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primary storage device (although it can operate
without it). This may support scenarios towards the
individual assignment of storage tokens (memory
cards) to staff members. The physical association
between professionals and storage tokens may help
on raising users’ confidence, especially for settings
in which the smart phone itself can be shared among
professionals. Note, however, that separation of user
contexts is already implemented by Access Control
Lists associated to nurses’ logins.
3 RESULTS
The HOPE system has been deployed in two
Hospitals, in Portugal. In each Hospital, a pilot users
group was formed, with volunteer nurses. Although
at an early stage of introduction, it was possible to
validate the entire workflow, including the
integration with the external Hospital-wide
information systems (different at each organization).
For this validation, a group of twelve nurses from
medical awards is being involved in pilot used. The
nurses are asked to use the mobile application to
search for a patient, collect the answers to a short
clinical interview and document skin lesions with
photos. In the present stage, nurses’ feedback is
being collected by a key domain user, which is a
nurse which received extensive train on the
application; he supports his peers and informally
collects usage feedback. A more formal and
extensive assessment is required, and structured
questionnaires will follow.
Preliminary observation of execution times
doesn’t reveal relevant speed-ups in care
documentation activities using HOPE. Other
benefits, however, have been perceived and reported
by the pilot users. The ability to browse previous
information and to record the nursing protocols at
the point of care (by the patient) is referred as the
main benefit of the system. The HOPE solution was
found to provide a more practical user interaction
and bears the potential to reduce documentation
omissions induced by deferring data entry.
The pilot use of the skin integrity monitoring in
HOPE has raised the awareness of this kind of tool
for clinical applications in both Hospitals. The
specific case of diabetic foot monitoring with a
regional scope is being piloted. (Fig. 5).
Work in progress includes collecting further
evidence that HOPE can provide a safer and more
productive environment for nursing care, besides the
existing pilot users group.
4 CONCLUSIONS
The HOPE system has successfully introduced off-
the shelf smartphones in nursing practice. A key
issue towards system acceptance was the careful
selection of the subset of the information to be
supported in the device, along the synchronization
with Hospital central systems, including the patient
EHR. The novel use of the built-in camera allows
for skin integrity monitoring along several days for
inpatients, establishing basic tools for wounds
evolution assessment.
Besides the use of the HOPE system for inpatient
nursing care, the system is being used also in multi-
institution nursing protocols, such as the diabetic
foot, for longitudinal documentation of wounds
assessment.
ACKNOWLEDGEMENTS
The authors would like to acknowledge the fruitful
collaboration of the Hospitals’ staff, both and HSS
(Feira) and HIP (Aveiro) and the technical
contributions from J. Ribeiro and J. C. Santos.
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