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

Author:

Fager Cecilia123ORCID,Rantala Andreas245ORCID,Svensson Anders236ORCID,Holmberg Mats237ORCID,Bremer Anders23ORCID

Affiliation:

1. Department of Ambulance Service, Kalmar County Kalmar Sweden

2. Centre of Interprofessional Collaboration within Emergency Care (CICE) Linnaeus University Växjö Sweden

3. Faculty of Health and Life Sciences Linnaeus University Växjö Sweden

4. Department of Ambulance Service, Region Skåne Helsingborg Sweden

5. Department of Health Sciences Lund University Lund Sweden

6. Department of Ambulance Service Växjö Sweden

7. Centre for Clinical Research Sörmland Uppsala University Eskilstuna Sweden

Abstract

AbstractAimTo 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.DesignInductive and descriptive approaches.MethodThirteen semi‐structured interviews were conducted in the spring of 2020. The data were analysed through the reflexive thematic analysis.ResultsThe 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.ConclusionNurses 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 CareThese 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 MethodConsolidated criteria for reporting qualitative research (COREQ).Patient or Public ContributionNone.

Funder

Forskningsrådet i Sydöstra Sverige

Publisher

Wiley

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