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drawbacks to and benefits of access to hand-held technology in the clinical setting and to make recommendations for healthy technological behaviours in the perioperative environment. Author Tarryn Armour MClinEd, GradDipAdNrsgPrac (periop), GCertHELT, BN, BaHthProm, RN, FACORN Elyse Coffey MNurs (Perian), GCertHELT, BN(Honours), RN Feature e-28 Journal of Perioperative Nursing Volume 34 Number 1 Autumn 2021 acorn.org.au Drawbacks to the use of hand-held technology Distraction has been identified in the literature as a major drawback to using hand-held technology in the clinical environment7–10. Distraction in the clinical environment can be defined as a direct interruption of a clinician’s immediate task by using their smartphone7 . Distraction from using a smartphone in the clinical area can lead to perceived performance deficits in clinical staff; however, no evidence of any actual or potential patient harm was observed in two studies. McBride8 compared self-reported data to performance errors of registered nurses (n=825) working in American health care organisations while Cambier9 examined the impact on workplace cognitive failure of registered nurses’ mobile phones (n=849) from three hospitals in Belgium. Using a smartphone for reasons not related to work, such as engaging with social media or ‘cyberloafing’, is a potential cause of distraction10. McBride and colleagues suggest that this misuse of smartphone technology may be attributed to an inadequate understanding of digital professionalism by registered nurses. Digital professionalism is required to judge when it is appropriate to access smartphone technology8 and is a professional attribute that must be developed and modelled. It is argued that the increasing diversity of resources and information accessible via a smartphone results in uncertainty about whether this technology is being used for cyberloafing or for legitimate workrelated activities. This uncertainty often results in any smartphone use being misconstrued as a distraction. In addition to the use of smartphones being perceived as a distraction from clinical activities, other research reports health care worker concerns related to patient privacy and infection control risks as well as an overall discomfort with the hand-held devices being used in the clinical environment11. Two studies examined the concept of smartphone addiction and how this can affect therapeutic relationships in the clinical environment12,13. A common theme of these studies was that negative perceptions of smartphone use were commonly based on older generations’ beliefs that smartphones were purely used for cyberloafing, rather than for seeking information related to patient care. Both studies recognised the need to develop strategies for preventing smartphone dependency and to promote healthy and safe use of smartphones to ensure appropriate, point-of-care access to clinical information and resources12,13. A qualitative study by Mather et al.1 reports on interviews with representatives from professional nursing organisations aiming to explore the factors influencing the governance of hand-held technology used at the point of care for informal learning and continuing professional development (CPD). Themes such as access, negative perceptions of use and distraction highlight the complexity of using hand-held technology for informal learning and continuing professional development in the clinical setting. Giles-Smith et al.14 also explored nurses’ use of hand-held technologies and showed that access to and use of smartphones is already occurring in the clinical setting with a lack of leadership, role modelling or professional guidance about how to support and foster positive use of this technology to enhance patient care14. This finding is supported by Mather et al.1 who determined that not only is leadership in digital professionalism within hospital management lacking but that professional nursing organisations are also reluctant to exert agency and challenge traditional work patterns to advance protocols to govern digital professionalism. While a number of drawbacks to using hand-held technology in the clinical environment were apparent in the literature,
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