BMC Med Inform Decis Mak - The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments.

Tópicos

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Resumo

CKGROUND: The disruptive potential of the Nurse Practitioner (NP) is evident in their ability to offer services traditionally provided by primary care practitioners and their provision of a health promotion model of care in response to changing health trends. No study has qualitatively investigated the role of the Emergency NP in Australia, nor the impact of Information and Communication Technology (ICT) on this disruptive workforce innovation. This study aimed to investigate ways in which Nurse Practitioners (NP) have incorporated the use of ICT as a mechanism to support their new clinical role within Emergency Departments.METHODS: A cross-sectional qualitative study was undertaken in the Emergency Departments (EDs) of two large Australian metropolitan public teaching hospitals. Semi-structured, in-depth interviews were conducted with five nurse practitioners, four senior physicians and five senior nurses. Transcribed interviews were analysed using a grounded theory approach to develop themes in relation to the conceptualisation of the ED nurse practitioner role and the influences of ICT upon the role. Member checking of results was achieved by revisiting the sites to clarify findings with participants and further explore emergent themes.RESULTS: The role of the ENP was distinguished from those of Emergency nurses and physicians by two elements: advanced practice and holistic care, respectively. ICT supported the advanced practice dimension of the NP role in two ways: availability and completeness of electronic patient information enhanced timeliness and quality of diagnostic and therapeutic decision-making, expediting patient access to appropriate care. The ubiquity of patient data sourced from a central database supported and improved quality of communication between health professionals within and across sites, with wider diffusion of the Electronic Medical Record holding the potential to further facilitate team-based, holistic care.CONCLUSIONS: ICT is a facilitator through which the disruptive impact of NPs can be extended. However, integration of ICT into work practices without detracting from provider-patient interaction is crucial to ensure utilisation of such interventions and realisation of potential benefits.

Resumo Limpo

ckground disrupt potenti nurs practition np evid abil offer servic tradit provid primari care practition provis health promot model care respons chang health trend studi qualit investig role emerg np australia impact inform communic technolog ict disrupt workforc innov studi aim investig way nurs practition np incorpor use ict mechan support new clinic role within emerg departmentsmethod crosssect qualit studi undertaken emerg depart ed two larg australian metropolitan public teach hospit semistructur indepth interview conduct five nurs practition four senior physician five senior nurs transcrib interview analys use ground theori approach develop theme relat conceptualis ed nurs practition role influenc ict upon role member check result achiev revisit site clarifi find particip explor emerg themesresult role enp distinguish emerg nurs physician two element advanc practic holist care respect ict support advanc practic dimens np role two way avail complet electron patient inform enhanc timeli qualiti diagnost therapeut decisionmak expedit patient access appropri care ubiqu patient data sourc central databas support improv qualiti communic health profession within across site wider diffus electron medic record hold potenti facilit teambas holist careconclus ict facilit disrupt impact nps can extend howev integr ict work practic without detract providerpati interact crucial ensur utilis intervent realis potenti benefit

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