Sowan Azizeh Khaled, Leibas Meghan, Tarriela Albert, Reed Charles
School of Nursing, University of Texas Health at San Antonio, San Antonio, TX, United States.
Center for Clinical Excellence, University Health System, San Antonio, TX, United States.
JMIR Hum Factors. 2019 Feb 12;6(1):e11846. doi: 10.2196/11846.
The integration of clinical practice guidelines (CPGs) into the nursing care plan and documentation systems aims to translate evidence into practice, improve safety and quality of care, and standardize care processes.
This study aimed to evaluate nurses' perceptions of the usability of a nursing care plan solution that includes 234 CPGs.
A total of 100 nurses from 4 adult intensive care units (ICUs) responded to a survey measuring nurses' perceptions of system usability. The survey included 37 rated items and 3 open-ended questions.
Nurses' perceptions were favorable with more than 60.0% (60/100) in agreement on 12 features of the system and negative to moderate with 20.0% (20/100), to 59.0% (59/100) in agreement on 19 features. The majority of the nurses (80/100, 80.0% to 90/100, 90.0%) agreed on 4 missing safety features within the system. More than half of the nurses believed they would benefit from refresher classes on system use. Overall satisfaction with the system was just above average (54/100, 54.0%). Common positive themes from the narrative data were related to the system serving as a reminder for complete documentation and individualizing patient care. Common negative aspects were related to duplicate charting, difficulty locating CPGs, missing unit-specific CPGs, irrelevancy of information, and lack of perceived system value on patient outcomes. No relationship was found between years of system use or ICU experience and satisfaction with the system (P=.10 to P=.25).
Care plan systems in ICUs should be easy to navigate; support efficient documentation; present relevant, unit-specific, and easy-to-find information; endorse interdisciplinary communication; and improve safety and quality of care.
将临床实践指南(CPG)整合到护理计划和文档系统中旨在将证据转化为实践,提高护理的安全性和质量,并规范护理流程。
本研究旨在评估护士对包含234项CPG的护理计划解决方案可用性的看法。
来自4个成人重症监护病房(ICU)的100名护士对一项测量护士对系统可用性看法的调查做出了回应。该调查包括37个评分项目和3个开放式问题。
护士的看法较为积极,超过60.0%(60/100)的护士同意该系统的12项功能;看法消极至中等的护士占20.0%(20/100)至59.0%(59/100),同意19项功能。大多数护士(80/100,80.0%至90/100,90.0%)认为系统中缺少4项安全功能。超过一半的护士认为他们将从系统使用复习课程中受益。对该系统的总体满意度略高于平均水平(54/100,54.0%)。叙述性数据中常见的积极主题与该系统可作为完整记录和个性化患者护理的提醒有关。常见的消极方面与重复记录、难以找到CPG、缺少特定科室的CPG、信息不相关以及对患者结局缺乏系统价值感有关。未发现系统使用年限或ICU经验与对系统的满意度之间存在关联(P = 0.10至P = 0.25)。
ICU中的护理计划系统应易于操作;支持高效记录;提供相关的、特定科室的且易于查找的信息;促进跨学科沟通;并提高护理的安全性和质量。