Martinez Rachael N, Etingen Bella, French Dustin D, Vallette Marissa A, Bidassie Balmatee, Cozart Huberta T, Weaver Frances M
Center of Innovation for Complex Chronic Healthcare, Department of Veterans Affairs, Edward Hines, Jr. VA Hospital, Hines, IL, USA.
Department of Ophthalmology and the Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Disabil Rehabil Assist Technol. 2020 Jan;15(1):67-75. doi: 10.1080/17483107.2018.1527956. Epub 2018 Nov 19.
Guided by an ecological perspective, the purpose of this study was to identify multilevel factors that influenced the implementation of environmental control units (ECUs) in Veterans Health Administration (VHA) Spinal Cord Injury/Disorders (SCI/D) Centres. Mixed methods including an online survey and qualitative interviews of VHA healthcare employees. VHA healthcare employees participated in the online survey ( = 153, 21% participation rate) and semi-structured interview ( = 28; 54% participation rate). About 58.2% of survey respondents indicated that patients admitted to a VHA SCI/D Centre received ECU training. Interview participants reported that patients might benefit from educational materials on using ECUs. About 53.7% of survey respondents indicated that they did not receive ECU training. Interview participants emphasized that more healthcare employees needed to be trained to distribute ECU-related tasks including patient training and troubleshooting problems. The most common challenge was the coordination involved in moving patients out of rooms that were being outfitted with an ECU. Application of an ecological framework highlighted a range of factors at multiple levels that dynamically influence ECU implementation while accounting for the SCI/D care context. Integrating this technology with the care experiences of patients, the workflow of healthcare employees, and the structure of the organization may improve the implementation of ECUs.IMPLICATIONS FOR REHABILITATIONAn environmental control unit (ECU) is an assistive technology device that provides persons with a physical disability (e.g., spinal cord injuries and disorders) increased independence in a home, hospital, or rehabilitation facility setting.An ECU allows a person to access and control appliances like their hospital bed, lights, television, doors, nurse call button, telephone, and computer, thus, decreasing workload on attendants and family members while increasing independence for the user.Application of an ecological framework in this study highlighted a range of factors at multiple levels that dynamically influence ECU implementation while accounting for the SCI/D care context.Integrating this technology with the care experiences of patients, the workflow of healthcare employees, and the structure of the organization may improve the implementation of ECUs in an inpatient setting.
本研究以生态视角为指导，旨在确定影响退伍军人健康管理局（VHA）脊髓损伤/疾病（SCI/D）中心环境控制单元（ECU）实施的多层次因素。采用了混合方法，包括对VHA医护人员进行在线调查和定性访谈。VHA医护人员参与了在线调查（n = 153，参与率21%）和半结构化访谈（n = 28；参与率54%）。约58.2%的调查受访者表示，入住VHA SCI/D中心的患者接受了ECU培训。访谈参与者报告称，患者可能会从有关使用ECU的教育材料中受益。约53.7%的调查受访者表示他们没有接受过ECU培训。访谈参与者强调，需要对更多医护人员进行培训，以分配与ECU相关的任务，包括患者培训和解决问题。最常见的挑战是在将患者从正在安装ECU的房间移出时所涉及的协调工作。应用生态框架突出了多层次的一系列因素，这些因素在考虑SCI/D护理背景的同时，动态影响着ECU的实施。将这项技术与患者的护理体验、医护人员的工作流程以及组织架构相结合，可能会改善ECU的实施情况。
对康复的启示
环境控制单元（ECU）是一种辅助技术设备，可为身体残疾者（如脊髓损伤和疾病患者）在家庭、医院或康复机构环境中提供更高的独立性。
ECU使人们能够访问和控制诸如病床、灯光、电视、门、护士呼叫按钮、电话和计算机等设备，从而减少护理人员和家庭成员的工作量，同时增加用户的独立性。
本研究中应用生态框架突出了多层次的一系列因素，这些因素在考虑SCI/D护理背景的同时，动态影响着ECU的实施。
将这项技术与患者的护理体验、医护人员的工作流程以及组织架构相结合，可能会改善住院环境中ECU的实施情况。
