title: Implementation of a model of robotic tele-presence (RTP) in the neuro-ICU: effect on critical care nursing team satisfaction.
abstract: BACKGROUND
  Robotic tele-presence (RTP) is a form of mobile telemedicine, which enables a direct face-to-face rapid response by the physician, instead of the traditional telephonic paradigm. We hypothesized that a model of RTP for after-hour ICU rounds and emergencies would be associated with improved ICU nurse satisfaction.
  
  
  METHODS
  We implemented a prospective nighttime multidisciplinary ICU round time, using RTP at our neuro-ICU. To test for critical ICU nurse team satisfaction, a questionnaire was implemented. The primary outcome was nurse satisfaction measured through a questionnaire with answers trichotomized into: agreement, disagreement, and no opinion. The occurrence of outcomes was compared between the groups by χ2 or Fisher exact tests for the difference in proportions (PD) with Bonferroni correction for multiple pairwise comparisons.
  
  
  RESULTS
  In total, 34 nurses completed the pre-survey and 40 nurses completed the post-survey. Night nurses were more likely to agree that RTP was associated with: ICU physicians being sufficiently available in the ICU (agreement 6-20%, PD 14%, p = 0.008), present during acute emergencies (agreement 44-65%, PD 21%, p = 0.007), and had enough time to get questions answered from the physician team (agreement 41-53%, PD 11%, p = NS).
  
  
  CONCLUSIONS
  This data suggest improvement in critical care nursing team satisfaction with a model of RTP in the neuroscience ICU, particularly during nighttime hours. RTP is a tool that may enhance communication among components of the ICU team.
authors.affiliation: Departments of Neurology, Divisions of Critical Care and Neurotrauma, Thomas Jefferson University, Philadelphia 19107, USA. fred.rincon@jefferson.edu
authors.forename: Fred
authors.initials: F
authors.lastname: Rincon
authors.forename: Matthew
authors.initials: M
authors.lastname: Vibbert
authors.forename: Valerie
authors.initials: V
authors.lastname: Childs
authors.forename: Robin
authors.initials: R
authors.lastname: Fry
authors.forename: Dennis
authors.initials: D
authors.lastname: Caliguri
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Urtecho
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenwasser
authors.forename: Jack
authors.initials: J
authors.lastname: Jallo
mesh_terms: D000208:Acute Disease; D001291:Attitude of Health Personnel; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D033183:Interdisciplinary Communication; D017146:Models, Organizational; D009551:Night Care / Q000379:methods / Q000458:organization & administration; D009741:Nursing Staff, Hospital / Q000458:organization & administration; D017063:Outcome Assessment, Health Care; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D019555:Physician-Nurse Relations; D015397:Program Evaluation; D011446:Prospective Studies; D012371:Robotics / Q000379:methods*; D013041:Specialties, Nursing / Q000295:instrumentation* / Q000458:organization & administration; D017216:Telemedicine / Q000295:instrumentation* / Q000379:methods*