Yes! Nurses everywhere tell us how hard it is to get everything done -- there's never enough time! -- and even just to remember it all. When we forget or don't have enough time our patients' safety is impacted. At last, here is help with task tracking and time management.

It is a to-do list that knows what your tasks are and when they must be done. It helps you plan your time and remember to do everything.

It builds your task list from four sources:

1. What type of unit you're working at, e.g. med-surg
2. Which shift, e.g. evening
3. Interventions your patients need, e.g. diabetes care
4. Reminders you request, e.g. page the MD if she doesn't call me back

No! You select these four things (unit, shift, interventions, reminders) from menus which require just a few taps on your iPhone or iPod Touch -- preferably while you're taking report from the outgoing nurse -- and then you're ready to start working your shift. Things are constantly changing and with a few taps you can add interventions and reminders on the fly, at any time during your shift.

Subscribe (see below) to NurseMind's online service. Login to the web site and create a fine-tuned "shift definition" (to-do list for your hospital unit). It's easy and it takes just a few minutes. Then you can share it with the other nurses on your unit. They will appreciate it!

It has all the protections required of any medical data. That is, nothing is collected or released that would identify you or any patient.

HIPAA regulates the collection and use of Protected Health Information (PHI). This is any data that could identify a patient such as name, phone number, medical record number, etc. The NurseMind app collects no PHI. For example, patients are identified only by their initials or by a nickname.

What does this mean in practical terms? It means that if you are using the NurseMind app as we recommend (not collecting patient identifiers) then you do not risk making HIPAA violations.

If you are sharing medical data (such as in our Share-Your-Brain Contest) you must first make sure that no patient identifiers are present in the data you share with us (or with anyone else).

The relevant legislation is Section 1171 of Part C of Subtitle F of Public Law 104-191 (August 21, 1996): Health Insurance Portability and Accountability Act of 1996: Administrative Simplification. It says that you must delete:

(A) Names;

(B) All geographic subdivisions smaller than a State, including street address, city, county, precinct, zip code, and their equivalent geocodes, except for the initial three digits of a zip code if, according to the current publicly available data from the Bureau of the Census:

(1) The geographic unit formed by combining all zip codes with the same three initial digits contains more than 20,000 people; and

(2) The initial three digits of a zip code for all such geographic units containing 20,000 or fewer people is changed to 000.

(C) All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death; and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older;

(D) Telephone numbers;

(E) Fax numbers;

(F) Electronic mail addresses;

(G) Social security numbers;

(H) Medical record numbers;

(I) Health plan beneficiary numbers;

(J) Account numbers;

(K) Certificate/license numbers;

(L) Vehicle identifiers and serial numbers, including license plate numbers;

(M) Device identifiers and serial numbers;

(N) Web Universal Resource Locators (URLs);

(O) Internet Protocol (IP) address numbers;

(P) Biometric identifiers, including finger and voice prints;

(Q) Full face photographic images and any comparable images; and

(R) Any other unique identifying number, characteristic, or code

We hope this helps us all stay out of trouble!

Download the NurseMind app from Apple's App Store!

It's free for the first 30 days!

After 30 days, a subscription costs: $3.99/month $39.99/year Why subscribe? With a subscription, you can: Connect to the NurseMind server and database. Use the newest tasks, protocols, precautions, shifts and hospitals. Access the growing collection of nursing resources on the server. Fine-tune protocols for your nursing unit. Share shifts and protocols with your team. Grow and monitor your work diary as your nursing career proceeds.

How do you subscribe? In the app, go to the Profile screen and click My Subscription.

You don't -- it's optional.

The app works fine without a subscription.

However, when you subscribe you get:

• The social networking features: shared to-do lists (shifts and protocols) fine-tuned for your hospital
• "Quick-refs" (phone numbers, door codes, passwords, etc.) for your hospital(s)
• Recording of your shift histories, enabling you to produce work diaries.

Every nurse benefits from these.

A work diary is a list of the shifts you've worked, including durations, locations, patient counts, and task counts. For example, you can see how many times you've given meds, done wound care, inserted NG tubes, etc.

Why do you need it? Your work diary is documentation of your work experience.  It confirms the accuracy of timeclock reports and paycheck stubs, and produces statistics about the patient populations you've served, e.g. what percentage is diabetic. We are fascinated by our nursing careers and presume you are, too. This gives us real numbers to describe them.

It also supports you with real data when you're updating your resume and when it's time for your performance review. For example, you can tell your supervisor things like, "Last year I put in 100 NG tubes... I'm good at it," and "I have had 300 stroke patients."

Here are the work diaries you can generate:

1. Shifts worked, detail -- every shift worked, with date, hours, unit, hospital/city, patient count, task count, and total of hours with subtotals by hospital.
2. Shifts worked, summary -- total number of shifts and hours worked at each hospital.
3. Tasks -- list of unique tasks done, with counts.
4. Protocols -- list of unique protocols done, with counts.
5. Precautions -- list of unique precautions taken for your patients, with counts.

At present, NurseMind runs only on Apple's iPhone, iPad, and iPod Touch. Our research tells us that this is the most popular smartphone among nurses today. If/when others such as those with Android become popular among nurses, we'll support them, too.

What about contamination? 

The handheld device is touched by gloved and ungloved fingers, before and after touching patients.

Common nosocomial (hospital-acquired) viral and bacterial infections -- often transmitted by the hands of health care workers -- include MRSA (methycillin-resistant staphylococcus aureus) and C-Diff (clostridium difficile).

The solution for this very real problem is a disposable plastic cover. Several are available:

• ShadesCases.
• CleanSleev.

When we describe our NurseMind app -- we call it a smart to-do list for nurses -- one of the first questions that comes up is, "How does it know what my to-dos (tasks) are? Wouldn't I waste a lot of time hand-entering them all at the start of my shift?"

Taking the second question first, the answer is, no, most nursing tasks belong to sets (we call them shifts and protocols) and, by making a few menu selections you select those sets, thus building your to-do list quickly and efficiently.  The process takes a minute or two and is typically done as part of receiving report from the departing nurses as you start your shift.

Here is the answer to the first question: how the to-do list is built. 

First, you select your shift -- choose it from a menu of shifts. Shifts are identified by hospital (the app contains a list of around 7000), time of day (day shift, evening shift), duration (8 hours, 12 hours), and unit (med-surg, emergency, etc.)

Next, you identify your patients. If a patient was on your shift yesterday, you simply choose them from a menu of prior patients. If a patient is new, you enter a little information about them such as their initials, room number, perhaps a few protocols (see below), and a few other details if you think you might need them. All these data elements are optional. The data entry process for a patient is quick -- a minute or two.

The protocols you selected are themselves little to-do lists. NurseMind has more than a hundred of these and the list grows daily. For example, if you select a diabetes protocol for a patient, the blood glucose and insulin tasks are added to your list.

Finally, tasks may be added to your list on the fly as your shift progreses. This happens if a new patient is admitted -- you add them as you did at the beginning of your shift -- and as new orders and requests occur. Those are termed Remind Me tasks.

Here's what happens inside the app as all this proceeds. It builds your to-do list of four types of tasks:

1. Per-Shift tasks -- those activities that you do every time on your shift, unrelated to a particular patient. These include anything that takes time, such as mandated work breaks. Other such tasks are hourly rounds, restocking carts, checking refrigerators, inventory, and so on. For the purpose of time management, every activity that takes time must be considered.
2. Per-Patient tasks -- those activities that you do for each patient on your shift, such as administering meds, setting up meal trays, and taking vital signs. If, for example, meds are passed at 11:00 a.m. in your unit and you have five patients, the 11:00 a.m. med task would be added to your to-do list five times.
3. Protocol tasks -- as described above, protocols are mini to-do lists that are added to your lists according to the individual needs of patients.
4. Remind Me tasks -- things that come up during the course of your shift such as remembering to check the results of some lab work an hour after it a sample is sent to the lab, to follow up with an MD, to return a call, etc.

Thus, NurseMind builds your to-do list intelligently and quickly, and keeps it up to date as your shift progresses.

How does NurseMind build my to-do list?  Do I have to tell it what all my tasks are?  Wouldn't that take a long time?

Based on the notion that most nursing tasks are routine and belong to task sets of various kinds, NurseMind uses an efficient method to build your to-do list.  Make a few selections from a few menus and you're done.

This diagram tells the story. The details are here in the user manual.

Though NurseMind appears to be just an app -- as with any of them, you download it and run it on your iPhone -- it is much more than that. When you use NurseMind, the main thing you get is a service. The service is delivered by the app, but behind the scenes is substantial infrastructure and data. Here are the details.

When you use NurseMind, the app connects over the Internet to a database on the www.nursemind.com server and a set of support programs. These enable the app to do its job. The app itself is just the visible part of a larger system.

There is also a support team. Unlike most free or cheap apps in Apple's App Store, NurseMind has people who answer questions, coach in its usage, and help resolve problems. We respond quickly and thoroughly. Your success is our success.

Most importantly, the data that gives the app its value -- deep knowledge of the content and process of modern nursing -- is maintained and updated frequently. New shifts and protocols are added and perfected every week. The app accesses them in real time. Thus, you can be confident that you are using the newest and most finely-tuned information.

You can also create your own shifts and protocols, fine-tuned for the way your hospital and unit do their work. Connection to the server enables you to save them, adding them to the database. Best of all, you can share them with the other nurses in your hospital and multiply the value of your work. This can add to the quality of the nursing work in your hospital and unit, and can become a best practice, recognized by management and appreciated by your colleagues.

Your subscription to the NurseMind service gets you all this. It is much more than "just an app"!

Contact us! Unlike most apps, this one has a real company behind it. We answer emails and phone calls. Your success is our success.

Yes, EMRs (electronic medical records) do some of what NurseMind does, but there are subtle yet important differences that fill a unique, unmet nursing need.

EMRs are order-driven and chart-centered, yet many nursing tasks do not come from orders and are not charted. Such activities include taking report, taking breaks, stocking rooms and carts, and routine patient care tasks such as hygiene and feeding. To effectively manage his or her time, the nurse must budget for all these -- charted and uncharted, ordered and not ordered, billed and not billed -- yet the EMR does not support this aspect of nursing work.

To do effective time management, the nurse must plan for everything he or she does that takes time, regardless of whether the EMR keeps track of it. That's what NurseMind does: it knows what nurses do -- everything they do -- and it supports the remembering and planning that it takes to do all these things completely and well.

Look at this question financially. Much of what comprises nursing service is rolled into a hospital's room rate. Most routine nursing activities are not distinct, billable line items. Thus, there is less incentive to track them in EMRs.

Perhaps the most useful way to describe the difference between NurseMind and an EMR is that EMRs are patient-centric whereas NurseMind is nurse-centric.  That is, the EMR serves primarily to meet the needs of the patient whereas NurseMind is a tool by and for nurses. It exists to help them be more effective and efficient in their work.

An example of the patient-centric nature of EMRs is that most are capable of displaying a nursing care plan-driven task list for a given patient, but not for all of a given nurse's patients combined into a single task list. Yet, such a list is extremely helpful to the nurse in setting priorities.

If you can see everything -- for all your patients -- that you need to do right now, you can choose from that list the action that's most important. This is one of the hardest parts of your job: deciding at any given moment which, of all the actions that await you, to do next. Given a list to choose from, this challenging cognitive task is made easier.

Yes! It will help you be certain you get everything done, on time, every time. And it will make your instructor confident in your performance. Here's how:

• With your instructor, decide what tasks you must accomplish on each shift.
• Capture this list in a NurseMind shift definition. Several templates are available that you can adapt for your own rotations.
• Use NurseMind on each shift, from start to finish.
• Start it running and set up your patients as you take report.
• From the list, select the next task -- your highest priority at the moment -- and do it.
• Check off each task once you've done it.
• Look at the list to make sure nothing is late and nothing is forgotten.
• Task icons turn yellow when they're due, red when they're late, and green when they're done.
• Use the Remind Me feature to add new tasks and protocols as they come up.
• Review the list to see what you accomplished on your shift.
• In the Advanced menu, you can choose Work Diary and email the list of what you did to yourself or to your instructor.

Your school, too, will love NurseMind.

Read more...