影响数字预先护理计划实施的因素:定性访谈研究
Andy Bradshaw1, Jacqueline Birtwistle2, Catherine J Evans1,3
1Cicely Saunders Institute, Kings College London, London, United Kingdom.
Journal of medical Internet research
|August 16, 2024
概括
由于个人,组织和技术障碍,电子息护理协调系统 (EPaCCS) 的使用是有限的. 需要重新设计,以改善数字预先护理规划和护理协调.
科学领域:
- 息护理和健康信息学
- 数字健康干预措施 数字健康干预措施
- 医疗保健系统实施科学科学
背景情况:
- 息护理可以提高临终性疾病患者的生活质量.
- 提前护理规划 (ACP) 确保患者的偏好指导护理.
- 电子健康记录系统,如英国的电子息护理协调系统 (EPaCCS),旨在改善非洲和非洲国家和地区的文档和共享,但面临实施挑战.
研究的目的:
- 探索影响EPaCCS在常规临床实践中的实施因素.
- 调查英格兰各种护理服务和环境中的实施情况.
主要方法:
- 以规范化过程理论 (NPT) 为指导的定性面试研究.
- 针对6个护理机构的52名医疗保健和社会护理从业人员进行了有目的的抽样.
- 对半结构面试进行主题框架分析,以确定对EPaCCS实施的多层次影响.
主要成果:
- 六个主题出现了,映射到NPT组件,突出个人,团队,组织和技术层面的影响.
- 关键因素包括明确的EPaCCS功能,从业者参与,与实践融合,领导力支持以及功能和互操作性等技术方面.
- 不一致的使用和信任问题源于访问问题和信息共享的故障.
结论:
- 个人,组织和技术因素阻碍了EPaCCS的实施,特别是访问和不一致的参与.
- 目前的数字ACP系统,如EPaCCS,并不总是促进电子信息共享和护理协调.
- 建议对EPaCCS进行重新设计,以优化实施并支持从业人员跨环境记录,访问和共享信息,为国际数字ACP方法提供教训.
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