Describing Telenurses' Decision Making Using Clinical Decision Support: Influential Factors Identified.

OBJECTIVE: Understand the cognitive processes of telenurses' decision making with the use of health information systems (HIS), specifically Clinical Decision Support Systems (CDSS). In addition, identify the factors that influence how telenurses use CDSS.

METHODS: Eight telenurses were recruited to manage two call scenarios in a clinical simulation. The call encounters were video recorded and the phone calls were audio recorded. The screens were also recorded to capture the HIS navigation. After the call was completed, the recordings were played back for the telenurse and discussion ensued regarding any issues with the system; this encounter was also recorded for further analysis.

RESULTS: Several factors were identified that influenced how telenurses made decisions while using the CDSS. It was found that the decision ladder model could be applied to describe telenurse strategies while using CDSS. The purpose of this paper is to describe the emerging factors that influence telenurses' decision making during a clinical simulation study in a telenursing call centre.