Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA.
Department of Pediatrics, Division of Pediatric Hospital Medicine, Stanford University School of Medicine, Palo Alto, California, USA.
J Hosp Med. 2022 Nov;17(11):880-887. doi: 10.1002/jhm.12953. Epub 2022 Aug 29.
As hospitals shift away from pagers and towards secure text messaging systems (STMS), limited research exists on the drawbacks of such systems. Preliminary data show that introduction of STMS can lead to a dramatic increase in interruptions, which may contribute to medical errors.
This study aimed to investigate residents' and nurses' experiences with STMS at a quaternary care children's hospital.
This was a qualitative study with focus groups.
Participants were pediatric residents and nurses at Lucile Packard Children's Hospital.
Focus groups were audio recorded, transcribed verbatim, and coded by 2 independent coders. Codes were discussed until consensus was reached.
Data was analyzed through a thematic, descriptive content analysis approach. Themes were developed alongside a framework of teamwork, patient safety, and clinician well-being.
Three resident focus groups (n = 14) and three nurse focus groups (n = 21) were held. Six themes were identified: (1) STMS can facilitate teamwork through multiple communication modalities and technological features. (2) STMS can negatively impact teamwork by decreasing face-to-face communication and frontline decision-making. (3) STMS can promote patient safety through closed-loop communication and ready access to team members. (4) STMS can negatively impact patient safety through alarm fatigue, interruptions, and miscommunication. (5) STMS can positively impact clinician well-being through satisfaction and relationship building. (6) STMS can negatively impact clinician well-being through increased stress related to communication volume.
Use of STMS in the hospital setting has many advantages as well as drawbacks. With appropriate guidelines and training designed to mitigate the drawbacks, STMS have the potential to be valuable means of communication for healthcare team members.
随着医院逐渐从传呼机转向使用安全文本消息系统（STMS），针对此类系统的缺点的研究十分有限。初步数据表明，引入 STMS 会导致中断显著增加，这可能导致医疗差错。
本研究旨在调查四级儿童保健医院的住院医师和护士对 STMS 的使用体验。
这是一项采用焦点小组的定性研究。
参与者为 Lucile Packard 儿童医院的儿科住院医师和护士。
对焦点小组进行录音、逐字转录，并由 2 名独立编码员进行编码。在达成共识之前，对编码进行了讨论。
通过主题式、描述性内容分析方法对数据进行分析。主题是在团队合作、患者安全和临床医生福祉的框架内制定的。
共进行了 3 次住院医师焦点小组（n=14）和 3 次护士焦点小组（n=21）。确定了 6 个主题：（1）STMS 可以通过多种通信方式和技术功能促进团队合作。（2）STMS 通过减少面对面沟通和一线决策，对团队合作产生负面影响。（3）STMS 通过闭环沟通和随时访问团队成员来促进患者安全。（4）STMS 通过警报疲劳、中断和沟通失误对患者安全产生负面影响。（5）STMS 通过满意度和关系建立对临床医生的幸福感产生积极影响。（6）STMS 通过与通信量相关的压力增加对临床医生的幸福感产生负面影响。
STMS 在医院环境中的使用有很多优点，也有缺点。通过制定适当的指南和培训来减轻缺点，STMS 有可能成为医疗保健团队成员有价值的沟通手段。
