Perceived benefit of a consultative telemedicine service in a highly staffed intensive care unit
Introduction: Telemedicine use in the ICU is increasing in efforts to improve delivery of intensivist resources. Little is known about the attitudes and perceptions of bedside staff working in these systems.
Hypothesis: The use of nocturnal ICU telemedicine service improves ICU culture, staff satisfaction, and perceptions of quality of care in a highly staffed university hospital.
Methods: The study used a pre-post design with concurrent controls in an academic medical center with full time intensivist staffing. We surveyed ICU staff using a previously validated tool before deployment and following a two month program of ICU telemedicine. Surveys were concurrently administered in a control ICU and in the test ICU in which a telemedicine center provided consultative care between 19:00–07:00 daily. The responses of individuals to questions exploring perceptions of patient care, effectiveness of care, relations, communication, psychological working conditions, burnout, job satisfaction, intention to quit, and education were compared before implementation and after completion of the telemedicine program. Responses were measured using a five point Likert scale and results were analyzed using paired t testing.
Results: Nurses in the intervention ICU (n 27) showed statistically significant improvement in the relations and communication score (2.99 ± 1.13 pre-intervention vs. 3.27 ± 1.27 postintervention p < 0.01), the psychological working conditions and burnout score (3.10 ± 1.10 pre vs. 3.23 ± 1.11 post p < 0.02), and the education score (3.52 ± 0.84 pre vs. 3.76 ± 0.78 post p < 0.03) while nurses in the control ICU (n = 11) showed a significant decline in the patient care and perceived effectiveness score (3.94 ± 0.80 pre vs. 3.48 ± 0.86 post p < 0.01) and the education score (3.95 ± 0.39 pre vs. 3.50 ± 0.80 post p < 0.05). There were no significant changes in bedside intensivist attitudes.
Conclusions: The introduction of ICU telemedicine services in a highly staffed academic ICU was associated with an improvement in nursing perceptions of working conditions and communications while these perceptions decreased in a control ICU. Telemedicine has the potential to improve ICU staff satisfaction in highly staffed ICUs.
Publication ( Name of Journal)
Critical Care Medicine
Romig, M. C.,
Gill, R. S.,
Pronovost, P. J.,
(2010). Perceived benefit of a consultative telemedicine service in a highly staffed intensive care unit. Critical Care Medicine, 38(12(Suppl.)).
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_anaesth/484