Communication and role clarity inform TeleICU use: a qualitative analysis of opportunities and barriers in an established program using AACN framework

BMC Health Services Research

Michael Di Martino¹  Anna Krupp²  Krzysztof Laudanski³  Wesley Chung⁴  Ann Marie Huffenberger⁵  Anish K. Agarwal⁶  Krisda Chaiyachati⁷ 

[1] College of Arts and Sciences, University of Pennsylvania, 249 South 36th St, 19104, Philadelphia, PA, USA;College of Nursing, University of Iowa, 52242, Iowa City, IA, USA;Department of Anesthesiology and Critical Care; University of Pennsylvania, JMB 127, 3620 Hamilton Walk, 19146, Philadelphia, PA, USA;Leonard Davis Institute for Healthcare Economics, JMB 127, 3620 Hamilton Walk, 19146, Philadelphia, PA, USA;Department of Chemistry, College of Arts and Sciences, Drexel University, 3141 Chestnut St., 19104, Philadelphia, PA, USA;Penn Medicine Center for Connected Care, The Clinical Practices of the University of Pennsylvania Health System, 19104, Philadelphia, PA, USA;The Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, The Leonard Davis Institute for Health Economics at the University of Pennsylvania, 19104, Philadelphia, PA, USA;The Department of Medicine, The University of Pennsylvania Perelman School of Medicine, The Leonard Davis Institute for Health Economics at the University of Pennsylvania, Penn Medicine Center for Connected Care, 19104, Philadelphia, PA, USA;

关键词: TeleICU;    Innovation;    Workflow;    Communication;    Nurse;    Qualitative;   

DOI  :  10.1186/s12913-021-06287-6

来源: Springer

【 摘 要 】

BackgroundUnderstanding the use of tele-intensive care unit (ICU) services is an essential component in evaluating current practice and informing future use as the adoption and application of teleICU services expands. We sought to explore if novel ways to utilize teleICU services can emerge within an established, consulting-style teleICU model considering the program’s flexible, provider-driven operation.MethodsThis was a qualitative study of one teleICU/hospital dyad using semi-structured interviews from a convenience sample of ICU (n = 19) and teleICU (n = 13) nurses. Interviews were analyzed using directed content analysis to identify themes that describe their experiences with teleICU using a deductive codebook developed from an expert consensus (American Association of Critical Care Nurses) AACN statement on teleICU nursing.ResultsThree themes were identified through the qualitative content analysis: [1] nurses described unique teleICU knowledge, including systems thinking and technological skills, [2] the teleICU partnership supported quality improvement initiatives, and [3] elements of the work environment influenced perceptions of teleICU and its use. When elements of the work environment, such as effective communication and role clarity, were not present, teleICU use was variable.ConclusionsFlexible, provider-driven approaches for integrating teleICU services into daily practice may help define the future use of the teleICU model’s applicability. Future work should focus on the importance of effective communication and role clarity in integrating the emerging teleICU services into teleICU/ICU practice.

【 授权许可】

CC BY