Evaluation of hand-held computers compared to pen and paper for documentation on an acute pain service

Abstract

Summary Purpose: To assess the utility of personal digital assistants for documentation at the bedside on an acute pain service. Methods: This reality-based unblinded randomized trial recruited 35 patients on the personal digital assistant (PDA) arm and 39 patients on the paper arm. The primary outcome measure was assessment time and comprehensiveness between patient visits documented on paper versus the PDA. Secondary objectives were to gather qualitative information about the use of PDAs at the point-of-care. Results: The median time to complete the initial patient assessment was 2.8 min on the PDA arm and 2.7 min on the paper arm. The median total patient encounter time (assessment and recording) was 6.1 and 4.6 min on the PDA and paper arms, respectively ( Z = −2.28, P -value = 0.00). Pain scores were documented on 65% of assessments on the PDA arm and 44% of the assessments on the paper arm. Nausea, pruritis and sedation were collected on 100% of PDA assessments, compared to 13–33% of paper assessments. Conclusions: This study found that patient encounter time was longer but more information was collected on the PDA compared to paper. Non-PDA owners took significantly longer to document on the PDA compared to paper.