Handheld Computer Devices to Support Clinical Decision-making in Acute Nursing Practice: Systematic Scoping Review

Area of Science:

• Nursing Informatics
• Health Technology Assessment
• Clinical Decision Support Systems

Background:

• Computerized information systems and decision support aids are increasingly integral to nursing care.
• Exploration of handheld computer devices (HCDs) in nursing practice remains limited.

Purpose of the Study:

• To understand the professional and clinical impacts of mobile health apps in nursing for acute care clinical decision-making.
• To explore the scope of published research and identify key nomenclature for HCDs in nursing.

Main Methods:

• A scoping review was conducted using a tripartite search of CINAHL, Embase, MEDLINE, and Google Scholar.
• Included studies were hand-searched for additional citations, and quality was appraised by two independent researchers.

Main Results:

• 28 studies were included, investigating HCD impact on nursing decisions, care effectiveness, safety, quality, usability, uptake, and acceptance.
• Studies exhibited moderate-to-high risk of bias, with heterogeneous terminology for HCDs across three technology platforms.
• Interventions varied in decision-making support, from unstructured clinical judgment to computerized algorithmic judgment.

Conclusions:

• Existing literature suggests HCDs can effectively support acute nursing care, but high-level evidence is scarce.
• Further research is required to investigate the impact of HCD implementation on nursing care delivery workflow.
• Rigorous experimental designs are needed to determine the full potential of HCDs in optimizing acute nursing care.