Christiana Care Health System, Newark, Delaware 19713, USA.
Telemed J E Health. 2010 Oct;16(8):894-7. doi: 10.1089/tmj.2010.0040. Epub 2010 Oct 6.
Remote intensive care unit (ICU) monitoring (tele-ICU) may provide a means to address the shortage of intensive care physicians. However, the consequences of implementing a tele-ICU system for house staff education and clinical experience are unknown. The purpose of this study was to determine resident perceptions of the impact of a tele-ICU implementation on patient care, education, and the overall work environment.
Cross-sectional survey of residents who rotated through the medical ICU within the first year after the implementation of a tele-ICU in a large, academically affiliated, community hospital. Each question was graded on a 5-point Likert scale.
Thirty-five of 60 residents completed the survey (58% response rate). Sixty-three percent of residents reported that tele-ICU was associated with an improved ability to focus on urgent patient issues, and 46% thought that the tele-ICU helped them to feel less overwhelmed. Although most residents were neutral (51%), 37% agreed that the tele-ICU was a valuable educational experience. Seventy-seven percent reported that the tele-ICU integration was associated with improved patient safety, but many were concerned about the impact on continuity and communication. There was no perceived association with patient or family satisfaction.
Our study suggests that a tele-ICU implementation in a medical ICU does not seem to have a negative impact on the educational experience of residents and is associated with perceived improvements in patient safety and quality. Future studies should objectively measure the educational impact of implementing a tele-ICU system.
远程重症监护病房（ICU）监测（远程 ICU）可能为解决重症监护医师短缺问题提供一种手段。然而，实施远程 ICU 系统对住院医师教育和临床经验的影响尚不清楚。本研究旨在确定住院医师对远程 ICU 实施对患者护理、教育和整体工作环境的影响的看法。
对一家大型学术附属社区医院在实施远程 ICU 后的第一年在医学 ICU 轮转的住院医师进行横断面调查。每个问题均采用 5 分李克特量表评分。
在 60 名住院医师中，有 35 名完成了调查（应答率为 58%）。63%的住院医师报告说，远程 ICU 有助于他们更专注于紧急患者问题，46%的住院医师认为远程 ICU 有助于他们减少不知所措的感觉。尽管大多数住院医师持中立态度（51%），但 37%的住院医师认为远程 ICU 是一种有价值的教育体验。77%的住院医师报告说，远程 ICU 的整合与提高患者安全性有关，但许多人担心对连续性和沟通的影响。远程 ICU 的整合与患者或家属满意度之间没有关联。
我们的研究表明，在医学 ICU 中实施远程 ICU 似乎不会对住院医师的教育体验产生负面影响，并且与患者安全和质量的感知改善有关。未来的研究应客观衡量实施远程 ICU 系统的教育影响。
