Caring within a Web of Paradoxes: The Critical Care Nurses’ Experiences of Beneficial and Harmful Effects of Technology on Nursing Care.

Introduction: Technology plays a major role in caring for critically ill patients. Its’ use in patient care can improve patient safety, save patients’ lives, facilitate nurses’ work and save time for them and reduce hospital costs. However, along with these benefits, technology can lead to some risks for patient, if the nurse is unaware of the principles of proper technology use. The aim of the present study was to describe the experiences of intensive care nurses regarding beneficial and harmful effects of technology on nursing care. Method: In a qualitative descriptive study, semi-structured, in-depth interviews were conducted with 9 intensive care nurses in south east of Iran during 2015. Interviews were transcribed and analyzed using qualitative content analysis. Findings: Two themes emerged from analyzing data included: “support”, and “adversity”. These two themes had seven categories. The theme of “support” is composed of saving nurses’ time, improving decision making and saving patients’ lives, while “adversity” is consisted of 4 categories: patients’ hardship, nurses’ distress, dependency and emerging challenges. Conclusion: Although technology was facilitative and supportive, but effective application of technology in patient care needs some infrastructures such as proper education of newcomer nurses for working in a technological environment, organizing continuous education programs about working with new advanced machines for those who are working in such environments, and organizational and managerial supports for nurses working in technological environments.

Critical Care Nurses’ Attitudes about Influences of Technology on Nursing Care.

Aims: This paper begins with developing a quantitative instrument to examine the opinions of critical care nurses’ regarding the influences of technology on nursing practice. Study Design and Methodology: After reviewing related literature, the draft of a 29-items questionnaire was developed. Based on the review of a panel of 3 experts, it was reduced to 23 items because 6 items measured similar criteria. Content validity index (CVI) of this instrument, based on the opinions of another panel of ten experts reached 0.92. Face validity was established via two focused groups of critical care nurses. All of the items were clear, relevant, and simple for these two groups. Principal component factor analysis with varimax rotation resulted two factors which altogether accounted for 52.5% of the total variance. These factors revealed negative and positive aspects of influence of technology on nursing practices. Coronbach’s a coefficient (a= 0.824) Showed acceptable internal consistency for the entire questionnaire and it’s the negative and positive aspects (0.896 and 0.925, respectively). In the next phase of the study, a convenience sample of 200 critical care nurses, in a cross-sectional study, filled the questionnaire. Results: The mean score for this sample was calculated as 82.21±9.88, indicating this sample of nurses held positive opinions regarding influences of technology on their practice. Younger nurses and those working in intensive care units had significantly higher mean scores in negative subscale compared to others. Conclusion: Considering the important role of technology in diagnosis, treatment and caring of various health conditions, adequate training of nurses for managing different technological tools and understanding the culture and values of technological care, can help them balance technological and humanized aspects of care, make technological caring more efficient and improve the quality of nursing care.