Ditchburn Jae-Llane, Marshall Alison
Department of Science, Natural Resources and Outdoor Studies, University of Cumbria, Carlisle, Cumbria, UK.
Department of Nursing, Health and Professional Practice, University of Cumbria, Lancaster, UK.
J Ren Care. 2017 Sep;43(3):175-182. doi: 10.1111/jorc.12207. Epub 2017 Jun 14.
The Lancashire Teaching Hospitals NHS Trust in the UK has been providing renal care through video-as-a-service (VAAS) to patients since 2013, with support from the North West NHS Shared Infrastructure Service, a collaborative team that supports information and communication technology use in the UK National Health Service.
Renal telemedicine offered remotely to patients on home dialysis supports renal care through the provision of a live high-quality video link directly to unsupported patients undergoing haemodialysis at home. Home haemodialysis is known to provide benefits to patients, particularly in making them more independent. The use of a telemedicine video-link in Lancashire and South Cumbria, UK, further reduces patient dependence on the professional team.
The purpose of this paper is to present the perspectives of the renal care team members using the renal telemedicine service to understand the perceived benefits and issues with the service.
Ten semi-structured interviews with members of the renal care team (two renal specialists, one matron, two renal nurses, one business manager, one renal technical services manager, two IT technicians and one hardware maintenance technician) were conducted. Thematic analysis was undertaken to analyse the qualitative data.
A range of incremental benefits to the renal team members were reported, including more efficient use of staff time, reduced travel, peace of mind and a strong sense of job satisfaction. Healthcare staff believed that remote renal care through video was useful, encouraged concordance and could nurture confidence in patients. Key technological issues and adjustments which would improve the renal telemedicine service were also identified.
The impact of renal telemedicine was positive on the renal team members. The use of telemedicine has been demonstrated to make home dialysis delivery more efficient and safe. The learning from staff feedback could inform development of services elsewhere.
自2013年以来，英国兰开夏郡教学医院国民保健服务信托基金在英国国家医疗服务体系信息与通信技术使用支持协作团队——西北国民保健服务共享基础设施服务的支持下，一直通过视频即服务（VAAS）为患者提供肾脏护理。
向接受家庭透析的患者远程提供肾脏远程医疗，通过直接为在家中进行血液透析且无支持的患者提供高质量实时视频链接来支持肾脏护理。众所周知，家庭血液透析对患者有益，尤其是能使他们更加独立。在英国兰开夏郡和南坎布里亚郡使用远程医疗视频链接，进一步减少了患者对专业团队的依赖。
本文旨在介绍使用肾脏远程医疗服务的肾脏护理团队成员的观点，以了解该服务的感知益处和问题。
对肾脏护理团队成员（两名肾脏专科医生、一名护士长、两名肾脏护士、一名业务经理、一名肾脏技术服务经理、两名信息技术技术员和一名硬件维护技术员）进行了10次半结构化访谈。采用主题分析法对定性数据进行分析。
报告了对肾脏团队成员的一系列增量益处，包括更有效地利用员工时间、减少出行、安心以及强烈的工作满意度。医护人员认为通过视频进行远程肾脏护理很有用，能促进依从性，并能增强患者的信心。还确定了可改善肾脏远程医疗服务的关键技术问题和调整措施。
肾脏远程医疗对肾脏团队成员产生了积极影响。事实证明，使用远程医疗可提高家庭透析服务的效率和安全性。从员工反馈中吸取的经验教训可为其他地方的服务发展提供参考。
