Staff acceptance of a telemedicine intensive care unit program: A qualitative study
Staff acceptance of a telemedicine intensive care unit program: A qualitative study
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DOI：
10.1016/j.jcrc.2013.05.008
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发表时间：
2013-12-01
影响因子：
3.7
通讯作者：
Reisinger, Heather Schacht
中科院分区：
文献类型：
--
作者：
Moeckli, Jane;Cram, Peter;Reisinger, Heather Schacht
目的：我们进行了评估，以确定相关因素重症监护病房（ICU）的工作人员接受远程医疗ICU（远程ICU）程序在preimplementation.Methods：个人或团体半结构化访谈和现场观察进行了工作人员从退伍军人事务部中西部医疗保健网络远程ICU和附属ICU。实施前和实施后的成绩单和现场记录进行了定性内容分析，以确定积极和消极影响远程ICU接受的主题。结果如下：远程医疗ICU培训，远程ICU的理解，感知需要，和组织因素出现的影响接受远程ICU实施前。实施后，远程ICU的理解，对工作系统的影响，感知的有用性，和关系的影响因素的接受和利用。实施的障碍包括对如何使用远程ICU的困惑、通信和工作流程的中断、未满足的期望以及对被监测的不适。促进者包括积极的经验，发现新的好处，并承认远程ICU工作人员作为补充床边care.Conclusions：远程医疗ICU的实施是复杂的。应分配时间和资源用于当地协调、对远程ICU支持的持续需求评估、工作人员培训、发展人际关系以及系统设计和评估。这些努力可能会得到回报，工作人员会更快地接受这项新技术。由爱思唯尔公司出版
Purpose: We conducted an evaluation to identify factors related to intensive care unit (ICU) staff acceptance of a telemedicine ICU (Tele-ICU) program in preimplementation and postimplementation phases.Methods: Individual or group semistructured interviews and site observations were conducted with staff from the Veterans Affairs Midwest Health Care Network Tele-ICU and affiliated ICUs. A qualitative content analysis of preimplementation and postimplementation transcripts and field notes was undertaken to identify themes positively and negatively influencing Tele-ICU acceptance. Results: Telemedicine ICU training, Tele-ICU understanding, perceived need, and organizational factors emerged as influencing acceptance of the Tele-ICU before implementation. After implementation, Tele-ICU understanding, impact on work systems, perceived usefulness, and relationships were factors influencing acceptance and utilization. Barriers to implementation included confusion about how to use the Tele-ICU, disruptions to communication and workflows, unmet expectations, and discomfort with being monitored. Facilitators included positive experiences, discovery of new benefits, and recognition of Tele-ICU staff as complementing bedside care.Conclusions: Telemedicine ICU implementation is complex. Time and resources should be allocated for local coordination, continuous needs assessment for Tele-ICU support, staff training, developing interpersonal relationships, and systems design and evaluation. Such efforts are likely to be rewarded with more rapid staff acceptance of this new technology. Published by Elsevier Inc.