Critical Appraisal Guidelines for The Chief Complaint App

Medical Application Critical Appraisal Guidelines: The Chief Complaint Alyssa Fulton Chamberlain University NR 599: Nursing Informatics for Advanced Practice Dr. Simmons October 11, 2023

Name My birthday is in June so the application I will be reviewing is The Chief Complaint. Author The creator of this application is Chris Feier M.D., Pharm D. who is a assistant professor of clinical emergency medicine at Keck school of Medicine. Illustrations are done by Sonia Johnson, creative consult is Ariel Bowman, Drug index is by Helen Lee, Content is by Max Fitzgerald, Ariiel Bowman, Ryan Raam and Brian Doane. Editing of the app was one by Craig Torres-Ness and Erik Akopian. This software was developed using the ESCAVO mobile publishing platform, with the lead developer Daniel Nichita. The app is managed by ESCAVO and is continually updated (The Chief Complaint, 2023. Endorsement This application is not endorsed and does not have any stated licenses. Although the information for this application comes from physicians and students at USC medical center and Keek School of medicine. Operation This application is best used on mobile devices, although it can be used on a computer, ipad or tablet. This application can be used on both android and apple products. This application is to be used as a pocketbook to help the medical community. A digital book that is always with you when need a reference or for education. Aesthetics This application is versatile and very easy to use. Upon opening the application, you see a colorful array of body systems, specialties, drugs, and calculator tabs. Each colored circle has a picture to go with the different subtype. For cardiac there is a heart, for pulmonary there are lungs and for heme/onc there are

drops of blood (The Chief Complaint, 2023. Under each category are subcategories which hold information. At the bottom of the screen are choices to go to your bookmarks, add notes, search and Application information. This app is easy enough to use without instructions, it has a basic set up of find the general body system, then narrow it down under the subcategories. Purpose The purpose of this application is to help medical professionals on the go be able to reference different complaints. When the application is first downloaded there is a warning that states this application does replace clinical judgement or expertise of medical professionals (The Chief Complaint, 2023). This application is used as a reference and a helpful tool for patient care. Clinical Decision Making This application can be used as a tool to reference and or educate the medical provider about their patients’ current symptoms and illness. In Emergency medicine this tool can help guide a provider to different situations and different ways to think about testing and the patients needs. Safety As with most information on the internet or on applications the possibility of the application not being the most up to date is there. There could be new information that has not made it onto the application and can pose a risk for our patients. Over reliability on the application can be a risk also. When relying on the application, the medical personnel could put the patient at risk. Also, this application is available to anyone, even non-medical personnel. Privacy/ Security

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The chief complaint application does have a privacy policy that states it does not collect personal data. It does state that it does compile information on general usage and technical data (The Chief Complaint, 2023. Information is not shared with third parties and does not report to an outside source. This application does not share information on social networks. Health information is not added into the app but a personal data breach would be explained to the user. User This application is intended to be used by medical professionals and medical students. Physicians, NP, PA and even nurses can find this app useful and informative. This app can also be helpful for medical professionals who are in school and especially clinical and or rotations. Medical knowledge and a medical background are needed to be able to use this app effectively. Distribution This application is used as wider distribution as it is able to be used all over the United States (The Chief Complaint, 2023. This application can be used abroad but may not be the same standards. Credibility This application seems to be credible as the information comes from medical professionals and a medical school. This school that the information comes from is very prestigious and well known. This application has many peer reviews and also has a list of references. Relevance It seems this application was last updated in June of 2023, although some information is dated from 2007. Since some of the information is dated to 2007, I would say it is not up to date to evidence-based standards. This could pose a risk to patients and providers’ ability to care for their patients.

Clinical Scenario: A 24-yer-old female name Lauren Hill presents to the emergency room with diffuse flank pain, urinary frequency, and hematuria. Doctor McDreamy is assigned to this patient and starts reviewing the patient’s chart. Laurens vitals are within normal limits except she is slightly tachycardic. Doctor McDreamy looks further into the chart and finds that Lauren is allergic to shellfish and adhesive. Lauren also has a family history of kidney stones but does not appear to have much of a medical history herself. After reviewing Laurens chart, Doctor McDreamy has an idea of what may be going on with Lauren but references his chief complaint application to help confirm his theory. Upon opening the application Doctor McDreamy clicks the genitourinary tab and further clicks the UTI/Pyelonephritis subcategory. After reviewing the application Dr. McDreamy heads into Laurens room to further assess the patient. Dr. McDreamy palpates Laurens abdomen and flank, asks urinary questions, and informs Lauren of his plan. The plan of care which was reinforced by the chief complaint app is to order an abdominal ultrasound, a urinalysis with reflex, repeat labs and a pregnancy test. After getting the results back Dr. McDreamy informs Lauren that she has a urinary tract infection and is not pregnant. Dr. McDreamy informs Lauren that women are at a higher risk for UTI and most commonly affect the bladder and urethra. Women are at a higher risk because the urethra is shorter, having a shorter distance for bacteria to travel ( Urinary Tract Infection (UTI) - Symptoms and Causes - Mayo Clinic , 2022). Dr. McDreamy explains to lauren that she will need a course of antibiotics and will be given a medication called Pyridium to help with bladder pain. Lauren is discharged with new prescriptions sent to her pharmacy and makes a full recovery. Dr.

Mcdreamy continues to use the chief complaint application to reference patients’ symptoms and verify her plan of care.

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Reference The Chief Complaint. (2022). The chief complaint medical references (Version 3.1). [Mobile app]. App Store. https://apps.apple.com/us/app/the-chief-complaint/id969426649 Urinary tract infection (UTI) - Symptoms and causes - Mayo Clinic . (2022, September 14). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/urinary-tract- infection/symptoms-causes/syc-20353447

week 6

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