多学科沟通网络在高度信息化养老院中的皮肤风险评估。
Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication.
机构信息
University of Missouri, Sinclair School of Nursing, United States.
Health Care Policy & Research, Mayo Clinic, 200 First Street SW, Harwick Bldg. 2-42, Rochester, MN 55905, United States.
出版信息
Int J Med Inform. 2014 Aug;83(8):581-91. doi: 10.1016/j.ijmedinf.2014.05.001. Epub 2014 May 21.
BACKGROUND
The role of nursing home (NH) information technology (IT) in quality improvement has not been clearly established, and its impacts on communication between care givers and patient outcomes in these settings deserve further attention.
OBJECTIVES
In this research, we describe a mixed method approach to explore communication strategies used by healthcare providers for resident skin risk in NH with high IT sophistication (ITS).
METHODS
Sample included NH participating in the statewide survey of ITS. We incorporated rigorous observation of 8- and 12-h shifts, and focus groups to identify how NH IT and a range of synchronous and asynchronous tools are used. Social network analysis tools and qualitative analysis were used to analyze data and identify relationships between ITS dimensions and communication interactions between care providers.
RESULTS
Two of the nine ITS dimensions (resident care-technological and administrative activities-technological) and total ITS were significantly negatively correlated with number of unique interactions. As more processes in resident care and administrative activities are supported by technology, the lower the number of observed unique interactions. Additionally, four thematic areas emerged from staff focus groups that demonstrate how important IT is to resident care in these facilities including providing resident-centered care, teamwork and collaboration, maintaining safety and quality, and using standardized information resources.
CONCLUSION
Our findings in this study confirm prior research that as technology support (resident care and administrative activities) and overall ITS increases, observed interactions between staff members decrease. Conversations during staff interviews focused on how technology facilitated resident centered care through enhanced information sharing, greater virtual collaboration between team members, and improved care delivery. These results provide evidence for improving the design and implementation of IT in long term care systems to support communication and associated resident outcomes.
背景
养老院（NH）信息技术（IT）在质量改进中的作用尚未明确确定，其对这些环境中护理人员之间沟通和患者结果的影响值得进一步关注。
目的
在这项研究中，我们描述了一种混合方法，以探索医疗保健提供者在具有高 IT 复杂性（ITS）的 NH 中用于居民皮肤风险的沟通策略。
方法
样本包括参与全州 ITS 调查的 NH。我们结合了对 8 小时和 12 小时轮班的严格观察，以及焦点小组，以确定 NH IT 和一系列同步和异步工具的使用方式。使用社会网络分析工具和定性分析来分析数据，并确定 ITS 维度与护理提供者之间沟通互动之间的关系。
结果
九个 ITS 维度中的两个（居民护理-技术和行政活动-技术）和总 ITS 与独特交互的数量呈显著负相关。随着居民护理和行政活动中的更多流程得到技术支持，观察到的独特交互数量就越低。此外，工作人员焦点小组中出现了四个主题领域，展示了 IT 在这些设施中对居民护理的重要性，包括提供以居民为中心的护理、团队合作和协作、保持安全和质量以及使用标准化信息资源。
结论
我们在这项研究中的发现证实了先前的研究，即随着技术支持（居民护理和行政活动）和总体 ITS 的增加，工作人员之间的观察到的交互次数减少。工作人员访谈中的对话重点介绍了技术如何通过增强信息共享、团队成员之间更大的虚拟协作以及改善护理服务来促进以居民为中心的护理。这些结果为改善长期护理系统中 IT 的设计和实施提供了证据，以支持沟通和相关的居民结果。
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