Int J Med Inform - Nurses' experiences of using an interactive tailored patient assessment tool one year past implementation.

Tópicos

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Resumo

CKGROUND: Despite evidence of benefits, integration of patient-centered communication in clinical practice is challenging. Interactive tailored patient assessment (ITPA) tools can contribute to a more patient-centered care approach. However, little research has examined the impact of such tools on nursing care once they have been implemented.OBJECTIVE: To explore nurses' experiences of the benefits of and barriers to using an ITPA called Choice, in cancer care one year after its implementation.METHODS: This investigation is a part of a larger study examining the use of Choice in cancer care. Four focus group interviews were conducted with 20 nurses experienced in using the Choice application. The data were analyzed using qualitative content analysis.RESULTS: Three themes and nine sub-themes emerged: (1) "Choice as facilitator for shared understanding and engagement in patients' own care," with three sub-themes: preparing both patient and nurse for communication, shared engagement in care planning, and giving the patients a voice; (2) "enhancing the patients' strengths," with two sub-themes: releasing patient's internal strengths and confirming "normalcy" for the patient; and (3) "new challenges for the nurse," with four sub-themes: organizational challenges, interactions with technology, a need for training in communication skills, and new ethical challenges.CONCLUSIONS: Findings suggest that, from nurses' perspectives, integration of ITPAs such as Choice in clinical practice offers many benefits that can contribute to patient-centered care. However, to reap these benefits, use of such tools must receive equal priority as other routines, and require sufficient time, space and competence. Choice also challenged nurses' professional roles and created dilemmas such as nurses' ambivalence regarding patients' levels of disclosure of sensitive issues and the nurses' ability to respond to them. Although patient-centered care is advocated as model for good clinical practice, this is not always internalized. Tools such as Choice may help to make such a shift happen.

Resumo Limpo

ckground despit evid benefit integr patientcent communic clinic practic challeng interact tailor patient assess itpa tool can contribut patientcent care approach howev littl research examin impact tool nurs care implementedobject explor nurs experi benefit barrier use itpa call choic cancer care one year implementationmethod investig part larger studi examin use choic cancer care four focus group interview conduct nurs experienc use choic applic data analyz use qualit content analysisresult three theme nine subthem emerg choic facilit share understand engag patient care three subthem prepar patient nurs communic share engag care plan give patient voic enhanc patient strength two subthem releas patient intern strength confirm normalci patient new challeng nurs four subthem organiz challeng interact technolog need train communic skill new ethic challengesconclus find suggest nurs perspect integr itpa choic clinic practic offer mani benefit can contribut patientcent care howev reap benefit use tool must receiv equal prioriti routin requir suffici time space compet choic also challeng nurs profession role creat dilemma nurs ambival regard patient level disclosur sensit issu nurs abil respond although patientcent care advoc model good clinic practic alway intern tool choic may help make shift happen

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