Smartphone Use in Healthcare Settings Among Nurses

Smartphone Use in Healthcare Settings: Nurses' Messages for Instant Action to Promote Patient Safety; A Cross-sectional Survey With Qualitative Open-ended Questions

This study assessed patterns of smartphone use among nurses and evaluated its impact on clinical performance and patient safety in healthcare settings in Egypt, using a convergent mixed-methods design. A cross-sectional survey was conducted between October 2025 and February 2026 across diverse clinical settings at Alexandria University Hospitals, including critical and emergency care, medical-surgical wards, operating theaters, outpatient clinics, home care services, and psychiatric support units. Of 900 nurses invited, 368 completed the online questionnaire via Google Forms (response rate: 40.9%). Quantitative data assessed nurses' patterns of smartphone use and its impact on patient care using an adapted validated scale. Qualitative data were collected through two open-ended narrative questions exploring smartphone-related clinical incidents and recommendations for safe use. A total of 105 clinical incidents attributed to smartphone distraction were identified and categorized into four themes, while 176 respondents provided actionable recommendations categorized into five strategic pillars for safe clinical integration.

Study Overview

• Status: Completed
• Conditions: Mobile Applications; Patient Safety; Nursing Care; Medical Errors; Clinical Communication
• Intervention / Treatment: Behavioral: Assessment of Personal Communication Device Usage Patterns.

Detailed Description

This study employs a prospective observational design to investigate the integration of smartphone technology in nursing workflows and its direct implications for patient safety. As healthcare environments become increasingly fast-paced, the reliance on instant messaging (e.g., WhatsApp, specialized hospital apps) for clinical communication has grown.

The research focuses on several key dimensions:

Communication Efficiency: Assessing how instant messages facilitate rapid clinical decision-making and "instant action" compared to traditional communication methods.

• An online self-administered questionnaire will be used for the quantitative part; it will be shared with participants through their personal WhatsApp number after meeting them and getting their approval to participate in the study.
• Semi-structured interviews will be used to collect data for the qualitative part; interviews will be conducted in the Arabic language, either face-to-face or online through the MS Teams platform (synchronous/asynchronous) mode for easy contact with participants

Patient Safety Outcomes: Monitoring the reporting of critical lab values, medication clarifications, and urgent patient status changes through digital messages.

Workflow Integration: Identifying how nurses prioritize urgent clinical messages amidst their daily responsibilities.

Data collection involves a mixed-methods approach, including the analysis of communication patterns and clinical outcome indicators. The study aims to provide evidence-based insights into how smartphone use can be standardized to minimize risks and maximize the speed of life-saving interventions in hospital settings.

• Study Type: Observational
• Enrollment (Actual): 368

Contacts and Locations

Study Locations

• Egypt
  • Alexandria, Egypt, 21511
    • Faculty of Nursing, Alexandria University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of nurses who are actively providing direct in-patient care in clinical settings. This includes nurses from various departments such as medical-surgical units, intensive care units, and specialized wards. These professionals are primarily those who utilize personal communication devices (PCDs) during their shifts and are capable of reporting their usage patterns and clinical incidents related to patient safety.

Description

Inclusion Criteria:

Device Usage: Must actively use a personal communication device (smartphone or tablet) during working hours for either personal or professional purposes.

Work Setting: Must be assigned to in-patient care units where direct patient monitoring and interaction occur.

Exclusion Criteria:

• Nurses on leave or those who declined to participate

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Participating Nurses; This arm includes staff nurses to assess their patterns of personal communication device use including frequency, duration, and types of applications while simultaneously evaluating the subsequent impact of these devices on in-patient care. Through a convergent parallel mixed-methods approach, the study examines how these usage patterns influence clinical workflows, nurses' responsiveness, and overall patient safety, focusing on identifying both the professional benefits and potential risks associated with the use of personal devices in clinical settings.

Behavioral: Assessment of Personal Communication Device Usage Patterns.; Participants will complete surveys and participate in interviews to assess their patterns of using personal communication devices during work hours. The intervention focuses on identifying frequency, duration, and clinical vs. personal use, as well as evaluating the perceived and actual impact of these behaviors on in-patient care quality and patient safety incidents. 368 nurses from Govermental Hospitals across medical-surgical, critical care, emergency, operating theater, outpatient, home care, and psychiatric settings

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patterns of Personal Communication Device usage.	Evaluation of how frequently and for what duration nurses use their personal devices for both professional and personal purposes during shift hours, measured via a structured survey.	October 2025 and February 2026

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Impact of Personal Communication Device Use on In-patient Care Indicators	Assessment of the correlation between device usage patterns and clinical care quality, such as nurses' responsiveness to patient needs and the frequency of reported near-misses or clinical errors related to distraction.	October 2025 and February 2026
Nurses' Perceptions and Reported Clinical Incidents.	Qualitative analysis of themes derived from nurses' descriptions of specific incidents and their subjective views on how smartphone messaging facilitates "instant action" or impacts patient safety.	October 2025 and February 2026

Collaborators and Investigators

• Sponsor: Alexandria University

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2025
• Primary Completion (Actual): January 1, 2026
• Study Completion (Actual): February 26, 2026

Study Registration Dates

• First Submitted: February 21, 2026
• First Submitted That Met QC Criteria: March 1, 2026
• First Posted (Actual): March 4, 2026

Study Record Updates

• Last Update Posted (Actual): April 22, 2026
• Last Update Submitted That Met QC Criteria: April 18, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Patient Safety; Interprofessional Communication; Smartphone Use; Instant Messaging; Nursing Communication; Instant Action; Healthcare Technology
• Other Study ID Numbers: AU-20-10-432

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared to protect the privacy and confidentiality of the participating nurses

Study Data/Documents

1. Study Protocol
   Information comments: Available upon request from the Principal Investigator for legitimate research purposes

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No