Telephone nurses’ use of a decision support system: An observational study

Abstract

Telephone nurses give advice and support and make assessments based on verbal communication only. Web-based decision support systems are often used to increase patient safety and make medically correct assessments. The aim of the present this study was to describe factors affecting the use of a decision support system and experiences with this system among telephone nurses in Swedish primary health care. Observations and semistructured interviews were conducted. Six registered nurses with at least 1 year of experience of telephone nursing participated. Field notes and interviews were analyzed by qualitative content analysis. The main findings of the present this study were factors that decrease the decision support system use or promote deviation from decision support system use, factors that are positive for decision support system use and the decision support system complicates the work.Underuse and deviations from decision support systems can be a safety risk, because decisions are based on too little information. Further research with observations of telephone nurses' use of decision support systems is needed to develop both telephone nursing and decision support systems. K E Y W O R D S content analysis, decision support system, participant observation, primary health care, telephone nursing

Registered nurses´ views on telephone nursing for patients with respiratory tract infections in primary healthcare – a qualitative interview study

“…This is possible in a healthcare system financed by taxes with well-educated and salaried RNs and GPs. Surprisingly, the DST and guidelines were only partly known and used, in line with earlier research [22,33]. In Sweden the national RTI guidelines are implemented through outreach PHCC visits, both for GPs and RNs [30].…”

Registered Nurses´ Views on Telephone Nursing for Patients with Respiratory Tract Infections in Primary Healthcare – A qualitative interview Study

“…This is possible in a healthcare system nanced by taxes with well-educated and salaried RNs and GPs. Surprisingly, the DST and guidelines were only partly known and used, in line with earlier research (22,33). In Sweden the national RTI guidelines are implemented through outreach PHCC visits, both for GPs and RNs (30).…”

Telephone nurses' strategies for managing difficult calls: A qualitative content analysis

“…On the other hand, CDSS can be seen as a fixed measuring instrument, forcing telenurses to reduce the patient's problem to one individual symptom that can be measured (Murdoch et al, 2015) and the linear process dictated by CDSS might miss out opportunities to support the fast-paced decision-making and quick responses required by telenurses (Tariq, Westbrook, Byrne, Robinson, & Baysari, 2017). Another risk is where telenurses have not been sufficiently educated in using CDSS; for example, Holmström, Gustafsson, Wesström, and Skoglund (2019) report that underuse and deviation from the CDSS means that the telenurses collected less information for making well-informed decisions, which might point to patient safety risks. Recent research shows that the domination of biomedical orientation in the CDSS downplays vital aspects of the human condition seen from a broader perspective (Björkman & Salzmann-Erikson, 2018).…”