Development and Evaluation of Mobile Telenursing System for Drug Administration

Abstract

Mobile telenursing is an emerging sub-field of mobile health that proposes remote nursing care provision with the aim of reducing stress on nurses by enabling them to spend more time on direct patient care rather than indirect care. Most existing mobile telenursing systems are limited to a simple phone call and Short Message Service (SMS) alert thereby rendering them inadequate to support indirect patient cares such as remote prescription based on consultant's advice and monitoring of drug usage adherence. Hence, this research developed a Mobile Telenursing and Drug Administration System (MTS) characterized by support for the aforementioned indirect patient cares. Domain-Driven Design was employed in designing MTS client-server architecture and its framework. The framework was implemented by developing an SMS reminder system and client mobile application which maintains real-time communication with the webserver. The MTS, which supports real-time consultation between nurse-patient and nurse-consultant, was developed for mobile devices running the Android operating system using the framework implemented. The MTS was programmed using JavaScript and Pusher real-time messaging library of the Android development Kits. The performance of the MTS was evaluated through users' assessment by administering a set of questionnaire on purposively selected 64 nurses; 53 patients chosen from four (4) purposively selected hospitals (General Hospital, New Bussa; Bowen University Teaching Hospital, Ogbomoso; Alimosho General Hospital, Lagos and Ifako-Ijaiye General Hospital, Lagos). The responses obtained from the questionnaires were statistically evaluated to determine MTS suitability for drug usage monitoring, remote prescription, palliative care, injection administration, patients' clean-up and follow-up treatment using a correlation test. Also, mean effectiveness and mean acceptability of MTS were evaluated using a t-test at 0.05 level of significance. The MTS was deployed on mobile devices running the Android operating system. The results of performance evaluation revealed that MTS recorded suitability values of drug usage monitoring (r = 0.656), remote prescription (r = 0.829), palliative care (r = 0.925), injection administration (r =-0.772), patients' clean-up (r =-0.841) and follow-up treatment (r = 0.868) of patients at (p < 0.05). Similarly, MTS recorded mean effectiveness and acceptability values of 3.596 and 3.32, 3.770 and 3.36 at (p < 0.05) for nurses and patients, respectively. The research developed MTS which is suitable for the provisioning of remote nursing care and drug administration without breaking basic medical ethics. The system can be adopted for mobile telenursing and drug administration system.