Nurses' Role in Implementing and Sustaining Acute Telemedicine: A Mixed‐Methods, Pre‐Post Design Using an Extended Technology Acceptance Model.

Autor:	Bagot, Kathleen, Moloczij, Natasha, Arthurson, Lauren, Hair, Casey, Hancock, Shaun, Bladin, Christopher F., Cadilhac, Dominique A.
Předmět:	STROKE treatment ANALYSIS of variance ATTITUDE (Psychology) CHANGE CHI-squared test CONTENT analysis EXPERTISE HEALTH services accessibility INTERVIEWING MATHEMATICAL models RESEARCH methodology MEDICAL cooperation MEDICAL personnel NURSES NURSES' attitudes ORGANIZATIONAL change REGRESSION analysis RESEARCH RESEARCH funding TELEMEDICINE TEAMS in the workplace THEORY OCCUPATIONAL roles THEMATIC analysis HUMAN services programs PRE-tests & post-tests CONTINUING education units DATA analysis software DESCRIPTIVE statistics HOSPITAL nursing staff
Zdroj:	Journal of Nursing Scholarship; Jan2020, Vol. 52 Issue 1, p34-46, 13p, 3 Charts
Abstrakt:	Purpose: Technology‐based systems like telemedicine are frequently being implemented into healthcare settings, impacting clinician practices. Little is known about factors influencing acute telemedicine uptake, if factors differ across time, or between nurses and non‐nurses. Design: A mixed‐methods, pre‐post design with implementation of a new acute stroke telemedicine service. Methods: A survey based on an extended Technology Acceptance Model (TAM) was administered to clinicians involved in acute stroke care at 16 regional hospitals (2014–2017). Open‐ended questions postimplementation (at 6 months) included strengths of the program and areas to improve. Subsequently, a secondary analysis of nurses' semistructured interviews at the first telemedicine site (2010–2011) was completed to provide greater explanatory detail. Findings: Surveys were completed by nurses (preimplementation n = 77, postimplementation n = 92) and non‐nurses (pre n = 90, post n = 44). Preimplementation, perceived usefulness was the only significant predictor of intending to use telemedicine for nurses, while perceived ease of use and social influence were significant for non‐nurses. Postimplementation, perceived usefulness was significant for both groups, as was facilitating conditions for nurses. Specific examples aligned to TAM categories from our detailed interviews (n = 11 nurses) included perceived usefulness (improved clinical support and patient care), perceived ease of use (technical, clinical aspects), facilitating conditions (setting, education, confidence), and social influence (working relationships). Conclusions: Important factors for acute stroke telemedicine varied between nurses and non‐nurses, and changed after implementation. The benefits of telemedicine should be emphasized to nurses. Preimplementation, more non‐nurses wanted systems to be easy. Support in clinical, technical, and relationship aspects of telemedicine consultations is required. Clinical Relevance: Nurses are influential in implementing acute telemedicine, which is complex, with clinical and technical aspects entwined. Evidence‐based implementation strategies must be tailored over time, and between nurses and non‐nurses, to ensure initial uptake and ongoing use. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
Externí odkaz:	Zobrazit plný text záznamu Plný text