Describing Telenurses' Decision Making Using Clinical Decision Support: Influential Factors Identified.

Area of Science:

• Nursing Informatics
• Human-Computer Interaction
• Cognitive Science

Background:

• Telenursing relies heavily on health information systems (HIS) for effective patient care.
• Clinical Decision Support Systems (CDSS) are integral tools within HIS, aiding nurses in making informed decisions.
• Understanding the cognitive processes and influencing factors of telenurses using CDSS is crucial for optimizing system design and training.

Purpose of the Study:

• To explore the cognitive decision-making processes of telenurses interacting with CDSS.
• To identify specific factors that influence telenurses' utilization of CDSS during patient interactions.
• To describe the decision-making strategies employed by telenurses within a simulated telenursing environment.

Main Methods:

• A qualitative study involving eight telenurses in a simulated telenursing call center environment.
• Data collection included video recording of call encounters, audio recording of phone calls, and screen recording of HIS navigation.
• Post-simulation playback sessions and discussions with telenurses were conducted and recorded for in-depth analysis.

Main Results:

• Several key factors influencing telenurses' decision-making while using CDSS were identified.
• The decision ladder model was found to be applicable in describing the decision-making strategies of telenurses using CDSS.
• Emerging factors impacting telenurses' decision-making processes were detailed through analysis of the simulation study.

Conclusions:

• The study provides insights into the complex interplay between telenurses, CDSS, and decision-making in a telenursing context.
• Findings can inform the development of more user-centered CDSS and targeted training programs for telenurses.
• Understanding these factors is essential for enhancing the efficiency and effectiveness of telenursing care delivery.