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Nurses' use of an advisory decision support system in ambulance services : A qualitative study

Fager, Cecilia ; Rantala, Andreas LU orcid ; Svensson, Anders ; Holmberg, Mats and Bremer, Anders (2024) In Journal of Advanced Nursing
Abstract

AIM: To illuminate from the perspective of nurses in ambulance services the experiences of using a web-based advisory decision support system to assess care needs and refer patients.

DESIGN: Inductive and descriptive approaches.

METHOD: Thirteen semi-structured interviews were conducted in the spring of 2020. The data were analysed through the reflexive thematic analysis.

RESULTS: The Swedish web-based advisory decision support system (ADSS) was found to strengthen nurses' feelings of security when they assess patients' care needs, promote their competence and professional pride, and help them manage stress. However, the system also generated difficulties for nurses to adjust to the dynamic ambulance team and revealed... (More)

AIM: To illuminate from the perspective of nurses in ambulance services the experiences of using a web-based advisory decision support system to assess care needs and refer patients.

DESIGN: Inductive and descriptive approaches.

METHOD: Thirteen semi-structured interviews were conducted in the spring of 2020. The data were analysed through the reflexive thematic analysis.

RESULTS: The Swedish web-based advisory decision support system (ADSS) was found to strengthen nurses' feelings of security when they assess patients' care needs, promote their competence and professional pride, and help them manage stress. However, the system also generated difficulties for nurses to adjust to the dynamic ambulance team and revealed a discrepancy between their professional roles and responsibilities to refer patients and provide self-care advice. The nurses thought that the support system facilitated their increased participation and helped them understand patients and significant others by offering transparency in assessment and decision making. Thus, the support system provides nurses with an opportunity to strengthen patients' independence through information and education. However, in the care relationship, nurses worked to overcome patients' expectations.

CONCLUSION: Nurses using the ADSS increased their security while performing assessments and referrals and found new opportunities to provide information and promote understanding of their decisions. However, nursing care values can be threatened when new support systems are introduced, especially as ambulance services become increasingly protocol-driven.

IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE: These findings have implications for nurses' work environments and help them maintain consistency in making medical assessments and in providing equivalent self-care advice when referring patients to the different levels of care. The findings will also impact researchers and policymakers who formulate decision support systems.

REPORTING METHOD: Consolidated criteria for reporting qualitative research (COREQ).

PATIENT OR PUBLIC CONTRIBUTION: None.

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author
; ; ; and
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type
Contribution to journal
publication status
epub
subject
in
Journal of Advanced Nursing
publisher
Wiley-Blackwell
external identifiers
  • pmid:38515226
  • scopus:85189096763
ISSN
0309-2402
DOI
10.1111/jan.16165
language
English
LU publication?
yes
id
623c9250-4b29-43f9-9ddc-67a00fdaf79b
date added to LUP
2024-03-22 14:42:40
date last changed
2024-11-13 11:07:10
@article{623c9250-4b29-43f9-9ddc-67a00fdaf79b,
  abstract     = {{<p>AIM: To illuminate from the perspective of nurses in ambulance services the experiences of using a web-based advisory decision support system to assess care needs and refer patients.</p><p>DESIGN: Inductive and descriptive approaches.</p><p>METHOD: Thirteen semi-structured interviews were conducted in the spring of 2020. The data were analysed through the reflexive thematic analysis.</p><p>RESULTS: The Swedish web-based advisory decision support system (ADSS) was found to strengthen nurses' feelings of security when they assess patients' care needs, promote their competence and professional pride, and help them manage stress. However, the system also generated difficulties for nurses to adjust to the dynamic ambulance team and revealed a discrepancy between their professional roles and responsibilities to refer patients and provide self-care advice. The nurses thought that the support system facilitated their increased participation and helped them understand patients and significant others by offering transparency in assessment and decision making. Thus, the support system provides nurses with an opportunity to strengthen patients' independence through information and education. However, in the care relationship, nurses worked to overcome patients' expectations.</p><p>CONCLUSION: Nurses using the ADSS increased their security while performing assessments and referrals and found new opportunities to provide information and promote understanding of their decisions. However, nursing care values can be threatened when new support systems are introduced, especially as ambulance services become increasingly protocol-driven.</p><p>IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE: These findings have implications for nurses' work environments and help them maintain consistency in making medical assessments and in providing equivalent self-care advice when referring patients to the different levels of care. The findings will also impact researchers and policymakers who formulate decision support systems.</p><p>REPORTING METHOD: Consolidated criteria for reporting qualitative research (COREQ).</p><p>PATIENT OR PUBLIC CONTRIBUTION: None.</p>}},
  author       = {{Fager, Cecilia and Rantala, Andreas and Svensson, Anders and Holmberg, Mats and Bremer, Anders}},
  issn         = {{0309-2402}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Advanced Nursing}},
  title        = {{Nurses' use of an advisory decision support system in ambulance services : A qualitative study}},
  url          = {{http://dx.doi.org/10.1111/jan.16165}},
  doi          = {{10.1111/jan.16165}},
  year         = {{2024}},
}