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Nurses' use of an advisory decision support system in ambulance services: A qualitative study
Linnaeus University, Faculty of Health and Life Sciences. Region Kalmar County, Sweden. (Ctr Interprofess Collaborat Emergency Care CICE)
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Region Skåne, Sweden;Lund University, Sweden. (Ctr Interprofess Collaborat Emergency Care CICE)ORCID iD: 0000-0002-6068-6273
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Region Kronoberg, Sweden. (Ctr Interprofess Collaborat Emergency Care CICE)ORCID iD: 0000-0001-7479-8092
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Uppsala University, Sweden. (Ctr Interprofess Collaborat Emergency Care CICE)ORCID iD: 0000-0003-1878-0992
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2025 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 81, no 1, p. 329-339Article in journal (Refereed) Published
Sustainable development
SDG 3: Ensure healthy lives and promote well-being for all at all ages
Abstract [en]

Aim: To illuminate from the perspective of nurses in ambulance services the experiences of using a web-based advisory decision support system to assess care needs and refer patients.

Design: Inductive and descriptive approaches.

Method: Thirteen semi-structured interviews were conducted in the spring of 2020. The data were analysed through the reflexive thematic analysis.

Results: The Swedish web-based advisory decision support system (ADSS) was found to strengthen nurses' feelings of security when they assess patients' care needs, promote their competence and professional pride, and help them manage stress. However, the system also generated difficulties for nurses to adjust to the dynamic ambulance team and revealed a discrepancy between their professional roles and responsibilities to refer patients and provide self-care advice. The nurses thought that the support system facilitated their increased participation and helped them understand patients and significant others by offering transparency in assessment and decision making. Thus, the support system provides nurses with an opportunity to strengthen patients' independence through information and education. However, in the care relationship, nurses worked to overcome patients' expectations.

Conclusion: Nurses using the ADSS increased their security while performing assessments and referrals and found new opportunities to provide information and promote understanding of their decisions. However, nursing care values can be threatened when new support systems are introduced, especially as ambulance services become increasingly protocol-driven.

Implications for Profession and/or Patient Care: These findings have implications for nurses' work environments and help them maintain consistency in making medical assessments and in providing equivalent self-care advice when referring patients to the different levels of care. The findings will also impact researchers and policymakers who formulate decision support systems.

Reporting Method: Consolidated criteria for reporting qualitative research (COREQ).

Patient or Public Contribution: None.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025. Vol. 81, no 1, p. 329-339
Keywords [en]
ambulance service, decision support systems, nursing practice, referral procedures, self-care
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-128507DOI: 10.1111/jan.16165ISI: 001188647700001PubMedID: 38515226Scopus ID: 2-s2.0-85189096763OAI: oai:DiVA.org:lnu-128507DiVA, id: diva2:1848053
Available from: 2024-04-02 Created: 2024-04-02 Last updated: 2025-01-14Bibliographically approved

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Fager, CeciliaRantala, AndreasSvensson, AndersHolmberg, MatsBremer, Anders

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