Karnehed Sara, Pejner Margaretha Norell, Erlandsson Lena-Karin, Petersson Lena
School of Health & Welfare, Halmstad University, Halmstad, Sweden.
Department of Home Care, Halmstad Municipality, Halmstad, Sweden.
Scand J Caring Sci. 2024 Jun;38(2):347-357. doi: 10.1111/scs.13237. Epub 2024 Jan 19.
The electronic medication administration record (eMAR) is an eHealth system that has replaced the traditional paper-based medication administration used in many healthcare settings. Research has highlighted that eHealth technologies can change working methods and professional roles in both expected and unexpected ways. To date, there is sparse research that has explored how nurses and nurse assistants (NA) in home healthcare experience eMAR in relation to their work environment.
The aim was to explore how nurses and nurse assistants experienced their work environment, in terms of job-demand, control, and support in a Swedish home healthcare setting where an electronic medication administration record had been implemented to facilitate delegation of medical administration.
We took a qualitative approach, where focus groups were used as data collection method. The focus groups included 16 nurses and nine NAs employed in a Swedish municipality where an eMAR had been implemented 6 months before the first focus groups were performed. The analysis adapted the job-demand-control-support model, by condensing the professionals' experiences into the three categories of demand, control, and support, in alignment with the model.
NAs experienced high levels of job demand and low levels of job control. The use of the eMAR limited NAs' ability to control their work, in terms of priorities, content, and timing. In contrast, the nurses described demands as high but manageable, and described having a high level of control. Both professions found the eMar supportive.
Nurses and NAs in home healthcare experienced changes in their work environment regarding demand, control, and support when an eMAR was implemented to facilitate delegation of medical administration. In general, nurses were satisfied with the eMAR. However, NAs felt that the eMAR did not cover all aspects of their daily work. Healthcare organisations should be aware of the changes that digitalisation processes entail in the work environment of nurses and NAs in home healthcare.
电子给药记录（eMAR）是一种电子健康系统，已取代了许多医疗机构中使用的传统纸质给药方式。研究表明，电子健康技术能够以预期和意外的方式改变工作方法和专业角色。迄今为止，鲜有研究探讨家庭医疗保健中的护士和护理助理（NA）如何根据其工作环境体验电子给药记录。
目的是探讨在瑞典家庭医疗保健环境中，护士和护理助理在工作需求、控制和支持方面如何体验其工作环境，该环境已实施电子给药记录以促进医疗给药的委托。
我们采用定性研究方法，将焦点小组作为数据收集方法。焦点小组包括瑞典一个市镇雇佣的16名护士和9名护理助理，在首次焦点小组进行前6个月，该市镇已实施电子给药记录。分析采用工作需求-控制-支持模型，通过将专业人员的经验浓缩为需求、控制和支持这三个类别，与该模型保持一致。
护理助理经历了高水平的工作需求和低水平的工作控制。电子给药记录的使用限制了护理助理在工作优先级、内容和时间安排方面控制工作的能力。相比之下，护士表示需求较高但可控，并表示具有较高的控制权。两个职业都认为电子给药记录具有支持性。
在实施电子给药记录以促进医疗给药委托时，家庭医疗保健中的护士和护理助理在工作环境的需求、控制和支持方面经历了变化。总体而言，护士对电子给药记录感到满意。然而，护理助理认为电子给药记录并未涵盖其日常工作的所有方面。医疗保健组织应意识到数字化过程对家庭医疗保健中护士和护理助理工作环境带来的变化。
