services Selector (ePSS) you
will be directed to following webpage http://epss.ahrq.gov/PDA/index.jsp that
details how the AHRQ preventative services App can inform patient decision
making by offering useful information in respect to an individual’s individual
health promotion and prevention needs. This App is a reliable and useful
resource for NP students and providers (iMedical Apps Team, 2010; Steinberg,
2011).
Companies that offer decision making Apps
with a degree of confidence to the provider are Skyscape products http://www.skyscape.com/index/home.aspx and
the Medscape App http://itunes.apple.com/us/app/medscape/id321367289?mt=8
(iMedical Apps Team, 2010). An excellent resource to review medical
applications based on professionals before you download is iMedical Apps (2010)
that can be found at http://www.imedicalapps.com/. Pharmacy
resources can be found online at Pharmacy Times http://www.pharmacytimes.com/web-exclusives/8-Must-Try-Apps-for-Pharmacists
(Enderle, 2011).
Online Nurse Practitioner Education (2012) has listed 20 revolutionary
applications for Nursing on their website. These applications range in price
and degree of usability for the NP student. To search and download Apps on a
device the user must have an account with an online store such as ITunes. Go to
the online store on the device and search categories such as medical for the
top selling and highest rated Apps. If you cannot find for what you are looking,
you may search the field based on key words for available Apps. Remember that
price does not necessarily reflect quality in the App world. Images are
expensive and Apps that have the ability to illustrate in 3 D will be more expensive
to develop and purchase (Skiba, 2010; Steinberg, 2011).
Below Tables 1, 2, 3, and 4 list examples of applications
that NP educators may suggest with confidence for students to use in the
clinical area for point of care patient decisions. Depending on the NP
specialty, there may be more specific Apps for certain areas such as Cardiology
or Women’s Health. Explore. There are hundreds of Apps. Just make certain it is
from a reputable source.
Table 1. Pharmacy Applications
|
Application |
Product Description
from Source |
Approximate Cost |
|
ePocrates |
ePocrates
offers free to more costly medical PDA software including drug interactions
and infectious disease databases |
Free to
$300 |
|
Lab
Values Pro |
Lab
Reference |
$2.99 |
|
Learn
Muscles: Anatomy Quiz and Reference |
A
great reference, testing and education tool. Includes 141 beautiful muscle
images with name, action, origin, insertion and comments, plus audio
pronounciation guide, a quiz maker, an action viewer and 6 short videos to
create a rich learning experience. |
$2.99 |
|
LexiComp |
Lexicomp, the most trusted and comprehensive
resource for mobile drug and clinical information for pharmacists, and
healthcare providers. |
$50 to
$300 |
|
MedScape |
Medscape
from WebMD (medscape.com) is the leading medical resource most used by
physicians, medical students, nurses and other healthcare professionals for
clinical information. |
Free |
|
Micromedex
|
Thomson Reuters Micromedex is the most
reliable, trusted name in evidence-based clinical reference. |
Free |
|
OTC
Guide |
As the
most accessible health care provider, pharmacists are in a unique position to
help consumers make the most educated choices about which over-the-counter
(OTC) products to use for the whole family. |
$3.99 |
|
PocketPharmacist |
The
Tool for Prescription Drugs and Medications |
$1.99 |
|
Shots
by STFM |
Updated
with 2012 CDC Immunization Schedule |
Free |
|
Tarascon
Prescriber |
Tarascon
contains vital information on thousands of drugs and antimicrobials to help
clinicians make better decisions at the point-of-care. |
$59.00 |
Table 2. Assessment and Diagnosis
|
Application |
Product
Description from Source |
Approximate
Cost |
|
AHRQ
ePSS |
The
ePSS application was developed to assist primary care clinicians identify the
screening, counseling, and preventive medication services that are
appropriate for their patients. |
Free |
|
Calculate
(QxMD
software) |
Calculate is a next-generation clinical calculator
and decision support tool for iPhone, iPad, Android and BlackBerry, freely
available to the medical community. |
Free |
|
Contraception
i-Pocketcards |
Nuts
and bolts of Contraception. |
$3.99 |
|
Eponyms |
Webster’s
definition of Eponym is: one for whom or which something is or is believed to
be named. This app contains over 1700 of these medical eponyms with
short descriptions of each – A nice learning tool for students. |
Free |
|
Infectious
Disease Compendium |
A
hyperlinked guide to Infectious Diseases. Over 600 pages of information on
antibiotics, organisms and diseases. |
$5.99 |
|
iRadiology |
iRadiology App, a free learning tool that provides
over 500 radiologic cases to learn from. |
Free |
|
iTriage |
iTriage is a free medical app that allows you to
check symptoms, find the closest doctors, and research diseases and medical
procedures. |
Free |
|
LabDx |
LabDx
is the application for medical students, doctors, nurses and other healthcare
professionals who need quick access to information on over 200 laboratory
tests. |
$9.99 |
|
MedCalc |
MedCalc
gives you easy access to complicated medical formulas, scores, scales and
classifications. |
$0.99 |
|
MedPage |
MedPage
Today Mobile puts breaking medical news, comprehensive drug information and
CME/CE credits at your fingertips, with daily coverage of over 30 specialties
and annual coverage of over 60 meetings and symposia. |
Free |
|
MedicalRadio |
MedicalRadio
allows you to keep up to date with changing clinical guidelines. |
Free |
|
MedScape |
Medscape from WebMD (medscape.com) is the
leading medical resource most used by physicians, medical students, nurses. |
Free |
|
MSK
Radiology Teaching File |
MSK
Radiology is the lite version of Radiopaedia.org’s Radiology Teaching
Files: Volume 3, an app designed to teach radiology. Although this is a
lite version, I was surprised to find out how much information it packs in 10
full cases. |
Free |
|
NeuroMind |
It’s a
great tool for medical students, neurology residents, and even
neurosurgeons. It contains a wide range of information, from basic
neuro-anatomy to the WHO Safe Surgery checklist items |
Free |
|
Pneumonia
Guide |
Pneumonia
distills and organizes the guidance found in the 2005 and 2007 American
Thoracic Society & Infectious Disease Society of America guidelines on
management of Community Acquired Pneumonia, Healthcare Associated Pneumonia,
and Hospital Acquired Pneumonia. |
Free |
|
Rx-Bayes |
Significantly
enlarged database of tests – sensitivity & specificity data for over 100
tests. |
$0.99 |
|
Visual
Dx |
This
new medical app combines physician-reviewed clinical information with
THOUSANDS of medical images from renowned physician and institutional
collections. The only medical application to represent the variation of
disease presentation through age, stage, and skin type, VisualDx Mobile
addresses the key complexities faced by many clinicians today when diagnosing
dermatologic and other visual conditions. |
Free
Trial |
|
Wikipanion |
Direct
access to Wikipedia…it is a top rated app and worthy of a mention. |
Free |
Table 3. Medical Translators and Dictionaries
|
Application |
Product Description
from Source |
Approximate Cost |
|
Google
Translate |
Translate
words and phrases between more than 60 languages using Google Translate for iOS |
Free |
|
MediBabble |
MediBabble
is a free, professional-grade medical translation tool. |
Free |
Table 4. Apps for Geriatrics
|
Application |
Product Description from Source |
Approximate Cost |
|
Includes
essential information about four must-have vaccines for seniors -- the flu,
pneumococcal, herpes zoster, and tetanus/diphtheria immunizations. It also
includes information about five additional vaccinations that older travelers
going abroad may need. For each of the four must-have vaccinations, the
application includes suggested “Talking Points with Patients.” |
Free |
|
|
Geriatrics
At Your Fingertips™ is an essential tool for all healthcare providers and
trainees who care for older adults. It contains specialized, up-to-date
evaluation and management strategies for common geriatric conditions and
disorders. |
$19.99 |
|
|
The
Geriatrics Cultural Navigator was developed from the Doorway Thoughts series
of books published by the American Geriatrics Society. |
Free |
|
|
Developed
to assist healthcare providers in managing psychotic symptoms and disorders
in older adults. It is based on two publications of the American Geriatrics
Society (AGS) (www.americangeriatrics.org), the 2010 edition of The Geriatrics
Review Syllabus and 2011 edition of Geriatrics At Your Fingertips. |
|
About
the Author Ellen Jones, DNP, FNP-C, FAANP, is an
Associate Professor at the University of North Carolina Greensboro. Contact Dr.
Jones at ellen_jones@uncg.edu
References
Enderle, L. (2011, December 27). 8 Must Try Apps for
Pharmacists. Pharmacy Times.
Retrieved from http://www.pharmacytimes.com/web-exclusives/8-Must-Try-Apps-for-Pharmacists
iMedical
Apps Team. (2010, February 15). Top 10 Free iPhone Medical Apps for Health
care Professionals. Retrieved
from http://www.imedicalapps.com/2010/02/top-10-free-iphone-medical-apps-for-health-care-professionals/10/
Online Nurse Practitioner Schools. (2012). 20 Incredible iPad Apps That Will
Revolutionize Nursing. Retrieved from http://onlinenursepractitionerschools.com/20-incredible-ipad-apps-that-will-revolutionize-nursing/
Skiba,
D. J. (2010). Back to School: What's in Your Students' Backpacks? Nursing Education Perspectives, 31(5),
318-320.
Steinberg, J. (20ll, October 25). Medical Resources for your IPhone/IPod/Touch. Society of
Teachers of Family Medicine. Retrieved from http://www.fmdrl.org/2423.