National survey focusing on the crucial information needs of intensive care charge nurses and intensivists: same goal, different demands

Heljä Lundgrén-Laine,Tommi Kauko,Sanna Salanterä,Jari Forsström,Elina Kontio,Heikki Korvenranta

doi:10.1186/1472-6947-13-15

Abstract

BackgroundAlthough information technology adequately supports clinical care in many intensive care units (ICUs), it provides much poorer support for the managerial information needed to coordinate multi-professional care. To gain a general view of the most crucial multi-professional information needs of ICU shift leaders a national survey was conducted, focusing on the information needs of charge nurses and intensivists.MethodsBased on our previous observation study an online survey was developed, containing 122 information need statements related to the decision-making of ICU shift leaders. Information need statements were divided into six dimensions: patient admission, organisation and management of work, allocation of staff and material resources, special treatments, and patient discharge. This survey involved all ICU shift leaders (n = 738) who worked in any of the 17 highest level ICUs for adults in university hospitals in Finland during the autumn of 2009. Both charge nurses’ and intensivists’ crucial information needs for care coordination were evaluated.ResultsTwo hundred and fifty-seven (50%) charge nurses and 96 (43%) intensivists responded to the survey. The consistency of the survey was found to be good (Cronbach’s α scores between .87–.97, with a total explanatory power of 64.53%). Altogether, 57 crucial information needs for care coordination were found; 22 of which were shared between shift leaders. The most crucial of these information needs were related to organisation and management, patient admission, and allocation of staff resources. The associations between working experience, or shift leader acting frequencies, and crucial information needs were not statistically significant. However, a statistically significant difference was found between the number of ICU beds and the ICU experience of charge nurses with information needs, under the dimension of organisation and management of work. The information needs of charge nurses and intensivists differed. Charge nurses’ information needs related to care coordination, were more varied, and concerned issues at a unit level, whereas intensivists focused on direct patient care.ConclusionsThe reliability and validity of our survey was found to be good. Our study findings show that care coordination at an ICU is a collaborative process among ICU shift leaders with multiprofessional information needs related to organisation and management, patient admission, and allocation of staff resources. Study findings can be used to identify the most crucial information needs of ICU shift leaders when new information technology is developed to support managerial decision-making during care coordination.

Highlights

Information technology adequately supports clinical care in many intensive care units (ICUs), it provides much poorer support for the managerial information needed to coordinate multi-professional care
The response rate was 50% (n = 257) for the charge nurses and 43% (n = 96) for the intensivists, the rates of this study were consistent with those seen in recent multi-professional surveys conducted in ICUs e.g. [28]
Managing the daily activities at an ICU is a collaborative process among ICU shift leaders

Summary

Introduction

Information technology adequately supports clinical care in many intensive care units (ICUs), it provides much poorer support for the managerial information needed to coordinate multi-professional care. Within intensive care units (ICUs) the coordination of daily care is usually managed by charge nurses and intensivists. From an international perspective there has been great interest in the information needs related to clinical work [4,5,6] as well as team work [7,8] Most of these studies have focused on direct care and patient-related tasks [9,10,11], and have not explored the information needs on the level of the shift leaders. Shift leaders’ roles in care coordination vary; they have varying multiprofessional information needs [1,12,13] This should be taken into account when information integration systems are developed to support ICU shift leaders’ daily care coordination. At the moment commercial information systems used in ICUs are still too inflexible regarding the data extraction needed for daily care coordination [14]

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