McBride Deborah L, LeVasseur Sandra A
Samuel Merritt University, San Mateo, CA, United States.
University of Hawaii at Manoa, Hawaii State Center for Nursing School of Nursing and Dental Hygiene, Manoa, HI, United States.
JMIR Hum Factors. 2017 Apr 13;4(2):e10. doi: 10.2196/humanfactors.5110.
Coincident with the proliferation of employer-provided mobile communication devices, personal communication devices, including basic and enhanced mobile phones (smartphones) and tablet computers that are owned by the user, have become ubiquitous among registered nurses working in hospitals. While there are numerous benefits of personal communication device use by nurses at work, little is known about the impact of these devices on in-patient care.
Our aim was to examine how hospital-registered nurses use their personal communication devices while doing both work-related and non‒work-related activities and to assess the impact of these devices on in-patient care.
A previously validated survey was emailed to 14,797 members of two national nursing organizations. Participants were asked about personal communication device use and their opinions about the impact of these devices on their own and their colleagues' work.
Of the 1268 respondents (8.57% response rate), only 5.65% (70/1237) never used their personal communication device at work (excluding lunch and breaks). Respondents self-reported using their personal communication devices at work for work-related activities including checking or sending text messages or emails to health care team members (29.02%, 363/1251), as a calculator (25.34%, 316/1247), and to access work-related medical information (20.13%, 251/1247). Fewer nurses reported using their devices for non‒work-related activities including checking or sending text messages or emails to friends and family (18.75%, 235/1253), shopping (5.14%, 64/1244), or playing games (2.73%, 34/1249). A minority of respondents believe that their personal device use at work had a positive effect on their work including reducing stress (29.88%, 369/1235), benefiting patient care (28.74%, 357/1242), improving coordination of patient care among the health care team (25.34%, 315/1243), or increasing unit teamwork (17.70%, 220/1243). A majority (69.06%, 848/1228) of respondents believe that on average personal communication devices have a more negative than positive impact on patient care and 39.07% (481/1231) reported that personal communication devices were always or often a distraction while working. Respondents acknowledged their own device use negatively affected their work performance (7.56%, 94/1243), or caused them to miss important clinical information (3.83%, 47/1225) or make a medical error (0.90%, 11/1218). Respondents reported witnessing another nurse's use of devices negatively affect their work performance (69.41%, 860/1239), or cause them to miss important clinical information (30.61%, 378/1235) or make a medical error (12.51%, 155/1239). Younger respondents reported greater device use while at work than older respondents and generally had more positive opinions about the impact of personal communication devices on their work.
The majority of registered nurses believe that the use of personal communication devices on hospital units raises significant safety issues. The high rate of respondents who saw colleagues distracted by their devices compared to the rate who acknowledged their own distraction may be an indication that nurses are unaware of their own attention deficits while using their devices. There were clear generational differences in personal communication device use at work and opinions about the impact of these devices on patient care. Professional codes of conduct for personal communication device use by hospital nurses need to be developed that maximize the benefits of personal communication device use, while reducing the potential for distraction and adverse outcomes.
随着雇主提供的移动通信设备的普及，包括用户拥有的基本手机和增强型手机（智能手机）以及平板电脑在内的个人通信设备，在医院工作的注册护士中已无处不在。虽然护士在工作中使用个人通信设备有诸多益处，但对于这些设备对住院患者护理的影响却知之甚少。
我们的目的是研究医院注册护士在进行与工作相关和非工作相关活动时如何使用他们的个人通信设备，并评估这些设备对住院患者护理的影响。
一份先前经过验证的调查问卷通过电子邮件发送给两个全国性护理组织的14797名成员。参与者被问及个人通信设备的使用情况以及他们对这些设备对自己和同事工作影响的看法。
在1268名受访者中（回复率为8.57%），只有5.65%（70/1237）的人在工作时（不包括午餐和休息时间）从未使用过个人通信设备。受访者自我报告在工作中使用个人通信设备进行与工作相关的活动，包括向医疗团队成员检查或发送短信或电子邮件（29.02%，363/1251）、用作计算器（25.34%，316/1247）以及获取与工作相关的医疗信息（20.13%，251/1247）。较少护士报告将设备用于非工作相关活动，包括向朋友和家人检查或发送短信或电子邮件（18.75%，235/1253）、购物（5.14%，64/1244）或玩游戏（2.73%，34/1249）。少数受访者认为他们在工作中使用个人设备对工作有积极影响，包括减轻压力（29.88%，369/1235）、有益于患者护理（28.74%，357/1242）、改善医疗团队之间患者护理的协调（25.34%，315/1243）或增强科室团队合作（17.70%，220/1243）。大多数（69.06%，848/1228）受访者认为，平均而言，个人通信设备对患者护理的负面影响大于正面影响，39.07%（481/1231）的受访者报告说个人通信设备在工作时总是或经常会分散注意力。受访者承认自己使用设备会对工作表现产生负面影响（7.56%，94/1243），或导致他们错过重要的临床信息（3.83%，47/1225）或犯医疗错误（0.90%，11/1218）。受访者报告目睹另一名护士使用设备对其工作表现产生负面影响（69.41%，860/1239），或导致他们错过重要的临床信息（30.61%，378/1235）或犯医疗错误（12.51%，155/1239）。年轻受访者报告在工作时使用设备的频率高于年长受访者，并且总体上对个人通信设备对其工作的影响有更积极的看法。
大多数注册护士认为在医院科室使用个人通信设备会引发重大安全问题。与承认自己分心的受访者比例相比，看到同事因设备而分心的受访者比例较高，这可能表明护士在使用设备时并未意识到自己的注意力缺陷。在工作中使用个人通信设备以及对这些设备对患者护理影响的看法上存在明显的代际差异。需要制定医院护士使用个人通信设备的专业行为准则，以在最大限度地发挥个人通信设备使用益处的同时，减少分心和不良后果的可能性。
