Beauséjour Waldo, Hagens Simon
Canada Health Infoway, Toronto, ON, Canada.
JMIR Nurs. 2022 Mar 31;5(1):e33586. doi: 10.2196/33586.
Canadian nurses are at the forefront of patient care delivery. Although the use of digital health technologies for care delivery is gaining momentum in Canada, nurses are encouraged to integrate virtual care into their practice. In early 2020, more Canadian nurses delivered care virtually compared with 3 years ago.
This study seeks to uncover the professional characteristics of Canadian nurses accessing virtual care in 2020, understand how these characteristics differ across types of technologies, investigate whether the nurses accessing virtual care possess the skills and knowledge needed to use these technologies, and determine the important drivers of the uptake of virtual care observed in 2020.
We used data from the 2017 and 2020 National Survey of Canadian Nurses. This survey collected data on the use of digital health technologies in nursing practice. It concerned regulated nursing professionals working in different health care settings and from different domains of nursing practice. We combined the chi-square independence test and logistic regression analysis to uncover the most relevant drivers of virtual care uptake by nurses in 2020.
In early 2020, before the declaration of the COVID-19 pandemic, nurses who delivered care virtually were predominantly nurse practitioners (135/159, 84.9%) and more likely to work in a primary or community care setting (202/367, 55%) and in an urban setting (194/313, 61.9%). Factors such as nursing designation (P<.001), perceived quality of care at the health facility where the nurses practiced (P<.001), and the type of patient record-keeping system they had access to (P=.04) had a statistically significant effect on the probability of nurses to deliver care virtually in early 2020. Furthermore, nurses' perception of the quality of care they delivered through virtual technologies was statistically associated with their perception of the skills (χ=308.7; P<.001) and knowledge (χ=283.4; P<.001) to use these technologies.
This study emphasizes the critical importance of nursing designation, geographic location, and type of patient record-keeping system in predicting virtual care integration in nursing practice. The findings related to geographic location can be used by decision-makers for better allocation of digital health resources among care settings in rural and urban areas. Similarly, the disparities observed across nursing designations have some implications for the digital training of nurses at all levels of practice. Finally, the association between electronic medical record use and uptake of virtual care could accelerate the implementation of more modernized record-keeping systems in care settings. Hence, this could advance interoperability and improve health care delivery.
加拿大护士处于患者护理服务的前沿。尽管在加拿大，使用数字健康技术提供护理服务的势头日益强劲，但仍鼓励护士将虚拟护理融入其实践中。2020年初，与3年前相比，更多的加拿大护士提供了虚拟护理服务。
本研究旨在揭示2020年使用虚拟护理的加拿大护士的专业特征，了解这些特征在不同技术类型之间的差异，调查使用虚拟护理的护士是否具备使用这些技术所需的技能和知识，并确定2020年观察到的虚拟护理采用的重要驱动因素。
我们使用了2017年和2020年加拿大护士全国调查的数据。该调查收集了护理实践中数字健康技术使用情况的数据。调查对象为在不同医疗环境和不同护理实践领域工作的受监管护理专业人员。我们结合卡方独立性检验和逻辑回归分析，以揭示2020年护士采用虚拟护理的最相关驱动因素。
在2020年初，即新冠疫情宣布之前，提供虚拟护理的护士主要是执业护士（135/159，84.9%），更有可能在初级或社区护理环境中工作（202/367，55%），且在城市环境中工作（194/313，61.9%）。护理职称（P<.001）、护士执业的医疗机构的护理质量感知（P<.001）以及他们可使用的患者记录系统类型（P=.04）等因素对2020年初护士提供虚拟护理的可能性具有统计学显著影响。此外，护士对通过虚拟技术提供的护理质量的感知与他们对使用这些技术的技能（χ=308.7；P<.001）和知识（χ=283.4；P<.001）的感知在统计学上相关。
本研究强调了护理职称、地理位置和患者记录系统类型在预测护理实践中虚拟护理整合方面的至关重要性。与地理位置相关的研究结果可供决策者用于在农村和城市地区的护理环境中更好地分配数字健康资源。同样，不同护理职称之间观察到的差异对各级护理人员的数字培训具有一定意义。最后，电子病历使用与虚拟护理采用之间的关联可能会加速在护理环境中实施更现代化的记录系统。因此，这可以促进互操作性并改善医疗服务的提供。
