Bettinelli Michele, Lei Yuxiu, Beane Matt, Mackey Caleb, Liesching Timothy N
1 Surgical Intensive Care Unit, Lahey Hospital & Medical Center , Burlington, Massachusetts.
2 Department of Pulmonary & Critical Care Medicine, Lahey Hospital & Medical Center , Burlington, Massachusetts.
Telemed J E Health. 2015 Aug;21(8):637-43. doi: 10.1089/tmj.2014.0162. Epub 2015 May 4.
Delivering healthcare using remote robotic telepresence is an evolving practice in medical and surgical intensive critical care units and will likely have varied implications for work practices and working relationships in intensive care units. Our study assessed the nurse-physician collaboration satisfaction about care decisions from surgical intensive critical care nurses during remote robotic telepresence night rounds in comparison with conventional telephone night rounds.
This study used a randomized trial to test whether robotic telerounding enhances the nurse-physician collaboration satisfaction about care decisions. A physician randomly used either the conventional telephone or the RP-7 robot (InTouch(®) Health, Santa Barbara, CA) to perform nighttime rounding in a surgical intensive care unit. The Collaboration and Satisfaction About Care Decisions (CSACD) survey instrument was used to measure the nurse-physician collaboration. The CSACD scores were compared using the signed-rank test with a significant p value of ≤0.05.
From December 1, 2011 to December 13, 2012, 20 off-shift nurses submitted 106 surveys during telephone rounds and 108 surveys during robot rounds. The median score of surveys during robot rounds was slightly but not significantly higher than telephone rounds (51.3 versus 50.5; p=0.3). However, the CSACD score was significantly increased from baseline with robot rounds (51.3 versus 43.0; p=0.01), in comparison with telephone rounds (50.5 versus 43.0; p=0.09). The mediators, including age, working experience, and robot acceptance, were not significantly (p>0.1) correlated with the CSACD score difference (robot versus telephone).
Robot rounding in the intensive care unit was comparable but not superior to the telephone in regard to the nurse-physician collaboration and satisfaction about care decision. The working experience and technology acceptance of intensive care nurses did not contribute to the preference of night shift rounding method from the aspect of collaboration with the physician about care decision-making.
在医疗和外科重症监护病房中，使用远程机器人临场感提供医疗服务是一种不断发展的实践，可能会对重症监护病房的工作实践和工作关系产生不同影响。我们的研究评估了在远程机器人临场感夜间查房期间，与传统电话夜间查房相比，外科重症监护护士对护理决策的医护协作满意度。
本研究采用随机试验来测试机器人远程查房是否能提高医护对护理决策的协作满意度。一名医生随机使用传统电话或RP - 7机器人（InTouch(®) Health，加利福尼亚州圣巴巴拉）在外科重症监护病房进行夜间查房。使用护理决策协作与满意度（CSACD）调查问卷来衡量医护协作。采用符号秩检验比较CSACD得分，显著p值≤0.05。
2011年12月1日至2012年12月13日，20名非值班护士在电话查房期间提交了106份调查问卷，在机器人查房期间提交了108份调查问卷。机器人查房期间调查问卷的中位数得分略高于电话查房，但无显著差异（51.3对50.5；p = 0.3）。然而，与电话查房相比（50.5对43.0；p = 0.09），机器人查房时CSACD得分从基线显著提高（51.3对43.0；p = 0.01）。包括年龄、工作经验和对机器人的接受程度在内的调节因素与CSACD得分差异（机器人对电话）无显著相关性（p>0.1）。
在医护协作和对护理决策的满意度方面，重症监护病房的机器人查房与电话查房相当，但并不优于电话查房。重症监护护士的工作经验和技术接受程度在与医生进行护理决策协作方面，对夜班查房方法的偏好没有影响。
