Warmbein Angelika, Rathgeber Ivanka, Seif Janesca, Mehler-Klamt Amrei C, Schmidbauer Lena, Scharf Christina, Hübner Lucas, Schroeder Ines, Biebl Johanna, Gutmann Marcus, Eberl Inge, Zoller Michael, Fischer Uli
Clinical Nursing Research and Quality Management Unit, University Hospital LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Professorship of Nursing Science, Faculty of Social Work, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany.
BMC Nurs. 2023 Feb 17;22(1):45. doi: 10.1186/s12912-023-01202-2.
Early mobilization can help reduce severe side effects such as muscle atrophy that occur during hospitalization. However, due to time and staff shortages in intensive and critical care as well as safety risks for patients, it is often difficult to adhere to the recommended therapy time of twenty minutes twice a day. New robotic technologies might be one approach to achieve early mobilization effectively for patients and also relieve users from physical effort. Nevertheless, currently there is a lack of knowledge regarding the factors that are important for integrating of these technologies into complex treatment settings like intensive care units or rehabilitation units.
European experts from science, technical development and end-users of robotic systems (n = 13) were interviewed using a semi-structured interview guideline to identify barriers and facilitating factors for the integration of robotic systems into daily clinical practice. They were asked about structural, personnel and environmental factors that had an impact on integration and how they had solved challenges. A latent content analysis was performed regarding the COREQ criteria.
We found relevant factors regarding the development, introduction, and routine of the robotic system. In this context, costs, process adjustments, a lack of exemptions, and a lack of support from the manufacturers/developers were identified as challenges. Easy handling, joint decision making between the end-users and the decision makers in the hospital, an accurate process design and the joint development of the robotic system of end-users and technical experts were found to be facilitating factors.
The integration and preparation for the integration of robotic assistance systems into the inpatient setting is a complex intervention that involves many parties. This study provides evidence for hospitals or manufacturers to simplify the planning of integrations for permanent use.
DRKS-ID: DRKS00023848; registered 10/12/2020.
早期活动有助于减少住院期间出现的肌肉萎缩等严重副作用。然而，由于重症监护和危重症护理中时间和人员短缺，以及患者的安全风险，往往难以坚持每天两次、每次20分钟的推荐治疗时间。新型机器人技术可能是一种有效实现患者早期活动并减轻使用者体力负担的方法。尽管如此，目前对于将这些技术整合到重症监护病房或康复病房等复杂治疗环境中的重要因素仍缺乏了解。
采用半结构化访谈指南，对来自机器人系统科学、技术开发和终端用户领域的13位欧洲专家进行访谈，以确定将机器人系统整合到日常临床实践中的障碍和促进因素。询问他们关于对整合有影响的结构、人员和环境因素，以及他们如何应对挑战。根据COREQ标准进行了潜在内容分析。
我们发现了与机器人系统的开发、引入和日常使用相关的因素。在此背景下，成本、流程调整、缺乏豁免以及制造商/开发者缺乏支持被确定为挑战。易于操作、终端用户与医院决策者之间的共同决策、准确的流程设计以及终端用户与技术专家共同开发机器人系统被发现是促进因素。
将机器人辅助系统整合到住院环境以及为整合做准备是一项涉及多方的复杂干预措施。本研究为医院或制造商简化永久性使用的整合规划提供了依据。
DRKS-ID：DRKS00023848；于2020年12月10日注册。
