This report describes current research investigating the use of wireless handheld computers at Southern Health and the Royal Women's Hospital (two major teaching hospitals in metropolitan Victoria, Australia) to determine the impact on patient safety and quality of care. There is a need for real-time point-of-care access (and input) to patient information, nursing reference information, and drug information for nurses in Australian hospitals. The use of mobile technologies including personal digital assistants and both laptop and tablet computers for healthcare personnel has increased exponentially. Since their introduction in the early 1990s, handheld computers, also known as personal digital assistants (PDAs), have become the most frequently used of these technologies, providing access to diagnostics, references, and decision support systems as well as e-prescribing of patient information and dictating of notes. The increasing complexity of the healthcare system makes the PDA a necessary work tool for clinicians because it provides an effective system for preventing errors and adverse events. Patient safety is a national and international problem, and many countries are identifying strategies for achieving substantial improvement in the quality of healthcare. In all developed countries, mobile information technology is seen as a way of improving patient safety and quality of care by enhancing communication and delivering clinical decision support in real time. However limited research has been undertaken in this area, and more research is needed to evaluate the effects of the technology on important patient health outcomes in various health settings.

The specific research questions are these:

1. Does the use of wireless PDAs enhance information and decision support by nurses in real time with the patient?

2. Does the use of wireless PDAs assist nurses in detecting or preventing adverse events?

3. What factors influence implementation of the wireless PDAs by nurses in the clinical units? This project aims to address this need by providing nurses with wireless handheld access to such resources.

Both quantitative and qualitative methods are being used to collect data. The quantitative method is quasi-experimental, using a nonequivalent experimental group design to provide data for measuring the effectiveness of PDAs in improving patient safety and quality care outcomes and for addressing research questions 1 and 2. The PDAs will be used for a 12-month trial period, and nurses in the experimental group will have access to a PDA on every shift. Focus group discussions will be conducted to ascertain how the nurses have embraced using the handheld computers and the difficulties they may have encountered in addressing research question 3.

The project is meeting its time lines. It will be completed over a 3-year period and is currently in the implementation phase. This project is extremely significant because the outcomes will provide nurses in Australia and overseas with a set of guidelines for managing wireless handheld computers in clinical units to enhance patient safety and quality of care.