NURS 3111 Week 10 Final Technology Proposal Example

Final Technology Proposal: Secure Messaging on Unit Smartphones to Replace Overhead Paging on a Medical-Surgical Unit

Student Name

College of Nursing, Walden University

NURS 3111: Nursing Informatics and Healthcare Technology

Instructor Name

Month Day, Year

Final Technology Proposal: Secure Messaging on Unit Smartphones to Replace Overhead Paging on a Medical-Surgical Unit

The Problem

On a composite 30-bed medical-surgical unit, nurses reach each other, pharmacy, transport, and providers through overhead pages and a unit phone that rings at the desk. A nurse who needs a provider pages, returns to a patient, and misses the callback when it comes to the desk. Overhead pages interrupt every patient on the unit, including those trying to sleep. None of this time is logged, so nobody knows how much of a shift is spent waiting for or chasing callbacks. The problem this proposal addresses is communication that is noisy for patients and unreliable for staff: messages that interrupt everyone but reach no one in particular.

The Proposed Technology

Each nurse, charge nurse, and nursing assistant on shift carries a unit smartphone running the hospital's secure messaging application, linked to the day's assignment so that a message to "bed 12 nurse" reaches the right person without looking up a name. Messages are encrypted, stored in the application rather than on the phone, and show whether they have been delivered and read. Overhead paging is limited to emergencies such as rapid response and code calls. Providers already use the same application on their own phones.

Evidence

Three kinds of evidence support the proposal. On noise, a hospital unit that replaced overhead paging with a smartphone platform eliminated overhead pages, cut transitory noise by about two thirds, and reduced the share of sounds above recommended thresholds from about 31% to under 1% (Hughes Driscoll et al., 2020). On satisfaction and workflow, a secure smartphone text messaging system on an inpatient medicine service improved providers' satisfaction and their perception of communication efficiency and workflow (Przybylo et al., 2014). On outcomes, a hospital that offered mobile secure text messaging to care providers and staff on its medicine services saw a relative decrease in length of stay of about three quarters of a day compared with a control hospital, with no change in readmissions (Patel et al., 2016). The last study was observational, and it cannot prove that messaging caused the shorter stays, but it suggests that faster communication may speed decisions.

Stakeholders

Nurses and nursing assistants gain direct messages and fewer interruptions but must carry and check a device. Charge nurses gain visibility of who is messaging whom. Providers, who already use the application, gain the ability to reach the right nurse directly. Patients gain a quieter unit. Information technology must supply, secure, and maintain the phones. The nurse manager must approve the policy on use during patient care.

Costs and Resources

The main costs are the devices and the time to set up and train. The unit needs about 14 phones to cover the largest shift, plus spares and charging stations; information technology would purchase them from the hospital's existing device contract, so no new software license is needed because the application is already in use. Training costs are about 30 minutes per staff member, scheduled during existing education time where possible. The informatics nurse and two champions would need protected time, about 4 hours a week each for 12 weeks. Against these costs, the proposal offers savings that are hard to price but real: fewer missed callbacks, less time spent walking to the desk phone, and fewer repeated pages. The evaluation measures are chosen partly so that, at 12 weeks, the manager can judge whether those savings justify extending the program to other units.

Implementation

Implementation runs in three phases over 12 weeks. In weeks 1 to 4, the unit's informatics nurse and two nurse champions build the assignment link, set message templates for common requests, and train staff in 30-minute sessions with practice messages. In weeks 5 to 8, the unit runs smartphones and overhead paging in parallel, so no message is lost while staff adapt. In weeks 9 to 12, overhead paging stops for anything but emergencies, and the champions hold short huddles each week to collect problems. A written policy sets expectations: phones on, checked at least every 15 minutes, and silenced but not ignored during procedures.

Evaluation

Measures are defined before rollout. Noise: overhead pages per shift, counted from the paging system log, and sound levels measured at the nurses' station and two patient rooms before and after. Communication: median time from message sent to message read, and from message read to reply, from the application's own data. Staff experience: a short survey before and at 12 weeks asking about interruptions and ease of reaching colleagues. Patient experience: the quietness-at-night item on the hospital's patient experience survey, compared across two quarters.

Risk

The largest new risk is a failure point that paging did not have in the same form: a message can be delivered and never actually read, while the sender believes it was. A read receipt shows that a message was opened, not that it was understood or acted on. A nurse who texts "potassium 6.2 bed 14" and sees "delivered" may move on, assuming the provider knows. The proposal addresses this in three ways. First, critical results and any change in patient condition requiring urgent action must be communicated by voice call, not by text, with the text used only to confirm afterward. Second, messages marked urgent that are not read within 5 minutes escalate automatically to the charge nurse. Third, the policy teaches that the sender remains responsible until a reply confirms the plan.

Other risks are smaller but real. Constant message notifications can create alert fatigue, so message templates distinguish urgent from routine. Phones can be lost or left in a patient room, so devices lock after inactivity and are logged in and out at each shift. And some older staff may be less comfortable with smartphone typing, so templates and voice-to-text are part of the training.

Conclusion

Secure messaging on unit smartphones offers a quieter unit and more reliable communication, with evidence that it can reduce noise, improve satisfaction, and possibly shorten stays. Its main risk, a false sense that delivery means understanding, is manageable with clear rules for urgent communication. The first step is a meeting with the nurse manager and the informatics team to agree the phased plan and the measures.

References

Hughes Driscoll, C. A., Cleveland, M., Gurmu, S., Crimmins, S., & El-Metwally, D. (2020). Replacing overhead paging with smartphones to reduce hospital noise. Biomedical Instrumentation & Technology, 54(4), 251-257. https://doi.org/10.2345/0899-8205-54.4.251

Patel, M. S., Patel, N., Small, D. S., Rosin, R., Rohrbach, J. I., Stromberg, N., Hanson, C. W., & Asch, D. A. (2016). Change in length of stay and readmissions among hospitalized medical patients after inpatient medicine service adoption of mobile secure text messaging. Journal of General Internal Medicine, 31(8), 863-870. https://doi.org/10.1007/s11606-016-3673-7

Przybylo, J. A., Wang, A., Loftus, P., Evans, K. H., Chu, I., & Shieh, L. (2014). Smarter hospital communication: Secure smartphone text messaging improves provider satisfaction and perception of efficacy, workflow. Journal of Hospital Medicine, 9(9), 573-578. https://doi.org/10.1002/jhm.2228