Asiedu Gladys B, Fang Jennifer L, Harris Ann M, Colby Christopher E, Carroll Katherine
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester Minnesota.
Division of Neonatal Medicine Mayo Clinic Rochester Minnesota.
Health Sci Rep. 2019 Jan 10;2(2):e111. doi: 10.1002/hsr2.111. eCollection 2019 Feb.
Little research has been done on tele-intensive care unit (ICU) implementation across different types of ICUs, and there exist few studies that have used qualitative research methods to analyze the human and organizational factors influencing optimization of telemedicine for newborn resuscitation. The objective of this study was to understand health care professionals' acceptance, utilization, and integration of video telemedicine for newborn resuscitation (termed ) in community hospital settings.
Focus group and individual interviews were conducted with 49 health care professionals at six affiliated health system hospitals. Data were gathered from physicians ( = 18), nurses ( = 30), and a nurse practitioner. Data were inductively analyzed using a thematic approach, and then constructs from normalization process theory (NPT) were deductively applied. NPT rendered a general framework to describe and assess how care teams perceive the implementation of teleneonatology and how they interact with this telemedicine service in their local setting.
Local health care professionals accepted teleneonatology as an important, helpful service, yet its implementation was perceived as both valuable and a threat to professional traditions. Utilization may depend on perceived benefit, mutual understanding of the guidelines, and expectations of use, and other relational, human, contextual, and system factors. Participants in this study agreed on the need for collective work to successfully integrate teleneonatology into the local practice.
NPT uncovered that successful implementation of a teleneonatology program may be facilitated by strong interpersonal relationships among care teams, continuous programmatic training and education, and communicating the clinical value of teleneonatology, including its opportunities and benefits.
针对不同类型重症监护病房（ICU）实施远程重症监护的研究较少，且很少有研究采用定性研究方法来分析影响新生儿复苏远程医疗优化的人员和组织因素。本研究的目的是了解社区医院环境中医疗保健专业人员对新生儿复苏视频远程医疗（称为 ）的接受、使用和整合情况。
对六家附属医疗系统医院的49名医疗保健专业人员进行了焦点小组和个人访谈。数据收集自医生（ = 18）、护士（ = 30）和一名执业护士。采用主题分析法对数据进行归纳分析，然后演绎应用规范化过程理论（NPT）的构建。NPT提供了一个通用框架，用于描述和评估护理团队如何看待远程新生儿学的实施，以及他们在当地环境中如何与这项远程医疗服务互动。
当地医疗保健专业人员将远程新生儿学视为一项重要且有帮助的服务，但其实施既被视为有价值，也对专业传统构成威胁。使用情况可能取决于感知到的益处、对指南的相互理解、使用期望以及其他关系、人员、背景和系统因素。本研究的参与者一致认为需要集体协作才能成功将远程新生儿学整合到当地实践中。
NPT发现，护理团队之间牢固的人际关系、持续的项目培训和教育，以及传达远程新生儿学的临床价值，包括其机会和益处，可能有助于远程新生儿学项目的成功实施。
