BMC Med Inform Decis Mak - Participatory eHealth development to support nurses in antimicrobial stewardship.

Tópicos

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Resumo

CKGROUND: Antimicrobial resistance poses a threat to patient safety worldwide. To stop antimicrobial resistance, Antimicrobial Stewardship Programs (ASPs; programs for optimizing antimicrobial use), need to be implemented. Within these programs, nurses are important actors, as they put antimicrobial treatment into effect. To optimally support nurses in ASPs, they should have access to information that supports them in their preparation, administration and monitoring tasks. In addition, it should help them to detect possible risks or adverse events associated with antimicrobial therapy. In this formative study, we investigate how nurses' can be supported in ASPs by means of an eHealth intervention that targets their information needs.METHODS: We applied a participatory development approach that involves iterative cycles in which health care workers, mostly nurses, participate. Focus groups, observations, prototype evaluations (via a card sort task and a scenario-based information searching task) and interviews are done with stakeholders (nurses, managers, pharmacist, and microbiologist) on two pulmonary wards of a 1000-bed teaching hospital.RESULTS: To perform the complex antimicrobial-related tasks well, nurses need to consult various information sources on a myriad of occasions. In addition, the current information infrastructure is unsupportive of ASP-related tasks, mainly because information is not structured to match nurse tasks, is hard to find, out of date, and insufficiently supportive of awareness. Based our findings, we created a concept for a nurse information application. We attuned the application's functionality, content, and structure to nurse work practice and tasks.CONCLUSIONS: By applying a participatory development approach, we showed that task support is a basic need for nurses. Participatory development proved useful regarding several aspects. First, it allows for combining bottom-up needs (nurses') and top-down legislations (medical protocols). Second, it enabled us to fragmentise and analyse tasks and to reduce and translate extensive information into task-oriented content. Third, this facilitated a tailored application to support awareness and enhance patient safety. Finally, the involvement of stakeholders created commitment and ownership, and helped to weigh needs from multiple perspectives.

Resumo Limpo

ckground antimicrobi resist pose threat patient safeti worldwid stop antimicrobi resist antimicrobi stewardship program asp program optim antimicrobi use need implement within program nurs import actor put antimicrobi treatment effect optim support nurs asp access inform support prepar administr monitor task addit help detect possibl risk advers event associ antimicrobi therapi format studi investig nurs can support asp mean ehealth intervent target inform needsmethod appli participatori develop approach involv iter cycl health care worker most nurs particip focus group observ prototyp evalu via card sort task scenariobas inform search task interview done stakehold nurs manag pharmacist microbiologist two pulmonari ward bed teach hospitalresult perform complex antimicrobialrel task well nurs need consult various inform sourc myriad occas addit current inform infrastructur unsupport asprel task main inform structur match nurs task hard find date insuffici support awar base find creat concept nurs inform applic attun applic function content structur nurs work practic tasksconclus appli participatori develop approach show task support basic need nurs participatori develop prove use regard sever aspect first allow combin bottomup need nurs topdown legisl medic protocol second enabl us fragmentis analys task reduc translat extens inform taskori content third facilit tailor applic support awar enhanc patient safeti final involv stakehold creat commit ownership help weigh need multipl perspect

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