Methodology of development of a Delirium clinical application and initial feasibility results.
BACKGROUND
Delirium is a highly prevalent condition in the hospital settings, with prevalence rates ranging from 6% to 56%, based on previous studies. A recent review provides evidence for the need of practice tools at the point of care to increase impact and to improve patient outcomes related to delirium care. The major challenge is to help maintain the skill-sets required by clinicians and allied healthcare workers over time. There have been massive advancements in smartphone technologies, as well as several papers being published recently about how clinicians could be application developers.


OBJECTIVE
The following study will serve to illustrate how the authors made use of the latest advances in application creation technologies in designing a Delirium education application, containing protocols that are appropriate to their healthcare setting. The study in itself will serve as a pilot project aimed at implementing smartphone technologies in delirium education, to determine its feasibility as well as user's perspectives towards such an implementation.


METHODS
The Delirium UHN Application was developed between the months of February 2013 to September 2014. Making use of the methodologies shared by Zhang MWB et al., the authors embarked on the development of the web-based and the native application. The web-based application was developed using HTML5 programming language and with the aid of an online application builder. Psychiatry residents and allied health professionals, at the University of Toronto were recruited to help evaluate the pilot web-based version of the application.


RESULTS
Since the introduction of the web-based application during the delirium awareness week, there has been a total of 1165 unique access to the online web-based application. Of significance, there is a shift in the confidence levels of the participants with regards to the management of delirium after using the application. The majority of the participants (44.0%) reported being moderately comfortable with managing delirium prior to the usage of the application, but this changed after the implementation of the application, with 39.0% reporting being very confident and 44.0% being extremely confident about managing delirium after using the application. 69.0% of the participants also perceived the smartphone application to be of use to their clinical care for delirious patients.


CONCLUSIONS
This study is one of the first to demonstrate the potential usage of smartphone innovations in delirium education. The current study demonstrated the added feasibility of smartphone applications, and demonstrated that users perceived that they are more abled with managing delirium after the usage of the smartphone application.
National HealthCare Group, Singapore.
Melvyn W B
MW
Zhang
Department of Psychological Medicine, National University Healthcare Systems, Singapore.
Roger C M
RC
Ho
University Health Network, University of Toronto, Toronto, ON, Canada.
Sanjeev
S
Sockalingam
D002985:Clinical Protocols; D003693:Delirium / Q000628:therapy*; D005260:Female; D006282:Health Personnel; D006801:Humans; D020407:Internet; D008297:Male; D063731:Mobile Applications; D010865:Pilot Projects; D019095:Point-of-Care Systems; D012107:Research Design
Technology; applications; clinical; delirium; developmental methods; education; management; mobile phones; smartphone