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Introduction of Tele-ICU in rural hospitals: Changing organisational culture to harness benefits.

Goedken CC, Moeckli J, Cram PM, Reisinger HS. Introduction of Tele-ICU in rural hospitals: Changing organisational culture to harness benefits. Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses. 2017 Jun 1; 40:51-56.

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Abstract:

OBJECTIVE: This study evaluates rural hospital staff perceptions of a telemedicine ICU (Tele-ICU) before and after implementation. METHODS: We conducted a longitudinal qualitative study utilising semistructured group or individual interviews with staff from three rural ICU facilities in the upper Midwest of the United States that received Tele-ICU support. Interviews occurred pre-implementation and at two time points post-implementation. Interviews were conducted with: ICU administrators (n = 6), physicians (n = 3), nurses (n = 9), respiratory therapists (n = 5) and other (n = 1) from July 2011 to May 2013. Transcripts were analysed for thematic content. FINDINGS: Overall, rural ICU staff viewed Tele-ICU as a welcome benefit for their facility. Major themes included: (1) beneficial where recruitment and retention of staff can be challenging; (2) extra support for day shifts and evening, night and weekend shifts; (3) reduction in the number of transfers larger tertiary hospitals in the community; (4) improvement in standardisation of care; and (5) organisational culture of rural ICUs may lead to under-utilisation. CONCLUSIONS: ICU staff at rural facilities view Tele-ICU as a positive, useful tool to provide extra support and assistance. However, more research is needed regarding organisational culture to maximise the potential benefits of Tele-ICU in rural hospitals.





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