title: Nursing Performance and Mobile Phone Use: Are Nurses Aware of Their Performance Decrements?
abstract: BACKGROUND
  Prior research has documented the effect of concurrent mobile phone use on medical care. This study examined the extent of hospital registered nurses' awareness of their mobile-phone-associated performance decrements.
  
  
  OBJECTIVE
  The objective of this study was to compare self-reported performance with reported observed performance of others with respect to mobile phone use by hospital registered nurses.
  
  
  METHODS
  In March 2014, a previously validated survey was emailed to the 10,978 members of the Academy of Medical Surgical Nurses. The responses were analyzed using a two-proportion z test (alpha=.05, two-tailed) to examine whether self-reported and observed rates of error were significantly different. All possible demographic and employment confounders which could potentially contribute to self-reported and observed performance errors were tested for significance.
  
  
  RESULTS
  Of the 950 respondents, 825 (8.68%, 825/950) met the inclusion criteria for analysis. The representativeness of the sample relative to the US nursing workforce was assessed using a two-proportion z test. This indicated that sex and location of primary place of employment (urban/rural) were represented appropriately in the study sample. Respondents in the age groups <40 years old were underrepresented, while age groups >55 years old were overrepresented. Whites, American Indians/Alaskan natives, and Native Hawaiian or Pacific Islanders were underrepresented, while Hispanic and multiple/other ethnicities were overrepresented. It was decided to report the unweighted, rather than the weighted survey data, with the recognition that the results, while valuable, may not be generalizable to the entire US registered nursing workforce. A significant difference was found between registered nurses' self-reported and observed rates of errors associated with concurrent mobile phone use in following three categories (1) work performance (z=-26.6142, P<.001, Fisher's exact test), (2) missing important clinical information (z=-13.9882, P=.008, Fisher's exact test), and (3) making a medical error (z=-9.6798, P<.001, Fisher's exact test). Respondents reported that personal mobile phone use by nurses at work was a serious distraction; always (13%, 107/825), often (29.6%, 244/825), sometimes (44.6%, 368/825), rarely (8.7%, 72/825), or never (1.2%, 10/825). On balance, 69.5% (573/825) of respondents believed that nurses' use of personal mobile phones while working had a negative effect on patient care. Since all possible confounders were tested and none were deemed significant, a multivariate analysis was not considered necessary.
  
  
  CONCLUSIONS
  Many hospitals are drawing up policies that allow workers to decide how to use their devices at work. This study found that nurses express a disproportionately high confidence in their ability to manage the risk associated with the use of mobile phones and may not be able to accurately assess when it is appropriate to use these devices at work.
authors.affiliation: Samuel Merritt University, Oakland, CA, United States. dmcbride@samuelmerritt.edu.
authors.forename: Deborah
authors.identifier: http://orcid.org/0000-0002-3408-6450
authors.initials: D
authors.lastname: McBride
authors.forename: Sandra A
authors.identifier: http://orcid.org/0000-0002-4133-7684
authors.initials: SA
authors.lastname: LeVasseur
authors.forename: Dongmei
authors.identifier: http://orcid.org/0000-0001-9140-2483
authors.initials: D
authors.lastname: Li
keywords: Internet; cellular phone; distraction; hospital; mobile phone; non-work related mobile phone use; nurses