Nurses distracted by Smartphone use during clinical practice: Italian validation of the "Nurses' use of Personal Communication Devices (PCD) questionnaire"


  • Distraction by Smartphone use during clinical practice;
  • Technology can help health professions;
  • Personal communication devices can generate potential distraction.

In healthcare as at home, digital technology is always a part of our everyday life. Regardless of social conditions or age, everyone has an electronic device (i.e. Smartphone, tablet, personal computer), as it allows fast communication and internet connection. Technological evolution has altered modern society radically, particularly healthcare, where digital systems provide medical consultation (McBride, 2015), and improve patient education (Shepherd, Badger-Brown, & Legassic, 2012). Mobile health (MHealth) is a very important element for eHealth, supporting healthcare practice through mobile devices such as smart phones, tablets, patient monitoring devices, personalized digital diaries (PDAs) and other wireless devices. MHealth is emerging as a rapidly developing sector, promoting healthcare transformation, improving quality and efficiency. A study showed that 63% of nurses, during their clinical practice, use smart phones for personal purposes (Whitlow, Drake, Tullmann, Hoke, & Barth, 2014). There are many advantages to technology in a care setting, such as drug dosage calculation (Di Simone et al., 2018a), or communication improvement between multidisciplinary teams as reported in the study by Wu et al. (Wu et al., 2010). Nevertheless, Smartphone use during the care process could cause distraction and medication errors (Di Simone et al., 2016), with negative consequences for the patients (Di Muzio, Tartaglini, De Vito, & La Torre, 2016a). As the goal of all heath care systems is to increase patient safety, distraction of the healthcare providers by electronic devices could serve as a potential risk towards that goal. Such concern is highlighted and shared by the World Health Organization (WHO), which as of 2001 asks for urgent action by the health organizations themselves. In a multicenter Italian study approximately 80% of intensive care unit (ICU) nurses answered that distractions, while preparing or administrating IV drugs, might lead to medication errors (Di Muzio, De Vito, Tartaglini, & Villari, 2017). A survey conducted in the UK (Robinson et al., 2013) among medical students, demonstrated that 70% of them associate Smartphone usage with sending and/or reading e-mails and internet browsing. A study conducted by Katz-Sidlow highlighted that most interviewed doctors had been distracted by Smartphone use during working hours (Katz-Sidlow, Ludwig, Miller, & Sidlow, 2012). While a separate study indicates that fatigue, physical or mental, can affect the use of the Internet during patient care (Lin, Tsai, Chen, & Koo, 2013). Several studies exhibit that interruptions during patient care are common in hospitals, (Schmucker, Heid, & Haag, 2014) contributing to errors in healthcare (Marquez Hernandez et al., 2019). Overall, this "distracted nursing" might affect patient care in a hospital setting and provide significant risk to their safety (McBride, Levasseur, & Li, 2013). A research showed how using a Smartphone for personal purposes negatively influenced the interdisciplinary communication between Health Professions and could decrease the nurse's working performance (Fujino & Kawamoto, 2013). McBride and colleagues (McBride et al., 2013) have developed an instrument devoted to examining the impact of personal communication device usage (such as basic cell phones, enhanced cell phones or smart phones, and tablet computers) on patient care. The questionnaire is composed of 30 multi-part questions, with four-domains (utilization, impact, opinions, and performance), resulting in a total of 50 items. It consists of questions used to obtain information about (a) demographics, (b) use of personal communication devices, (c) opinions about the electronic device's effects on the work of registered nurses, and (d) hospital policies concerning personal communication devices. According to the authors (McBride et al., 2013), Nurses' Use of Personal Communication Devices Questionnaire (PCDs Questionnaire) may be used to explore registered nurses' perceptions of the impact that personal electronic devices have on hospital units in Italy. In the context of the Italian nursing education and health system, with patient safety as its theoretical and practical core-curriculum, it is necessary to support the management process of personal devices appropriately. Validating an instrument such as the Nurses' Use of Personal Communication Device.