Documentation of Emergency Medicine Resident Procedures Using a Personal Digital Assistant

• Published in: Academic emergency medicine 2003-05, Vol.10 (5), p.537-538
• Main Author: Lane, D. R
• Format: Article
• Language: English
• ISSN: 1069-6563; 1553-2712
• DOI: 10.1197/aemj.10.5.537-b

BACKGROUND: Personal Digital Assistants (PDAs) have been integrated into daily practice for many emergency physicians and residents. Few objective data exist that quantify the effect of PDAs on documentation. OBJECTIVE: The objective of this study was to determine whether use of a PDA would improve emergency medicine resident documentation of procedures and patient resuscitations. METHODS: Twelve first-year residents were provided a Palm V (Palm, Inc., Santa Clara, CA) PDA. A customizable patient procedure and encounter program was constructed and loaded into each PDA. Residents were instructed to enter information on patients who had any of 20 procedures performed, were deemed clinically unstable, or on whom follow-up was obtained. These data were downloaded to the residency coordinator's desktop computer on a weekly basis for 36 months. The median number of procedures and encounters performed per resident over a three year period were then compared with those of 12 historical controls from the previous residency class that had recorded the same information using exclusively a handwritten card system for 36 months. Medians of both groups were compared using the Mann-Whitney U test with Bonferroni correction for multiple comparisons. RESULTS: Median documentation of three procedures significantly increased in the PDA vs handwritten groups: conscious sedation 24.0 vs 0.03; thoracentesis 3.0 vs 0.0; and ED ultrasound 24.5 vs. 0.0. In the handwritten cohort, only the number of cardioversions/defibrillations (26.5 vs 11.5) was statistically increased (p = 0.001). CONCLUSIONS: Use of a PDA did not significantly change EM resident procedure or patient resuscitation documentation when used over a three-year period. Statistically significant differences between the handwritten and PDA groups likely represent alterations in the standard of ED care over time. This favorable comparison and the numerous other uses of PDAs may make them an attractive alternative for EM resident documentation.