1
|
Bissonette S, Chartrand J, Bailey L, Lalonde M, Tyerman J. Interventions to improve nurse-family communication in the emergency department: A scoping review. J Clin Nurs 2024. [PMID: 38476035 DOI: 10.1111/jocn.17068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/24/2023] [Accepted: 02/02/2024] [Indexed: 03/14/2024]
Abstract
AIM To determine and describe what interventions exist to improve nurse-family communication during the waiting period of an emergency department visit. BACKGROUND Communication between nurses and families is an area needing improvement. Good communication can improve patient outcomes, satisfaction with care and decrease patient and family anxiety. DESIGN Scoping Review. METHODS A scoping review was conducted following the Joanna Briggs Institution methodology: (1) identify the research question, (2) define the inclusion criteria, (3) use a search strategy to identify relevant studies using a three-step approach, (4) select studies using a team approach, (5) data extraction, (6) data analysis, and (7) presentation of results. DATA SOURCES Medline, CINAHL, EMBASE, PsychInfo and grey literature were searched on 3 August 2022. RESULTS The search yielded 1771 articles from the databases, of which 20 were included. An additional seven articles were included from the grey literature. Paediatric and adult interventions were found targeting staff and family of which the general recommendations were summarised into communication models. CONCLUSION Future research should focus on evaluating the effectiveness of interventions using a standardised scale, understanding the specific needs of families, and exploring the communication models developed in this review. IMPLICATIONS FOR CLINICAL PRACTICE Communication models for triage nurses and all emergency department nurses were developed. These may guide nurses to improve their communication which will contribute to improving family satisfaction. REPORTING METHOD PRISMA-ScR. TRIAL AND PROTOCOL REGISTRATION Protocol has been registered with the Open Science Framework, registration number 10.17605/OSF.IO/ETSYB. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Sarah Bissonette
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Julie Chartrand
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Liana Bailey
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Michelle Lalonde
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Montfort Hospital, Ottawa, Ontario, Canada
| | - Jane Tyerman
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
2
|
Østervang C, Jensen CM, Coyne E, Dieperink KB, Lassen A. Usability and Evaluation of a Health Information System in the Emergency Department: Mixed Methods Study. JMIR Hum Factors 2024; 11:e48445. [PMID: 38381502 PMCID: PMC10918535 DOI: 10.2196/48445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/30/2023] [Accepted: 12/17/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND A lack of information during an emergency visit leads to the experience of powerlessness for patients and their family members, who may also feel unprepared to cope with acute symptoms. The ever-changing nature and fast-paced workflow in the emergency department (ED) often affect how health care professionals can tailor information and communication to the needs of the patient. OBJECTIVE This study aimed to evaluate the usability and experience of a newly developed information system. The system was developed together with patients and their family members to help provide the information needed in the ED. METHODS We conducted a mixed methods study consisting of quantitative data obtained from the System Usability Scale questionnaire and qualitative interview data obtained from purposively selected participants included in the quantitative part of the study. RESULTS A total of 106 patients and 14 family members (N=120) answered the questionnaire. A total of 10 patients and 3 family members participated in the interviews. Based on the System Usability Scale score, the information system was rated close to excellent, with a mean score of 83.6 (SD 12.8). Most of the participants found the information system easy to use and would like to use it again. The participants reported that the system helped them feel in control, and the information was useful. Simplifications were needed to improve the user experience for the older individuals. CONCLUSIONS This study demonstrates that the usability of the information system is rated close to excellent. It was perceived to be useful as it enabled understanding and predictability of the patient's trajectory in the ED. Areas for improvement include making the system more usable by older individuals. The study provides an example of how a technological solution can be used to diminish the information gap in an ED context.
Collapse
Affiliation(s)
- Christina Østervang
- Department of Emergency Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Charlotte Myhre Jensen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
| | - Elisabeth Coyne
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | - Karin B Dieperink
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Oncology, Odense University Hospital, Odense, Denmark
- Family Focused Healthcare Research Center (FACE), University of Southern Denmark, Odense, Denmark
| | - Annmarie Lassen
- Department of Emergency Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
3
|
Østervang C, Lassen A, Schmidt T, Coyne E, Dieperink KB, Jensen CM. Development of a health information system to promote emergency care pathways: A participatory design study. Digit Health 2022; 8:20552076221145856. [PMID: 36601282 PMCID: PMC9806496 DOI: 10.1177/20552076221145856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/30/2022] [Indexed: 12/28/2022] Open
Abstract
Objective The successful development and implementation of sustainable healthcare technologies require an understanding of the clinical setting and its potential challenges from a user perspective. Previous studies have uncovered a gap between what emergency departments deliver and the needs and preferences of patients and family members. This study investigated whether a user-driven approach and participatory design could provide a technical solution to bridge the identified gap. Methods We conducted four workshops, and five one-to-one workshops with patients, family members, healthcare professionals, and information technology specialists to codesign a prototype. Revisions of the prototype were made until an acceptable solution was agreed upon and tested by the participants. The data were analyzed following iterative processes (plan → act → observe → reflect). Results The participants emphasized the importance of a person-centered approach focusing on improved information. An already implemented system for clinicians' use only was redesigned into a unique patient module that provides a process line displaying continually updated informative features, including (1) person-centered activities, (2) general information videos, (3) a notepad, (4) estimated waiting time, and (5) the nurse and physician responsible for care and treatment. Conclusion Participatory design is a usable approach to designing an information system for use in the emergency department. The process yielded insight into the complexity of translating ideas into technologies that can actually be implemented in clinical practice, and the user perspectives revealed the key to identifying these complex aspects. The iterations with the participants enabled us to redesign an existing technology.
Collapse
Affiliation(s)
- Christina Østervang
- Department of Emergency Medicine, Odense University
Hospital, Odense, Denmark,Department of Clinical Research, University of Southern
Denmark, Odense, Denmark,Christina Østervang, Department of
Emergency Medicine, Odense University Hospital, Odense, Denmark; Department of
Clinical Research, University of Southern Denmark, Fælles Akutmodtagelse, Odense
University Hospital, Kløvervænget 25 DK-5000, Odense, Denmark.
| | - Annmarie Lassen
- Department of Emergency Medicine, Odense University
Hospital, Odense, Denmark,Department of Clinical Research, University of Southern
Denmark, Odense, Denmark
| | - Thomas Schmidt
- Center for Health Informatics and Technology,
University of
Southern Denmark, Odense, Denmark
| | - Elisabeth Coyne
- Department of Clinical Research, University of Southern
Denmark, Odense, Denmark,School of Nursing and Midwifery, Griffith
University, Brisbane, Australia
| | - Karin Brochstedt Dieperink
- Department of Clinical Research, University of Southern
Denmark, Odense, Denmark,Department of Oncology, Odense University
Hospital, Odense, Denmark,Family-Focused Healthcare Research Centre (FaCe),
University of
Southern Denmark, Odense, Denmark
| | - Charlotte Myhre Jensen
- Department of Clinical Research, University of Southern
Denmark, Odense, Denmark,Department of Orthopedic Surgery and Traumatology,
Odense
University hospital, Odense, Denmark
| |
Collapse
|
4
|
Sarantis D, Soares DS, Carvalho J. Assessment of hospitals' websites in Portugal. Front Public Health 2022; 10:995153. [PMID: 36091525 PMCID: PMC9458903 DOI: 10.3389/fpubh.2022.995153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/08/2022] [Indexed: 01/26/2023] Open
Abstract
Technological advances have highly facilitated the accession of health-related information. As the public search on hospital websites for information and services is increasing, hospitals need to upgrade their websites to meet the high standards and demands of health-care consumers. Today, many hospital websites use a patient-centric approach to promote engagement and encourage interaction for better health-related decision making. However, little is known about the current state of hospital websites in Portugal. This study aims to assess hospital websites in Portugal and offer improvement insights. In this paper, the websites of 132 selected hospitals were thoroughly examined and assessed according to a predefined list of indicators and sub indicators, based on four criteria: technology, content, services and community interaction, defined in the Health Sector Website Assessment Index (HSWAI) instrument. Most of the websites scored satisfactorily in the technology criterion, performed fairly well in providing fundamental content, but showed shortcomings in quality metrics data and online patient services, and most of them fell short in community interaction elements. Overall, the results show that each hospital website must be improved in specific features in order to become effective and efficient. Several of the identified assessment elements (indicators/sub indicators) fall under Sustainable Development Goal (SDG) 3, United Nations health-focused goal, and could be used by governments to assess their progress toward achieving that specific goal. Therefore, this study not only provides a comprehensive and systematic approach that quantitatively measures hospital websites' overall performance, but also contributes to practical applications in terms of worthwhile recommendations for a website that meets patient's demands and hospital's operational needs.
Collapse
|
5
|
Rochat J, Ehrler F, Siebert JN, Ricci A, Garretas Ruiz V, Lovis C. Usability Testing of a Patient-Centered Mobile Health App for Supporting and Guiding the Pediatric Emergency Department Patient Journey: Mixed Methods Study. JMIR Pediatr Parent 2022; 5:e25540. [PMID: 35289754 PMCID: PMC8965675 DOI: 10.2196/25540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/18/2021] [Accepted: 12/21/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Patient experience in emergency departments (EDs) remains often suboptimal and can be a source of stress, particularly in pediatric settings. In an attempt to support patients and their families before, during, and after their visit to a pediatric ED, a mobile health (mHealth) app was developed by a multidisciplinary team based on patient-centered care principles. OBJECTIVE This study aims to evaluate the usability (effectiveness, efficiency, and satisfaction) of a new mHealth app, InfoKids, by potential end users through usability testing. METHODS The app was assessed through an in-laboratory, video-recorded evaluation in which participants had to execute 9 goal-oriented tasks, ranging from account creation to the reception of a diagnostic sheet at the end of the emergency care episode. Effectiveness was measured based on the task completion rate, efficiency on time on task, and user satisfaction according to answers to the System Usability Scale questionnaire. Think-aloud usability sessions were also transcribed and analyzed. Usability problems were rated for their severity and categorized according to ergonomic criteria. RESULTS A total of 17 parents participated in the study. The overall completion rate was 97.4% (149/153). Overall, they reported good effectiveness, with the task successfully completed in 88.2% (135/153) of cases (95% CI 83%-93%). Each task, with the exception of the first, created difficulties for some participants but did not prevent their completion by most participants. Users reported an overall good to excellent perceived usability of the app. However, ergonomic evaluation identified 14 usability problems occurring 81 time. Among these, 50% (7/14) were serious as their severity was rated as either major or catastrophic and indicated areas of improvements for the app. Following the suggested usability improvements by participants, mitigation measures were listed to further improve the app and avoid barriers to its adoption. CONCLUSIONS Usability of the InfoKids app was evaluated as good to excellent by users. Areas of improvement were identified, and mitigation measures were proposed to inform its development toward a universal app for all ED patients visiting a digitalized institution. Its contribution could also be useful in paving the way for further research on mobile apps aimed at supporting and accompanying patients in their care episodes, as research in this area is scarce.
Collapse
Affiliation(s)
- Jessica Rochat
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Frédéric Ehrler
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Johan N Siebert
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, University Hospitals of Geneva, Geneva, Switzerland
| | - Arnaud Ricci
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Victor Garretas Ruiz
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Christian Lovis
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| |
Collapse
|
6
|
Nimmolrat A, Sutham K, Thinnukool O. Patient triage system for supporting the operation of dispatch centres and rescue teams. BMC Med Inform Decis Mak 2021; 21:68. [PMID: 33608001 PMCID: PMC7893871 DOI: 10.1186/s12911-021-01440-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 02/15/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The Thai medical application for patient triage, namely Triagist, is an mHealth application designed to support the pre-hospital process. However, since the functions of the application that are necessary for the pre-hospital process have been found not to be fully developed, the addition of a back-end system has been considered to increase its performance and usability. OBJECTIVE To determine the ability of the previous version to effectively manage the pre-hospital process and analyse the current problems with the pre-hospital operation. Therefore, the new system was developed to support the connection of dispatch centres or operational centres to the Triagist mobile application and system evaluation. METHOD Design thinking methodology was used to analyse, design and develop a patient triage system to support the pre-hospital process in Thailand based on users' requirements. 68 active members of the rescue teams and emergency medical staff in Chiang Mai and Lampang provinces were recruited to test the reliability of the system based on a prototype application. RESULTS The new medical mobile application for patient triage in Thailand was validated for use due to containing the two essential functions of Initial Dispatch Code (IDC) geolocation and IDC management. When the system was tested by emergency staff who were responsible for using it, those with the least experience were found to use it better than their highly experienced colleagues. Moreover, in cases where the system had been implemented, it was found to determine the frequency of symptoms, the time period during which cases occurred, and the density of cases in each area. CONCLUSION This system, which has been developed based on the use of smart technology, will play an important role in supporting emergency services in Thailand by enhancing the efficiency of the pre-hospital process. Emergency centres will receive IDC information from the geolocation system so that they can determine patients' location without undue delay. Emergency services will be able to rapidly prepare the necessary resources and administrative tasks will be supported by linking the dispatch centre to central rescue teams.
Collapse
Affiliation(s)
- Acrapol Nimmolrat
- College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Krongkarn Sutham
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Orawit Thinnukool
- Research Group of Embedded Systems and Mobile Application in Health Science, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, 50200, Thailand.
| |
Collapse
|