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The Use of Smart Devices by Care Providers in Emergency Departments: Cross-Sectional Survey Design

机译:急诊科医疗服务提供者对智能设备的使用:跨部门调查设计

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Background The use of smart devices (SDs) by health care providers in care settings is a common practice nowadays. Such use includes apps related to patient care and often extends to personal calls and applications with frequent prompts and interruptions. These prompts and interruptions enhance the risk of distractions caused by SDs and raise concerns about service quality and patient safety. Such concerns are exacerbated in complex care settings such as the emergency department (ED). Objective The objective of this study was to measure the frequency and patterns of SD use among health care providers in the ED of a large academic health center in Lebanon. The perceived consequences of care providers using SDs on provider-to-provider communication and the care quality of patients in the ED were assessed. Additionally, factors associated with the use of SDs and the approval for regulating such use were also investigated. Methods The study was carried out at the ED of an academic health center with the highest volume of patient visits in Lebanon. The data were collected using a cross-sectional electronic survey sent to all ED health care providers (N=236). The target population included core ED faculty members, attending physicians, residents, medical students, and the nursing care providers. The regression model developed in this study was used to find predictors of medical errors in the ED because of the use of SDs. Results Half of the target population responded to the questionnaire. A total of 83 of 97 respondents (86%) used one or more medical applications on their SDs. 71 out of 87 respondents (82%) believed that using SDs in the ED improved the coordination among the care team, and 71 out of 90 (79%) respondents believed that it was beneficial to patient care. In addition, 37 out of 90 respondents (41%) acknowledged that they were distracted when using their SDs for nonwork purposes. 51 out of 93 respondents (55%) witnessed a colleague committing a near miss or an error owing to the SD-caused distractions. Regression analysis revealed that age ( P =.04) and missing information owing to the use of SDs ( P =.02) were major predictors of committing an error in the ED. Interestingly, more than 40% of the respondents were significantly addicted to using SDs and more than one-third felt the need to cut down their use. Conclusions The findings of this study make it imperative to ensure the safety and wellbeing of patients, especially in high intensity, high volume departments like the ED. Irrespective of the positive role SDs play in the health care process, the negative effects of their use mandate proper regulation, in particular, an ethical mandate that takes into consideration the significant consequences that the use of SDs may have on care processes and outcomes.
机译:背景技术当今,医疗保健提供者在护理环境中使用智能设备(SD)是一种常见的做法。这样的用途包括与患者护理有关的应用程序,并且经常扩展到个人呼叫和频繁提示和中断的应用程序。这些提示和干扰会增加由SD引起的干扰的风险,并引起对服务质量和患者安全性的担忧。在诸如急诊科(ED)的复杂护理环境中,这种担忧更加严重。目的这项研究的目的是测量黎巴嫩一个大型学术健康中心急诊室中医疗保健提供者使用SD的频率和方式。评估了医疗服务提供者在医疗服务提供者与医疗提供者之间进行沟通时使用SD的感知后果以及急诊室中患者的医疗质量。此外,还研究了与SD使用相关的因素以及批准对此类使用的监管。方法这项研究是在一个学术健康中心的ED进行的,该中心的病人访视量在黎巴嫩最高。使用发送给所有ED医疗保健提供者的横断面电子调查收集数据(N = 236)。目标人群包括ED核心教职人员,主治医师,居民,医学生和护理提供者。由于使用SD,使用了本研究中开发的回归模型来查找ED中医疗错误的预测因素。结果一半的目标人群回答了问卷。 97位受访者中,有83位(占86%)在其SD上使用了一项或多项医疗应用程序。在87位受访者中,有71位(82%)认为在急诊室使用SD可改善护理团队之间的协调性;在90位受访者中(79%),有71位认为这对患者护理有益。此外,在90位受访者中,有37位(41%)承认,将SD用于非工作目的时会分散他们的注意力。 93名受访者中有51名(55%)目睹一位同事由于SD引起的分心而差点错过或出错。回归分析表明,年龄(P = .04)和由于使用SD导致的信息缺失(P = .02)是造成ED错误的主要预测因素。有趣的是,超过40%的受访者对SD的使用非常上瘾,而超过三分之一的受访者认为有必要减少SD的使用。结论这项研究的结果使得必须确保患者的安全和健康,尤其是在急诊部等高强度,大流量的部门。不论SD在医疗保健过程中发挥的积极作用,使用它们的负面影响都要求适当的监管,特别是考虑到SD的使用可能对护理过程和结果产生重大影响的道德要求。

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