Navigating care and communication: a qualitative study on nurses' perspectives in response centres.

Abstract

Background: Following recommendations from the Norwegian Directorate of Health, there has been an emphasis on social alarms with associated response services in Norwegian municipalities. The aim is to enable older persons to live in their own homes for as long as possible, optimise resource utilisation, and enhance the quality of municipal health and care services. However, there is limited knowledge about nurses' experiences at response centres and the content of conversations between patients and nurses after an alarm is triggered. Understanding these interactions is crucial for optimising telecare services and improving patient outcomes.

Purpose: To explore nurses' experiences of nurse-patient interactions after triggered social alarms at response centres located in Norwegian municipalities.

Method: This study employed a qualitative research design involving semi-structured interviews with five nurses at two different response centres in Norway. Data were analysed using qualitative content analysis.

Results: The study identified three key categories related to nurses' experiences in response centres. First, nurses emphasised the importance of clinical expertise and patient familiarity in ensuring safety, highlighting that their experience and familiarity with patients were essential for delivering safe care during remote interactions. Second, decision-making processes were challenging, as nurses were responsible for assessing appropriate care levels and faced the demanding task of making critical decisions. Lastly, communication barriers posed significant challenges, including variations in practice standards, vague explanations from patients, and technological limitations. Together, these categories reflect the latent theme of clinical judgment and managing uncertainty in practice, reflecting how nurses navigate the complexities of decision-making, accountability, and patient safety.

Conclusion: This study contributes new insights into the role of nurses at response centres in ensuring patient safety, particularly in navigating complexities of remote decision-making. This study sheds light on nurses' experiences in ensuring patient safety, emphasizing their strong sense of responsibility and the importance of clinical experience in managing complex remote decision-making scenarios. It also highlights the challenges they face, including the challenge of making accurate decisions often based on vague patient descriptions and technological communication challenges.

Trial registration: Not applicable to the study.