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Chamberlain University College of Nursing *

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Medicine

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Dec 6, 2023

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1 Pahli Thao Medical Application Critical Appraisal Chamberlain University: Nurse Practitioner Track NR503-60567 Population Health Epidemiology and Statistical Principles Dr. Aimee Kirkendol July 23, 2023
2 NAME The Chief Complaint AUTHOR Chris C. Feier M.D. is a clinical assistant professor of emergency medicine at Keck School of Medicine. The app also had contributing authors whom helped with editing, content, drug index, creative consult, and illustrations. ENDORESMENT Unfortunately at this time the app is not endorsed by the Food and Drug Administration or any academic institution. The application was created by Chris Feier M.D. as a self-tool before he decided to share it with others. There are no noted endorsements for this application. OPERATION The Chief Complaint would be more suitable on a mobile platform, due to the design set forth by the software developer. The publishing platform utilized for the application is ESCVAO a mobile public of scientific and medical content. AESTHETICS Upon the initial opening of the app, it brings you to a very detailed and well-illustrated broad of body systems. As you click on the options available it brings you to the list of associated problems or concerns one may be experiencing. The engineering of the application is simple and user friendly as one does not need instructions to navigate the application. The sources are also listed for anyone that may have concerns regarding scholarly and up to date information.
3 PURPOSE As clinicians in emergency department explore, diagnose and treat patents, The Chief Compliant mobile application allows clinicians to treat and focus on the critical or worse complaints first. The app was developed to help guide those who are new to medicine/emergency medicine. Although originally, this was developed just for personal use, it become a tool for residents and new EM doctors. CLINICAL DECISION MAKING As I played in the app, I was able to utilize the calculator option to view what kind of information would be presented to individuals who utilized that option. Overall, I would rate the app as a low risk app due to the fact that it does not provide any calculations on dosages based on weight or dose formulations. What it does provide is calculations of Glasgow coma scale, CURB-65, and PERC Rule for PE. SAFETY The application does have the potential to harm if it is used in parts of the world that does not have the same standard of care and protocols as the U.S. Which is why the disclosure of the application notes the app was not recommended for clinicians out of the U.S. Lastly, the app does also disclose the reliance on the app to have up to date procedure and protocols can also be a factor that leads to harm if it not current. PRIVACY/SECURITY Under the “More” tabs list the privacy policy of the application. It does not state directly on the application if they share information or that information is encrypted. However, provided
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4 is a link to ESCAVO the privacy policy which provides additional information on privacy. The policy shares in-depth information on third party sharing and what happens with data collected by the app. Information gathered is not listed as being shared with social networks. The main use of tracking information is to assess traffic volumes on the mobile app or online web. USER The app is intended for use by clinicians in relations to emergency medicine (EM) such as (medical students in EM, and new EM clinicians). Although the intent is for EM, this app is also intended for easy pocket use due to the context, accessibility and ease of use. DISTRIBUTION Due to differences in policies and standards of practice, the suggested distribution is anywhere within the U.S. This would be considered a local use to the U.S. territory only. As use of the app outside of the U.S. can result in incorrect treatments as the developer has shared the content in the app does not reflect protocols and standards of other countries. CREDIBILITY The credibility is reliable as the application has a list of references for individuals to cross reference if they choose to. Not only are references listed but the author states in the disclosure, continuous changes are being made to update best practices changes as studies are made. RELEVANCE Unfortunately, there were no identifiable dates listed for when the last update was made on the application. I elected to cross reference check the information listed under congested heart failure (CHF), as the American Heart Association (AHA) is always updating stand of care. Based
5 upon the cross reference the application did provide the most updated guidelines per the AHA. Both dates for references also aligned with what was listed for the AHA. Clinical Scenario The Chief Complaint would be a great tool or application to utilize in a hospital setting, particularly in the emergency department (ED). For example, a 68-year-old female Caucasian presents to the urgent care with mild confusion and shortness of breath with respiratory rate > 30, and a fever that has not resolved over 3 days. After ordering a CMP the lab work shows a BUN > 20 mg/dL. As the advanced nurse practitioner (APN), utilization of the app will indicate that the patient may be experiencing symptoms associated with pneumonia. This was based on the CURBo-65 calculations. This puts the patient in the highest rate group based on The Chief Complaint app and the next step would be assessing if the client needs to be transferred to the ED for admission.
6 Reference Feier, C. (2022). The chief complaint (Version 2.3). Escavo INC. escavo.com Heidenrich, A. P., Bozkurt, B., Aguilar, D., Allen, A. L., Byun, J. J., Colvin, A., Drazner, H. M., Dunlay, M. S., Evers, R. L., Fang, C. J., Fedson, E. S., Fonarow, C. G., Hayek, S. S., Hernadez, F. A., Khazanie, P., Kittleson, M. M., Lee, S. C., Link, S. M., Milano, A. C., Nncheta, C. L., Sandhu, T. A., Stevenson, L., Vardeny, O., Vest, R. A., Yancy, W. C. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. AHA Journal. https://doi.org/10.1161/CIR.0000000000001063
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