4th Nursing World Conference
- August 19-21, 2019
- London, UK
Dr. Silje Gustafsson studied Nursing Sciences at Luleå University of technology, Sweden, and graduated as a RN in 2007. She then studied district nursing, and graduated as MSc in 2009. She received her PhD degree in 2016 at the same university, on the topic self-care in minor illness. She then continued doing research in several research groups at the department of health sciences at Luleå University of technology, and has now obtained the position of an Assistant Professor at the same institution. She has published several articles on the topic of self-care and telephone nursing.
Background: Telephone nursing is a rapidly increasing arena for medical support and advice via distance technology, and on-call telephone nursing services have been introduced in many countries. Telephone nursing has been found to reduce costs and optimize health care utilization, but the delivery of health care assessment and advice over the telephone has also been questioned with regards to quality and patient safety issues. Knowledge about what factors influence quality is needed in order to monitor and evaluate quality. Aim: To study factors indicating quality in telephone nursing. Methods: A systematic review was conducted and 32 articles from 2004-2018 were identified. Results: In total, 10 factors were identified that indicate quality in telephone nursing. Within the structure area, four factors were identified; Availability and simplicity of the service, Nurses’ working conditions, Nurses’ education and experience, and Health care resources and organization. In the field of process, three factors were identified; Communication, Person-centered care and Competence. In the area of outcome, three factors indicating quality were identified; Appropriateness and patient safety, Efficiency and Satisfaction. Conclusions: Healthcare services need to establish management systems for systematic quality work to improve and develop the services to match the needs of the population. To provide a patient-safe care it is of great importance that the telephone nurses' work environment is optimized, i.e. that time pressure and requirements for handling large amounts of calls quickly is reduced. Nurses' education and competence are important prerequisites for high quality care and telephone nursing is a complex task. Thus telephone nursing should be provided by nurses with a specialist competence in both nursing care and medicine. Nursing competence is necessary to create a good encounter and to work person-centered, which increases patients' satisfaction and adherence to nursing advice and thereby provide a more efficient care. Medical competence is crucial in order to be able to make a correct assessment and provide adequate advice. Digital medical decision support systems is a tool that can aid the nurse in this regard. Furthermore, the communication between the nurse and the nurse seeking center is in order for a correct assessment and advice to take place. Paraphrasing, summarizing and comprehension check are strategies that can be used to ensure mutual understanding.