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To reduce technology prior discharge from intensive care – important but difficult?: A grounded theory
Mittuniversitetet.
Mittuniversitetet.
Mittuniversitetet.ORCID iD: 0000-0001-7959-606X
2013 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, 506-515 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to provide a deeperunderstanding of the experience of intensive care staffregarding the reduction in the use of medical technologyprior to patients’ transfer from the ICU.Background: The goal of ICU transitional care, provided forintensive care patients before, during and after the transferfrom the ICU to another care unit, is to ensure minimaldisruption and optimal continuity of care for the patient.To smooth this transition, there is a need to prepare for aless technological environment and therefore also a needfor a gradual reduction in the use of monitoring equipment.Method: Group interviews and individual interviews, togetherwith participant observations, were conducted withICU staff in two hospitals in Sweden. The data wereanalysed using classic grounded theory.Results: The main concern was the ICU staff’s ambiguityregarding whether and how to reduce the use of medicaltechnology devices. Insecurity about weaning patientsfrom medical equipment combined with a lack of standardizedroutines made it difficult for staff to reduce thetechnical support. The core category describes how theambiguity was solved primarily by ’prioritizing control’.However, this often caused the ICU staff to use advancedtechnology while the patients were in the ICU until theward staff arrived, even if this should have been handledotherwise. Why and how the ICU staff used the strategy of’prioritizing control’ is further explained in the categories’being affected by cultural/contextual aspects’, ’searching forguidance and a shared understanding’ and ’weighing advantageswith more v s less technology’.Conclusion: It is important to consider ICU staff ambiguityconcerning the reduction in technology and to establishstrategies for a safe and structured transitional phase withstep-down procedures in which technology and monitoringis gradually reduced prior to transfer from ICU.

Place, publisher, year, edition, pages
2013. Vol. 27, no 3, 506-515 p.
Keyword [en]
Continuity of care, Grounded theory, Patient discharge, Patient transfer, Intensive care, Health care technology, Patient safety, Step-down unit
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:esh:diva-5515DOI: 10.1111/j.1471-6712.2012.01063.xISI: 000321625800003PubMedID: 22892039Scopus ID: 2-s2.0-84880287552OAI: oai:DiVA.org:esh-5515DiVA: diva2:1065553
Available from: 2012-09-27 Created: 2016-11-30 Last updated: 2017-03-21Bibliographically approved

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