Département des sciences administratives, Université du Québec en Outaouais, Gatineau, QC, Canada.
Département des sciences infirmières, Université du Québec en Outaouais, Gatineau, QC, Canada.
JMIR Aging. 2024 Nov 27;7:e65111. doi: 10.2196/65111.
In Quebec, the shortage of nurses during night shifts compromises the safety and quality of resident care, particularly in small residential and long-term care centers ("Centres d'hébergement et de soins de longue durée"; CHSLDs) located in rural areas. The need to ensure the continuous presence of nurses 24 hours a day in CHSLDs has become more pressing, forcing some facilities to implement exceptional measures such as on-call telephone services to ensure access to a nurse. In light of these challenging circumstances, the Direction nationale des soins et des services infirmiers of Quebec's Ministère de la Santé et des Services sociaux has rolled out a teleconsultation pilot project.
This study aims to explore nurses' and nursing assistants' experience of integrating teleconsultation during night shifts in rural CHSLDs with ≤50 residents.
The 6-month pilot project was rolled out sequentially in 3 rural CHSLDs located in 2 administrative regions of Quebec between July 2022 and March 2023. A total of 18 semistructured interviews were conducted with 9 nurses and nursing assistants between February and July 2023.
Participants' experiences revealed that teleconsultation provided significant added value by improving clinical, administrative, and organizational practices. Some practices remained unchanged, indicating stable workflows. Workflow optimization through an expanded scope of practice ensured efficient and safe continuity of care. Enhanced collaboration between nurses and nursing assistants led to improved care coordination and communication. The leadership played a significant role in clarifying professionals' roles and in supporting effective adaptation to teleconsultation.
This pilot project represents a significant step forward in improving care for CHSLD residents in Quebec. Teleconsultation not only makes it possible to overcome recruitment challenges and ensure the continuous presence of nurses during night shifts but also optimizes professional practices while ensuring the safety and quality of care provided to residents.
在魁北克省，夜间轮班护士短缺，危及居民护理的安全和质量，尤其是在农村地区的小型住宿和长期护理中心（“Centres d'hébergement et de soins de longue durée”；CHSLD）。确保 CHSLD 24 小时内有护士持续存在的需求变得更加紧迫，迫使一些设施采取特殊措施，如提供随叫随到的电话服务，以确保能够联系到护士。鉴于这些具有挑战性的情况，魁北克省卫生与社会服务部的国家护理与服务局推出了一项远程咨询试点项目。
本研究旨在探讨夜间在农村 CHSLD 中为 ≤50 名居民提供夜间轮班护士时整合远程咨询的经验。
该 6 个月的试点项目于 2022 年 7 月至 2023 年 3 月期间在魁北克的 2 个行政区域的 3 家农村 CHSLD 中顺序推出。2023 年 2 月至 7 月期间，对 9 名护士和护理助理进行了 18 次半结构化访谈。
参与者的经验表明，远程咨询通过改善临床、行政和组织实践提供了重要的附加值。一些实践保持不变，表明工作流程稳定。通过扩大实践范围进行工作流程优化，确保了护理的高效和安全连续性。护士和护理助理之间的协作得到加强，改善了护理协调和沟通。领导层在明确专业人员的角色和支持对远程咨询的有效适应方面发挥了重要作用。
该试点项目是在改善魁北克 CHSLD 居民护理方面迈出的重要一步。远程咨询不仅使克服招聘挑战并确保夜间轮班护士持续存在成为可能，而且还优化了专业实践，同时确保为居民提供安全和高质量的护理。
