King Christopher Ryan, Shambe Ayanna, Abraham Joanna
Department of Anesthesiology, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
Saint Louis University School of Medicine, St. Louis, Missouri, USA.
JAMIA Open. 2023 Mar 16;6(1):ooad015. doi: 10.1093/jamiaopen/ooad015. eCollection 2023 Apr.
Situational awareness and anticipatory guidance for nurses receiving a patient after surgery are keys to patient safety. Little work has defined the role of artificial intelligence (AI) to support these functions during nursing handoff communication or patient assessment. We used interviews to better understand how AI could work in this context.
Eleven nurses participated in semistructured interviews. Mixed inductive-deductive thematic analysis was used to extract major themes and subthemes around roles for AI supporting postoperative nursing.
Five themes were generated from the interviews: (1) nurse understanding of patient condition guides care decisions, (2) handoffs are important to nurse situational awareness, but multiple barriers reduce their effectiveness, (3) AI may address barriers to handoff effectiveness, (4) AI may augment nurse care decision making and team communication outside of handoff, and (5) user experience in the electronic health record and information overload are likely barriers to using AI. Important subthemes included that AI-identified problems would be discussed at handoff and team communications, that AI-estimated elevated risks would trigger patient re-evaluation, and that AI-identified important data may be a valuable addition to nursing assessment.
Most research on postoperative handoff communication relies on structured checklists. Our results suggest that properly designed AI tools might facilitate postoperative handoff communication for nurses by identifying specific elevated risks faced by a patient, triggering discussion on those topics. Limitations include a single center, many participants lacking of applied experience with AI, and limited participation rate.
术后接收患者时护士的情景意识和预前指导是患者安全的关键。在护理交接班沟通或患者评估过程中,很少有工作明确人工智能(AI)在支持这些功能方面的作用。我们通过访谈来更好地了解AI在这种情况下如何发挥作用。
11名护士参与了半结构化访谈。采用混合归纳-演绎主题分析法,围绕AI支持术后护理的作用提取主要主题和子主题。
访谈产生了五个主题:(1)护士对患者病情的了解指导护理决策;(2)交接班对护士的情景意识很重要,但多种障碍降低了其有效性;(3)AI可能解决交接班有效性的障碍;(4)AI可能增强护士在交接班之外的护理决策和团队沟通;(5)电子健康记录中的用户体验和信息过载可能是使用AI的障碍。重要的子主题包括,在交接班和团队沟通时将讨论AI识别出的问题,AI估计的风险升高将触发对患者的重新评估,以及AI识别出的重要数据可能是护理评估的宝贵补充。
大多数关于术后交接班沟通的研究依赖于结构化检查表。我们的结果表明,设计得当的AI工具可能通过识别患者面临的特定风险升高情况,引发对这些话题的讨论,从而促进护士的术后交接班沟通。局限性包括单一中心、许多参与者缺乏AI应用经验以及参与率有限。