护理人员对住宅护理设施中实施无线护士呼叫系统的促进因素和障碍的评价。一项横断面研究。
Nursing staff's evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.
机构信息
The Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.
National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway.
出版信息
BMC Health Serv Res. 2020 Mar 4;20(1):163. doi: 10.1186/s12913-020-4998-9.
BACKGROUND
Traditional nurse call systems used in residential care facilities rely on patients to summon assistance for routine or emergency needs. Wireless nurse call systems (WNCS) offer new affordances for persons unable to actively or consciously engage with the system, allowing detection of hazardous situations, prevention and timely treatment, as well as enhanced nurse workflows. This study aimed to explore facilitators and barriers of implementation of WNCSs in residential care facilities.
METHODS
The study had a cross-sectional descriptive design. We collected data from care providers (n = 98) based on the Measurement Instrument for Determinants of Innovation (MIDI) framework in five Norwegian residential care facilities during the first year of WNCS implementation. The self-reporting MIDI questionnaire was adapted to the contexts. Descriptive statistics were used to explore participant characteristics and MIDI item and determinant scores. MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation.
RESULTS
More facilitators (n = 22) than barriers (n = 6) were identified. The greatest facilitators, reported by 98% of the care providers, were the expected outcomes: the importance and probability of achieving prompt call responses and increased safety, and the normative belief of unit managers. During the implementation process, 87% became familiar with the systems, and 86 and 90%, respectively regarded themselves and their colleagues as competent users of the WNCS. The most salient barriers, reported by 37%, were their lack of prior knowledge and that they found the WNCS difficult to learn. No features of the technology were identified as barriers.
CONCLUSIONS
Overall, the care providers gave a positive evaluation of the WNCS implementation. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. WNCSs offer a range of advanced applications and services, and further research is needed as more WNCS functionalities are implemented into residential care services.
背景
传统的养老院呼叫系统依赖于患者主动发出常规或紧急需求的信号来寻求帮助。无线护士呼叫系统（WNCS）为无法主动或有意识地与系统交互的人提供了新的辅助手段，能够检测危险情况，预防和及时治疗，并改善护士的工作流程。本研究旨在探讨 WNCS 在养老院中的实施促进因素和障碍因素。
方法
本研究采用了横断面描述性设计。我们在 WNCS 实施的第一年，在挪威的五家养老院中，基于创新测定量表（MIDI）框架，从护理人员（n=98）那里收集数据。根据上下文对自我报告的 MIDI 问卷进行了调整。使用描述性统计来探索参与者的特征以及 MIDI 项目和决定因素的评分。对于得分≥20%的参与者不同意/完全不同意的 MIDI 项目被视为实施的障碍因素，而得分≥80%的参与者同意/完全同意的 MIDI 项目被视为实施的促进因素。
结果
我们发现了更多的促进因素（n=22）而不是障碍因素（n=6）。98%的护理人员报告的最大促进因素是预期的结果：及时响应呼叫的重要性和可能性以及提高安全性，以及单位管理人员的规范信念。在实施过程中，87%的人熟悉了系统，86%和 90%的人分别认为自己和同事是 WNCS 的熟练用户。37%的人报告的最明显障碍是他们缺乏先前的知识，并且他们发现 WNCS 很难学习。没有发现技术的任何特点是障碍。
结论
总的来说，护理人员对 WNCS 的实施给予了积极的评价。通过培训和实践技术技能，以及管理人员和养老院单元内同事的影响和支持，解决了实施的障碍。WNCS 提供了一系列先进的应用和服务，随着更多 WNCS 功能被引入养老院服务，需要进一步研究。
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