Each task is represented on the iPhone as an icon. The app knows not only what you need to do but also when. When a task comes due, it floats to the center of the screen. When its deadline is within fifteen minutes, it turns yellow. If it's late, it turns red. You mark it done once you've done it. That turns it green. The essential concepts are familiar -- deadline, status (done, not done), etc. -- these are described in detail below.
NurseMind is a smart to-do list:
- It knows what you need to do (your tasks) on your shift.
- It knows when each task needs to be done.
- It keeps track of the status of each task and displays it with a color (clear=not yet due, red=late, green=done)
Here are the concepts in NurseMind. (Click for detail.)
A task -- Something you need to get done.
- Most tasks are associated with specific patients. For example, passing meds is a task you must do on every shift for every patient. So if you have five patients, then you will have five meds tasks to do on your shift, or ten if you give meds twice on the shift.
- When you've done a task, check it off your list. NurseMind records this with a timestamp. It keeps track of what you did and when.
- Some tasks have data fields to make note-taking easy. For example, the Vital Signs task has Temperature, Respiration Rate, Pulse, Blood Pressure, SpO2, and Pain. Tasks related to diabetes have Blood Glucose Level, Insulin Units and Insulin Type fields.
- Tasks and data fields can be flagged. To do this, you simply switch the Flag switch to the "on" position. If later you click the SBAR (Situation-Background-Assessment-Recommendation) button, all your flags are shown. This is useful for remembering things you are concerned about, especially when you give report at the end of your shift.
A task deadline -- When is the task due? The deadline is relative to one of:
- Start of shift -- e.g. you must take report no later than 30 minutes after your shift starts.
- Start of protocol -- e.g. you must obtain vital signs within 60 minutes after a patient is admitted (per hospital policy -- your hospital's may differ). Note that the tasks and timings of an admission comprise a protocol.
- End of protocol -- e.g. all the pre-op patient preparations must be completed by the time the patient is to go for a surgical procedure, so, for example, antibiotics must be given 30 minutes before the procedure.
A task status -- Has the task been done? Is it late? Task status is one of:
- Not done but not yet late -- clear.
- To be done now (deadline is within 15 minutes) -- yellow.
- Late (deadline has passed) -- red.
- Done -- green.
- Discharged or deleted (the task has been dropped from this shift though it's still in the shift definition) -- task no longer shown.
A protocol -- A set of tasks needed by a particular patient in addition to those that are standard in every shift.
- For example, if your patient is immobile, then you will need to turn them every two hours to prevent pressure ulcers. If your shift is eight hours long, then selecting this protocol will add four turn-the-patient tasks to your shift.
- Here are the protocols currently implemented in the app. Users add more protocols as they need them and the list is growing all the time.
A shift definition -- The standard tasks to be done in a shift.
- For each type of hospital unit or clinic where nursing care is provided (med-surg, emergency, oncology, telemetry, ICU, etc.) NurseMind has a task list.
- This task list is called a shift definition -- it lists the tasks that a nurse typically does when working a shift.
- "Defining a shift" consists of selecting a set of tasks that the nurse does for every patient on every shift.
- This list may vary from one hospital to another.
- It also varies by time of day; evening shift's tasks are different from those of the day shift.
- You can take a generic shift definition and add and delete tasks to fine-tune it for the way your hospital runs. Thereafter, you will use your fine-tuned shift definition instead of our generic one.
A precaution -- special care needed by a patient.
- Some patients have conditions that require you to provide their care differently. For example, if a patient with difficulty swallowing needs feeding and medication administration tasks performed differently; bring thickeners for liquids, and bring applesauce to mix with crushed pills.
- The icons for these patients -- those to whom you have assigned "precautions" -- are displayed with "P" badges. This helps you remember that special care is required.
- Precautions include allergies, fragile skin, contact precautions, isolation precautions, risk for falls, NPO, and more.
A generic patient -- a reusable patient record with a "canned" to-do list.
- Especially in fast-paced units such as Emergency Departments where turnover is quick and stays are brief, there isn't time to setup each new patient in the app. Instead, you can select the type of patient (e.g. Abdominal Pain, Abnormal Vital Signs, Back Pain, Constipation, etc.) from a menu of "Generic Patients". The patient is then created in the app with the appropriate protocol and the setup process is completed with just two or three clicks.
- In an ED, most visits are for about two dozen reasons, thus about two dozen pre-defined Generic Patients suffice. However, it is easy to create more when they are needed.
- Recall that NurseMind is a to-do list not a medical record. Thus, it is okay -- even desirable, for economy of effort -- to reuse Generic Patient records. It is only the to-do list that is being reused, not medical data about the patient.
A nurse profile -- ID and preferences.
- Email (also serves as ID)
- Handle (nickname)
- Late task notification style (ring/vibrate/silent)
- Fahrenheit or Centigrade -- personal preference overrides nursing unit's
- Kgs or lbs -- personal preference overrides nursing unit's
- 12- or 24-hour clock -- personal preference overrides nursing unit's
- Verbose/terse -- give occasional messages about what's going on inside the program and its connection to the web server
- Novice/expert -- detailed instructions and labels (or not)
- Preferred text size: small, medium, large (default medium)
- Subscription status (paid up? lapsed?)
- Last login
- You can click the Flag checkbox to flag any task or datum (e.g. blood pressure).
- When you push the SBAR button, all the flagged tasks and data will be shown.
- This helps you remember things you want to follow-up, mention in shift report, or SBAR.