Wentzel Jobke, van Drie-Pierik Regine, Nijdam Lars, Geesing Jos, Sanderman Robbert, van Gemert-Pijnen Julia E W C
Department of Psychology, Health, and Technology, Faculty of Behavioural, Management and Social Sciences, Universitity of Twente, Enschede, The Netherlands.
Department of Pharmacy, Medisch Spectrum Twente, Enschede, The Netherlands.
Am J Infect Control. 2016 Jun 1;44(6):677-84. doi: 10.1016/j.ajic.2015.12.038. Epub 2016 Feb 19.
Nurses can be crucial contributors to antibiotic stewardship programs (ASPs), interventions aimed at improving antibiotic use, but nurse empowerment in ASPs adds to their job complexity. Nurses work in complex settings with high cognitive loads, which ask for easily accessible information. An information application (app) was developed to support nurses in ASPs. The efficiency, effectiveness, and user satisfaction regarding this antibiotic app were tested in a pilot study.
The app was introduced into 2 lung wards of a local teaching hospital. During the 8-month pilot study, the 62 nurses of the wards had access to the app. Changes in user satisfaction regarding information support, safety attitudes, and ASP behavior were assessed with a questionnaire. At baseline, 28 nurses completed the (e-mail) questionnaire; after the study, 18 nurses participated. Scenario-based tests were done to assess app efficiency and effectiveness at baseline (n = 16) and in a randomized control (without the app, n = 17) and intervention condition (with the app, n = 17).
Significant improvements were found regarding task support (P = .041), reliability (P = .004), unobtrusiveness (P = .000), relevance (P = .002), user friendliness (P = .000), speed, and hyperlinks (P = .001). An improvement in communication was observed regarding nurse-physician understanding (P = .034). With the app, nurses solved the scenarios faster than without it.
The human-centered design approach and persuasive strategy of task support were effective in reducing time needed to find information. Stewardship-related behaviors need active education strategies.
护士可以成为抗生素管理计划(ASP)的关键贡献者,ASP是旨在改善抗生素使用的干预措施,但ASP中的护士赋权增加了他们的工作复杂性。护士在认知负荷高的复杂环境中工作,这需要易于获取的信息。开发了一个信息应用程序(应用)来支持ASP中的护士。在一项试点研究中测试了该抗生素应用的效率、有效性和用户满意度。
该应用被引入当地一家教学医院的2个肺病病房。在为期8个月的试点研究期间,病房的62名护士可以使用该应用。通过问卷调查评估用户在信息支持、安全态度和ASP行为方面的满意度变化。基线时,28名护士完成了(电子邮件)问卷;研究结束后,18名护士参与。在基线(n = 16)、随机对照(不使用应用,n = 17)和干预条件(使用应用,n = 17)下进行基于场景的测试,以评估应用的效率和有效性。
在任务支持(P = 0.041)、可靠性(P = 0.004)、不干扰性(P = 0.000)、相关性(P = 0.002)、用户友好性(P = 0.000)、速度和超链接(P = 0.001)方面发现了显著改善。在护士与医生的理解方面观察到沟通有所改善(P = 0.034)。使用该应用时,护士解决场景的速度比不使用时更快。
以用户为中心的设计方法和任务支持的说服策略有效地减少了查找信息所需的时间。管理相关行为需要积极的教育策略。