Department of Nursing Science, University of Turku, Turku, Finland.
BMC Med Inform Decis Mak. 2013 Jan 29;13:15. doi: 10.1186/1472-6947-13-15.
Although information technology adequately supports clinical care in many intensive care units (ICUs), it provides much poorer support for the managerial information needed to coordinate multi-professional care. To gain a general view of the most crucial multi-professional information needs of ICU shift leaders a national survey was conducted, focusing on the information needs of charge nurses and intensivists.
Based on our previous observation study an online survey was developed, containing 122 information need statements related to the decision-making of ICU shift leaders. Information need statements were divided into six dimensions: patient admission, organisation and management of work, allocation of staff and material resources, special treatments, and patient discharge. This survey involved all ICU shift leaders (n = 738) who worked in any of the 17 highest level ICUs for adults in university hospitals in Finland during the autumn of 2009. Both charge nurses' and intensivists' crucial information needs for care coordination were evaluated.
Two hundred and fifty-seven (50%) charge nurses and 96 (43%) intensivists responded to the survey. The consistency of the survey was found to be good (Cronbach's α scores between .87-.97, with a total explanatory power of 64.53%). Altogether, 57 crucial information needs for care coordination were found; 22 of which were shared between shift leaders. The most crucial of these information needs were related to organisation and management, patient admission, and allocation of staff resources. The associations between working experience, or shift leader acting frequencies, and crucial information needs were not statistically significant. However, a statistically significant difference was found between the number of ICU beds and the ICU experience of charge nurses with information needs, under the dimension of organisation and management of work. The information needs of charge nurses and intensivists differed. Charge nurses' information needs related to care coordination, were more varied, and concerned issues at a unit level, whereas intensivists focused on direct patient care.
The reliability and validity of our survey was found to be good. Our study findings show that care coordination at an ICU is a collaborative process among ICU shift leaders with multiprofessional information needs related to organisation and management, patient admission, and allocation of staff resources. Study findings can be used to identify the most crucial information needs of ICU shift leaders when new information technology is developed to support managerial decision-making during care coordination.
尽管信息技术在许多重症监护病房(ICU)中充分支持临床护理,但它对协调多专业护理所需的管理信息的支持却很差。为了全面了解 ICU 轮班主管最重要的多专业信息需求,我们进行了一项全国性调查,重点关注值班护士和重症监护医生的信息需求。
基于我们之前的观察研究,开发了一项在线调查,其中包含 122 条与 ICU 轮班主管决策相关的信息需求陈述。信息需求陈述分为六个维度:患者入院、工作组织和管理、人员和物资资源分配、特殊治疗和患者出院。这项调查涉及芬兰大学医院 17 家最高级别成人 ICU 中所有轮班护士(n=738)和重症监护医生,调查评估了值班护士和重症监护医生在护理协调方面的关键信息需求。
257 名(50%)值班护士和 96 名(43%)重症监护医生对调查做出了回应。调查的一致性被发现很好(Cronbach's α 分数在.87-.97 之间,总解释力为 64.53%)。总共发现了 57 个护理协调的关键信息需求,其中 22 个是轮班主管之间共享的。这些信息需求中最重要的与组织和管理、患者入院以及人员资源分配有关。工作经验或轮班主管担任职务的频率与关键信息需求之间没有统计学上的显著关联。然而,在工作组织和管理维度上,值班护士的 ICU 床位数和 ICU 经验与信息需求之间存在统计学上的显著差异。值班护士和重症监护医生的信息需求不同。值班护士的护理协调信息需求更加多样化,关注单位层面的问题,而重症监护医生则专注于直接的患者护理。
我们的调查的可靠性和有效性被发现很好。我们的研究结果表明,ICU 的护理协调是 ICU 轮班主管之间的协作过程,他们有与组织和管理、患者入院以及人员资源分配相关的多专业信息需求。研究结果可用于在开发新的信息技术以支持护理协调期间的管理决策时,确定 ICU 轮班主管最重要的信息需求。