Assessing the Impact of Telemedicine on Nursing Care in Intensive Care Units

Kleinpell, Ruth M.; Barden, Connie; Rincon, Teresa; McCarthy, Mary; Rufo, Rebecca J. Zapatochny

doi:10.4037/ajcc2016808

Cited by 38 publications

(17 citation statements)

References 11 publications

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“…Usefulness was the most prominent technical factor relating to the app’s features. In alignment with previous research, perceived usefulness was closely related to time-saving and efficacy resulting from the usage of the app [ 2 , 47 , 48 , 86 ], its positive impact on the quality of patient care [ 66 , 72 , 87 , 88 ], and the potential benefit for research and scientific evidence because of better data availability [ 42 , 89 ]. Perceived ease of use is an equally important facilitator that has been widely reported in similar studies [ 2 , 90 - 93 ].…”

Section: Discussionsupporting

confidence: 76%

Factors Impacting Clinicians’ Adoption of a Clinical Photo Documentation App and its Implications for Clinical Workflows and Quality of Care: Qualitative Case Study

Jacob

Sánchez-Vázquez

Ivory

2020

JMIR Mhealth Uhealth

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Background Mobile health (mHealth) tools have shown promise in clinical photo and wound documentation for their potential to improve workflows, expand access to care, and improve the quality of patient care. However, some barriers to adoption persist. Objective This study aims to understand the social, organizational, and technical factors affecting clinicians’ adoption of a clinical photo documentation mHealth app and its implications for clinical workflows and quality of care. Methods A qualitative case study of a clinical photo and wound documentation app called imitoCam was conducted. The data were collected through 20 in-depth interviews with mHealth providers, clinicians, and medical informatics experts from 8 clinics and hospitals in Switzerland and Germany. Results According to the study participants, the use of mHealth in clinical photo and wound documentation provides numerous benefits such as time-saving and efficacy, better patient safety and quality of care, enhanced data security and validation, and better accessibility. The clinical workflow may also improve when the app is a good fit, resulting in better collaboration and transparency, streamlined daily work, clinician empowerment, and improved quality of care. The findings included important factors that may contribute to or hinder adoption. Factors may be related to the material nature of the tool, such as the perceived usefulness, ease of use, interoperability, cost, or security of the app, or social aspects such as personal experience, attitudes, awareness, or culture. Organizational and policy barriers include the available clinical practice infrastructure, workload and resources, the complexity of decision making, training, and ambiguity or lack of regulations. User engagement in the development and implementation process is a vital contributor to the successful adoption of mHealth apps. Conclusions The promising potential of mHealth in clinical photo and wound documentation is clear and may enhance clinical workflow and quality of care; however, the factors affecting adoption go beyond the technical features of the tool itself to embrace significant social and organizational elements. Technology providers, clinicians, and decision makers should work together to carefully address any barriers to improve adoption and harness the potential of these tools.

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Section: Discussionsupporting

confidence: 76%

Factors Impacting Clinicians’ Adoption of a Clinical Photo Documentation App and its Implications for Clinical Workflows and Quality of Care: Qualitative Case Study

Jacob

Sánchez-Vázquez

Ivory

2020

JMIR Mhealth Uhealth

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“…Health care teams were also satisfied with the use of telemedicine, since the technology employed proved to be easy to use, contributed to improving the care provided to the patient, and reduced their level of anxiety [ 22 ]. Kleinpell et al [ 36 ], in a study of nurses’ perceptions of intensive care telemedicine, highlighted that using telemedicine, on a daily basis, improves patient care, increases productivity, and makes the nurse’s job easier, as it is performed in collaboration with other health professionals at a distance. Kissi et al [ 37 ] reported that telemedicine supports physicians’ responsibilities related to service delivery and general medical decisions.…”

Section: Discussionmentioning

confidence: 99%

The use of telemedicine in the PICU: A systematic review and meta-analysis

et al. 2021

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The use of telemedicine in ICUs has grown and is becoming increasingly recognized. However, its impact on PICUs remains unclear. This systematic review and meta-analysis aimed to evaluate whether telemedicine in the PICU has the potential to improve clinical and non-clinical outcomes. PubMed, Scopus, LILACS, and CINAHL electronic databases were searched to identify studies that assessed the impact of telemedicine on clinical outcomes, with no publication date restrictions. The reference lists of the selected articles were hand-searched for additional studies that had not been identified by the initial electronic search. Studies were included if they had a cohort design, used telemedicine, were conducted in PICUs or specialized PICUs, and were published in Portuguese, English, or Spanish. Two groups of reviewers independently screened titles and abstracts for inclusion. The same group of reviewers independently assessed the full-text articles for eligibility and extracted the following information: telecommunication method, intervention characteristics, patient characteristics, sample size, and main results. Studies were meta-analyzed using a random-effects model to estimate the pooled prevalence of PICU mortality and length of PICU stay. Risk of bias was assessed using the Newcastle-Ottawa Scale. Of 2703 studies initially identified, 2226 had their titles and abstracts screened. Of these, 53 were selected for full-text reading, of which 10 were included and analyzed. The main results of interest were length of PICU stay, number of deaths or mortality rate, and satisfaction of health professionals and family members. The results of meta-analysis show that the mortality rate reduced by 34% with an increase of the length of PICU stay in the PICUs with the use of telemedicine. Family members and health professionals were satisfied with the use of telemedicine. Telemedicine has the potential to improve PICU outcomes, such as mortality rate and family and staff satisfaction. However, it extended length of PICU stay in the studies included in this systematic review.

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“…As with other studies, in this study health team members utilized digital technology to ensure healthy, safe treatment and the environment for patient care in ICU. Electronic health records save time, reduce nursing workloads and facilitate nurses' work by increasing access to patient information (Kleinpell et al., 2016 ; Kossman & Scheidenhelm, 2008 ; Wikström et al., 2007 ).…”

Section: Discussionmentioning

confidence: 99%

A focused ethnography of the culture of inclusive caring practice in the intensive care unit

Al-Shamaly¹

2021

Nursing Open

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The concept "caring" is complex. Numerous theoretical and operational perspectives of caring within the context of nursing have emerged. The ongoing discussion about what constitutes caring within nursing practice domains is nowhere more evident than in the adult ICU specialization, where humanistic caring is juxtaposed with advanced technology. Caring in ICU has been discussed in terms of one entity as the patient (Cutler et al., 2013), their family (Mackie et al., 2017), nurses (Hales et al., 2018), health professionals (Handberg & Voss, 2018) or a couple of entities such as patients and nurses (Happ et al., 2014). However, ICU is not limited to caring for patients, their families and nursing staff. This study examines the multidimensional inclusive nature of caring in ICU. | BACKG ROU N DSeveral authors discussed different caring ICU entities from various perspectives, including patients' perspectives and experiences of care (Cutler et al., 2013), patients' descriptions of the art of nursing (Gramling, 2004), and patients' perceptions of nursing care qual-

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Assessing the Impact of Telemedicine on Nursing Care in Intensive Care Units

Cited by 38 publications

References 11 publications

Factors Impacting Clinicians’ Adoption of a Clinical Photo Documentation App and its Implications for Clinical Workflows and Quality of Care: Qualitative Case Study

Factors Impacting Clinicians’ Adoption of a Clinical Photo Documentation App and its Implications for Clinical Workflows and Quality of Care: Qualitative Case Study

The use of telemedicine in the PICU: A systematic review and meta-analysis

A focused ethnography of the culture of inclusive caring practice in the intensive care unit

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