Krupp Anna, Di Martino Michael, Chung Wesley, Chaiyachati Krisda, Agarwal Anish K, Huffenberger Ann Marie, Laudanski Krzysztof
College of Nursing, University of Iowa, Iowa City, IA, 52242, USA.
College of Arts and Sciences, University of Pennsylvania, 249 South 36th St, Philadelphia, PA, 19104, USA.
BMC Health Serv Res. 2021 Mar 25;21(1):277. doi: 10.1186/s12913-021-06287-6.
Understanding the use of tele-intensive care unit (ICU) services is an essential component in evaluating current practice and informing future use as the adoption and application of teleICU services expands. We sought to explore if novel ways to utilize teleICU services can emerge within an established, consulting-style teleICU model considering the program's flexible, provider-driven operation.
This was a qualitative study of one teleICU/hospital dyad using semi-structured interviews from a convenience sample of ICU (n = 19) and teleICU (n = 13) nurses. Interviews were analyzed using directed content analysis to identify themes that describe their experiences with teleICU using a deductive codebook developed from an expert consensus (American Association of Critical Care Nurses) AACN statement on teleICU nursing.
Three themes were identified through the qualitative content analysis: [1] nurses described unique teleICU knowledge, including systems thinking and technological skills, [2] the teleICU partnership supported quality improvement initiatives, and [3] elements of the work environment influenced perceptions of teleICU and its use. When elements of the work environment, such as effective communication and role clarity, were not present, teleICU use was variable.
Flexible, provider-driven approaches for integrating teleICU services into daily practice may help define the future use of the teleICU model's applicability. Future work should focus on the importance of effective communication and role clarity in integrating the emerging teleICU services into teleICU/ICU practice.
随着远程重症监护病房（ICU）服务的采用和应用不断扩大，了解其使用情况是评估当前实践并为未来使用提供依据的重要组成部分。考虑到该项目灵活的、由提供者驱动的运作方式，我们试图探索在既定的咨询式远程ICU模式中是否能出现利用远程ICU服务的新方法。
这是一项针对一个远程ICU/医院组合的定性研究，采用半结构化访谈，访谈对象为从ICU护士（n = 19）和远程ICU护士（n = 13）中方便抽样选取的人员。使用定向内容分析法对访谈进行分析，以识别描述他们在远程ICU经历的主题，该方法使用从美国重症护理护士协会（AACN）关于远程ICU护理的专家共识声明中制定的演绎编码手册。
通过定性内容分析确定了三个主题：[1]护士描述了独特的远程ICU知识，包括系统思维和技术技能；[2]远程ICU伙伴关系支持质量改进举措；[3]工作环境因素影响了对远程ICU及其使用的看法。当工作环境因素，如有效沟通和角色明确不存在时，远程ICU的使用情况会有所不同。
将远程ICU服务整合到日常实践中的灵活的、由提供者驱动的方法可能有助于确定远程ICU模式适用性的未来用途。未来的工作应侧重于有效沟通和角色明确在将新兴的远程ICU服务整合到远程ICU/ICU实践中的重要性。
