title: Decision aid software programs in telenursing: not used as intended? Experiences of Swedish telenurses.
abstract: Telenurses at call centers use decision aid software programs to offer triage recommendations and self-care advice to the general public. Decision aid programs are intended to support medical safety but were suggested by telenurses to be a hindrance to the dialogue. The aim of this study was to explore the use of decision aid software programs for telenursing, from the perspective of the users. A qualitative, descriptive approach was used. Twelve telenurses in Sweden were interviewed twice. The interviews were transcribed and analyzed thematically. Four themes were found: support for assessment but not for the decision; inconsistency between actual practice and the decision aid software; limited support for learning and information; and communication challenges and software programs. The software programs were a support for assessment, rather than decision-making, assuring the nurses that the relevant questions were asked. They were not fully adapted to current clinical practice, focusing mainly on acute conditions. Nurses worked to a large extent with self-care advice, often over-riding the recommendations made.
authors.affiliation: Department of Public Health and Caring Sciences, Health Services Research, Uppsala Science Park, Uppsala, Sweden. inger.holmstrom@pubcare.uu.se
authors.forename: Inger
authors.initials: I
authors.lastname: Holmström
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003142:Communication; D003197:Computer Literacy; D003200:Computer User Training; D003661:Decision Support Techniques; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D015277:Hotlines / Q000458:organization & administration; D006801:Humans; D008875:Middle Aged; D009730:Nursing Assessment; D048108:Nursing Informatics / Q000193:education; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000523:psychology*; D010353:Patient Education as Topic; D036301:Qualitative Research; D012984:Software / Q000592:standards*; D011795:Surveys and Questionnaires; D013548:Sweden; D017216:Telemedicine / Q000592:standards*; D014218:Triage / Q000592:standards