Lyngstad Merete, Grimsmo Anders, Hofoss Dag, Hellesø Ragnhild
Institute of Health and Society, University of Oslo, Oslo, Norway.
J Clin Nurs. 2014 Dec;23(23-24):3424-33. doi: 10.1111/jocn.12590. Epub 2014 Mar 20.
To investigate the experiences of home care nurses with electronic messaging (e-messaging) and to determine how it influenced their communication with general practitioners.
Nurses in home care services must collaborate with general practitioners to care for homebound patients. Studies have shown that communication and collaboration are often constrained because they are organised separately and are dispersed. The use of information and communication technology is expected to support communication and to be a tool for increased patient safety and higher-quality care.
Cross-sectional study with group comparisons
The data were collected with a mailed questionnaire that was answered by home care nurses (n = 425) who had implemented e-messaging and by home care nurses in a comparison group who had not implemented e-messaging (n = 364). The data were analysed using descriptive analyses, chi-square test, Mann-Whitney U-test and multilevel analysis.
The home care nurses who used e-messages reported to a greater extent that they had communication procedures with general practitioners compared to what the home care nurses in the comparison group reported. The implementation of e-messaging did not result in timelier communication or differences between the two groups in the use of nonelectronic communication, except for a lower use of faxes in the e-messaging group. However, the home care nurses who used e-messaging reported more frequent contacts with general practitioners.
The results demonstrate that even if e-messaging was implemented, the home care nurses and the general practitioners continued to use nonelectronic communication methods.
E-messaging did not replace but rather complemented the communication methods and thereby transformed clinical communication and collaboration. This should be considered when planning and implementing new information technology in primary care.
调查居家护理护士使用电子信息传递(电子消息)的体验,并确定其如何影响她们与全科医生的沟通。
居家护理服务中的护士必须与全科医生合作,以照顾居家患者。研究表明,沟通与合作常常受到限制,因为它们是分别组织且分散的。信息与通信技术的使用有望支持沟通,并成为提高患者安全性和提升护理质量的工具。
采用组间比较的横断面研究
通过邮寄问卷收集数据,问卷由实施了电子消息的居家护理护士(n = 425)以及未实施电子消息的对照组居家护理护士(n = 364)作答。数据采用描述性分析、卡方检验、曼-惠特尼U检验和多水平分析进行分析。
与对照组居家护理护士相比,使用电子消息的居家护理护士更多地报告称她们与全科医生有沟通程序。电子消息的实施并未带来更及时的沟通,两组在非电子通信的使用上也没有差异,只是电子消息组的传真使用较少。然而,使用电子消息的居家护理护士报告称与全科医生的联系更频繁。
结果表明,即使实施了电子消息,居家护理护士和全科医生仍继续使用非电子通信方式。
电子消息并未取代而是补充了沟通方式,从而改变了临床沟通与合作。在基层医疗中规划和实施新的信息技术时应考虑这一点。