Utility of a digital app to enhance patient-nurse communications and patient involvement in bedside handover: patient and nurse perceptions.

Penelope Casey, Eva Yuen, Raj Liskaser, Philippa Blencowe, Leanne Boyd, Mohamed Abdelrazek, Zoe Wang, Julie Considine
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Abstract

Objective This study aimed to explore patient and nurse perceptions of using a prototype co-designed app to support patient-nurse communication and patient engagement in bedside handover. Methods This qualitative descriptive study evaluated usability of the app with a convenience sample of patient-nurse dyads in a 22-bed medical/oncology ward, during morning shifts. Participants were nurses, and patients proficient in English but without cognitive impairment or physical or mental distress. Patients entered healthcare questions and preferences into the app, nurses acknowledged the information in the app and responded during their usual workflow. Patient comfort level with app use was surveyed. Handovers were observed, and patient involvement rated. After handover, semi-structured interviews and feedback surveys on app usability were conducted. Interviews were recorded, transcribed, and then analysed thematically. Survey data were analysed using descriptive statistics. Results Patient-nurse dyads (n =18) used the app between March and May 2023. Patients were mostly older (median 69.5years; IQR 52.3, 75), female, and frequent users of smartphones. Nurses were mostly younger (median 23years; IQR 21, 40) and female. Five themes were identified, which indicated that using the app empowered patients to engage in healthcare communications, facilitated opportunities for patient-centred information sharing, and refocused nurses' attention onto patient-centred care. Views differed on the app's influence on patient involvement in handover. Surveys (n =36, 100%) indicated that the interface was easy to navigate, features were useful, and only minor amendments were suggested. Conclusion This prototype app shows potential to facilitate patient-centred communication and patient engagement with health care, including bedside handover. With further refinement and testing, this app could enhance experiences of care and reduce harm from miscommunication.

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在床边交接班中加强护患沟通和患者参与的数字应用程序的效用:患者和护士的看法。
本研究旨在探讨患者和护士对使用共同设计的应用程序原型的看法,以支持床旁交接中的患者-护士沟通和患者参与。方法这项定性描述性研究评估了该应用程序的可用性,研究对象是22张病床的内科/肿瘤科病房中晨间轮班的患者-护士二人组。参与者包括护士和精通英语但无认知障碍或身心不适的患者。患者在应用程序中输入医疗保健问题和偏好,护士确认应用程序中的信息,并在通常的工作流程中作出回应。对患者使用应用程序的舒适度进行了调查。对交接工作进行了观察,并对患者的参与度进行了评分。交接工作结束后,就应用程序的可用性进行了半结构化访谈和反馈调查。对访谈进行记录、转录,然后进行专题分析。调查数据采用描述性统计进行分析。结果患者-护士二人组(18 人)在 2023 年 3 月至 5 月期间使用了该应用程序。患者大多年龄较大(中位数 69.5 岁;IQR 52.3,75),女性,并且经常使用智能手机。护士大多较年轻(中位数为 23 岁;IQR 为 21-40 岁),女性。研究确定了五个主题,表明使用该应用程序可增强患者参与医疗保健沟通的能力,促进以患者为中心的信息共享机会,并将护士的注意力重新集中到以患者为中心的护理工作上。关于该应用程序对患者参与交接班的影响,各方观点不一。调查(n=36,100%)显示,界面易于浏览,功能实用,仅提出了一些小的修改建议。 结论:该应用原型显示出促进以患者为中心的沟通和患者参与医疗护理(包括床旁交接班)的潜力。通过进一步的改进和测试,该应用程序可以提升护理体验,减少因沟通不当造成的伤害。
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