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Havard M, Whistance M, Johns G, Drew S, Cusens C, Thomas S, Khalil S, Ogonovsky M, Ahuja A. Defining digital nursing. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:72-77. [PMID: 38271040 DOI: 10.12968/bjon.2024.33.2.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
BACKGROUND The use of technology in health care, including nursing, is growing, owing in part to the COVID-19 pandemic and in response to national policy. AIMS To investigate nurses' perceptions of digital nursing (DN). METHODS Community and primary care nurses from across Wales were recruited (n=249) through a survey comprising open and closed questions. This was supplemented with semistructured interviews (n=25). Thematic analysis was used to analyse qualitative data. FINDINGS Nurses had a broad range of perspectives on what DN meant, with four main themes being identified: access; impact on care; technology; and digital future. The positive impacts of DN on ways of working and patient outcomes were supported by answers to closed survey questions. CONCLUSION Many nurses understand the value of digital tools within nursing and are clear about their benefits for patients, nurses and multiprofessional teams. However, there is a need for a clear definition and increased awareness of DN.
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Affiliation(s)
- Megan Havard
- Research Assistant, Technology Enabled Care Cymru, Aneurin Bevan University Health Board, Newport
| | - Megan Whistance
- Research Assistant, Technology Enabled Care Cymru, Aneurin Bevan University Health Board, Newport
| | - Gemma Johns
- Head of Research, Technology Enabled Care Cymru, Aneurin Bevan University Health Board, Newport
| | - Simon Drew
- National Lead for Clinical Adoption and Business Change, Technology Enabled Care Cymru, Aneurin Bevan University Health Board, Newport
| | - Chiquita Cusens
- National Lead Nurse for Primary and Community Care, Strategic Programme for Primary Care, Aneurin Bevan University Health Board, Newport
| | - Sian Thomas
- Consultant Nurse in Child Health, Department of Nursing, Aneurin Bevan University Health Board, Newport
| | - Sara Khalil
- National Programme Lead, Technology Enabled Care Cymru, Aneurin Bevan University Health Board, Newport
| | - Mike Ogonovsky
- Director, Technology Enabled Care Cymru, Aneurin Bevan University Health Board, Newport
| | - Alka Ahuja
- Natiional Clinical Lead, Technology Enabled Care Cymru, Aneurin Bevan University Health Board, Newport
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Gunasekeran DV, Liu Z, Tan WJ, Koh J, Cheong CP, Tan LH, Lau CS, Phuah GK, Manuel NDA, Chia CC, Seng GS, Tong N, Huin MH, Dulce SV, Yap S, Ponampalam K, Ying H, Ong MEH, Ponampalam R. Evaluating Safety and Efficacy of Follow-up for Patients With Abdominal Pain Using Video Consultation (SAVED Study): Randomized Controlled Trial. J Med Internet Res 2020; 22:e17417. [PMID: 32459637 PMCID: PMC7324993 DOI: 10.2196/17417] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/20/2020] [Accepted: 02/29/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The benefits of telemedicine include cost savings and decentralized care. Video consultation is one form that enables early detection of deteriorating patients and promotion of self-efficacy in patients who are well but anxious. Abdominal pain is a common symptom presented by patients in emergency departments. These patients could benefit from video consultation, as it enables remote follow-up of patients who do not require admission and facilitates early discharge of patients from overcrowded hospitals. OBJECTIVE The study aimed to evaluate the safety and efficacy of the use of digital telereview in patients presenting with undifferentiated acute abdominal pain. METHODS The SAVED study was a prospective randomized controlled trial in which follow-up using existing telephone-based telereview (control) was compared with digital telereview (intervention). Patients with undifferentiated acute abdominal pain discharged from the emergency department observation ward were studied based on intention-to-treat. The control arm received routine, provider-scheduled telereview with missed reviews actively coordinated and rescheduled by emergency department staff. The intervention arm received access to a platform for digital telereview (asynchronous and synchronous format) that enabled patient-led appointment rescheduling. Patients were followed-up for 2 weeks for outcomes of service utilization, efficacy (compliance with their disposition plan), and safety (re-presentation for the same condition). RESULTS A total of 70 patients participated, with patients randomly assigned to each arm (1:1 ratio). Patients were a mean age of 40.0 (SD 13.8; range 22-71) years, predominantly female (47/70, 67%), and predominantly of Chinese ethnicity (39/70, 56%). The telereview service was used by 32 patients in the control arm (32/35, 91%) and 18 patients in the intervention arm (18/35, 51%). Most patients in control (33/35, 94%; 95% CI 79.5%-99.0%) and intervention (34/35, 97%; 95% CI 83.4%-99.9%) arms were compliant with their final disposition. There was a low rate of re-presentation at 72 hours and 2 weeks for both control (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 2/35, 6%, 95% CI 1.0%-20.5%) and intervention (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 3/35, 9%, 95% CI 2.2%-24.2%) arms. There were no significant differences in safety (P>.99) and efficacy (P>.99) between the two groups. CONCLUSIONS The application of digital telereview for the follow-up of patients with abdominal pain may be safe and effective. Future studies are needed to evaluate its cost-effectiveness and usefulness for broader clinical application. TRIAL REGISTRATION ISRCTN Registry ISRCTN28468556; http://www.isrctn.com/ISRCTN28468556.
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Affiliation(s)
- Dinesh Visva Gunasekeran
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Zhenghong Liu
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Win Jim Tan
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Joshua Koh
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Chiu Peng Cheong
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Lay Hong Tan
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Chee Siang Lau
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Gaik Kheng Phuah
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | | | - Che Chong Chia
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Gek Siang Seng
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Nancy Tong
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - May Hang Huin
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | | | - Susan Yap
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Kishanti Ponampalam
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Hao Ying
- Health Services Research Center, Singhealth Services, Singapore, Singapore
| | - Marcus Eng Hock Ong
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
- Health Services Research Center, Singhealth Services, Singapore, Singapore
- Health Services and Systems Research, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - R Ponampalam
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
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