远程医疗部署后新型冠状病毒病区护理工作流程的变化卡塔尔世界杯8强波胆分析使用实时定位系统的观察研究% a Vilendrer,Stacie % a Lough,Mary E % a Garvert,Donn W % a Lambert,Monique H % a Lu,Jonathan Hsijing % a Patel,Birju % a Shah,Nigam H % a Williams,Michelle Y % a Kling,Samantha M R %+斯坦福大学医学院初级保健和人口健康学部评估科学单元，加利福尼亚州斯坦福韦尔奇路1265号，94305，美国，1587 206 4043，staciev@stanford.edu %K远程医疗%K远程医疗%K信息学%K实时定位系统%K COVID-19 %K大流行%K护理%K患者安全%K PPE %K虚拟护理%K护士%K患者结局%K病原体暴露%K健康风险%K医护人员%K医护专业人员%D 2022 %7 17.6.2022 %9原始论文%J J医学互联网研究%G英语%XCOVID-19大流行促使广泛实施远程医疗，包括在住院环境中，其目标是减少潜在的病原体暴露事件和个人防护装备(PPE)的使用。鉴于床边护理时间与患者安全之间的关系，在这些新环境中护理工作流程的适应特别有趣。因此，了解在COVID-19背景下引入新型远程医疗平台后护士与患者接触的频率和持续时间，可以深入了解对患者安全、病原体暴露和个人防护装备使用的下游影响。目的:本研究的目的是利用实时定位系统(RTLS)评估在COVID-19病房部署住院远程医疗后，护理工作流程相对于大流行前水平的变化。方法:2020年3月，在1个新型冠状病毒病区的病房和3个比较病区的移动推车上安装远程医疗。现有的RTLS记录了大流行前1个和后5个阶段(2020年1月至12月)的护士流动情况。计算护士与患者直接接触的变化、每次接触在病房花费的时间以及相对于基线每班与患者相处的总时间。 Generalized linear models assessed difference-in-differences in outcomes between COVID-19 and comparison units. Telehealth adoption was captured and reported at the unit level. Results: Change in frequency of encounters and time spent per encounter from baseline differed between the COVID-19 and comparison units at all stages of the pandemic (all P<.001). Frequency of encounters decreased (difference-in-differences range –6.6 to –14.1 encounters) and duration of encounters increased (difference-in-differences range 1.8 to 6.2 minutes) from baseline to a greater extent in the COVID-19 units relative to the comparison units. At most stages of the pandemic, the change in total time nurses spent in patient rooms per patient per shift from baseline did not differ between the COVID-19 and comparison units (all P>.17). The primary COVID-19 unit quickly adopted telehealth technology during the observation period, initiating 15,088 encounters that averaged 6.6 minutes (SD 13.6) each. Conclusions: RTLS movement data suggest that total nursing time at the bedside remained unchanged following the deployment of inpatient telehealth in a COVID-19 unit. Compared to other units with shared mobile telehealth units, the frequency of nurse-patient in-person encounters decreased and the duration lengthened on a COVID-19 unit with in-room telehealth availability, indicating “batched” redistribution of work to maintain total time at bedside relative to prepandemic periods. The simultaneous adoption of telehealth suggests that virtual care was a complement to, rather than a replacement for, in-person care. However, study limitations preclude our ability to draw a causal link between nursing workflow change and telehealth adoption. Thus, further evaluation is needed to determine potential downstream implications on disease transmission, PPE utilization, and patient safety. %M 35635840 %R 10.2196/36882 %U //www.mybigtv.com/2022/6/e36882 %U https://doi.org/10.2196/36882 %U http://www.ncbi.nlm.nih.gov/pubmed/35635840