Background. In parallel with public health responses, health systems have had to rapidly implement infection control strategies during the SARS-CoV-2 (COVID-19) pandemic. Various technologies, such as digital contact tracing (DCT), have been implemented to enhance case investigations among healthcare workers' (HCWs). Currently, little attention has focused on the perspectives of those who have implemented DCT innovations and those who have adopted such technologies within a healthcare environment. -- Objective. This study aimed to describe the implementation, acceptance, and outcomes of a web-based DCT tool used extensively at a specialized pediatric acute-care hospital in Ontario during the COVID-19 pandemic from the perspective of key stakeholders. -- Methods. Using an exploratory qualitative design, this research involved 21 semi-structured interviews with healthcare administrators (n=6; 29%), occupational health specialists (n=8; 38%), and healthcare workers (n=7; 33/%) at the Children's Hospital of Eastern Ontario. Interview protocols and analysis were guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The interviews lasted on average 33.6 minutes in length and were audio-recorded. Verbatim transcripts were subjected to thematic analysis using NVivo software. -- Results. The implementation of DCT during the COVID-19 pandemic was viable and well-received among stakeholders. End-users cited that their engagement with the DCT tool was facilitated by its perceived ease of use and the ability to gain awareness of probable COVID-19 exposures; however, risk-assessment consequences and access concerns were present as barriers (reach). Stakeholders commonly agreed that the DCT tool exerted a positive outcome on the hospital's capacity to meet the demands of COVID-19, notably through the facilitation of timely case investigations and by informing decision-making processes (effectiveness). Implementors and occupational specialists conveyed staffing impacts, and the loss of nuanced information as unintended consequences (effectiveness). Safety-focused communication strategies and having a technology that was human-centered were crucial factors driving staff adoption. Conversely, adoption was challenged by the misaligned delivery of the DCT tool with HCWs standard practices, alongside the evolving perspectives of COVID-19. Some end-users expressed an initial disconnect towards the DCT tool, raising questions about the fidelity of the implementation. However, stakeholders collectively agreed on the viability of the DCT approach and its applicability to infectious disease practices (maintenance). -- Conclusion. Stakeholders reported DCT in the hospital context to be acceptable and efficient in meeting the demands of the COVID-19 pandemic. Recommendations for optimized DCT use include education and training for relevant personnel, improved access and usability, and integration into clinical systems. The findings contribute to evidence-based practices and guide future scale-up initiatives focused on digital surveillance in the hospital context.

Bakgrund Digitalisering har blivit allt vanligare och digitala vårdkontakter har implementerats i vården. Sveriges kommuner och regioner ser digitaliserade vårdtjänster som en naturlig del av framtidens vårdutbud. Sjuksköterskor behöver arbeta i enlighet med sitt ansvarsområde inom sjukvård och omvårdnad, även inom digital kontakt. Därför behövs sammanställd kunskap om patienters erfarenheter, för att sjuksköterskor ska arbeta i enlighet med sina ansvarsområden. Syfte Syftet var att beskriva vuxna patienters upplevelser av digital kontakt i en vårdkontext. - Hur upplevde patienterna den digitala kontakten med sjuksköterskor? - Vilka fördelar och nackdelar upplevde patienter med digital kontakt med vården? Metod Designmetoden var en icke-systematisk litteraturöversikt. Tio originalartiklar valdes från databaserna Pubmed och CINAHL. Artiklar var peer-review granskade, godkända från etikprövning, skrivna på engelska och publicerades mellan år 2013-2024. Integrerad analys användes för att sammanställa resultaten i relation till varandra. Resultat Fyra huvudkategorier identifierades. Upplevelser av kommunikationen visade detaljer som bidrog till bra eller försämrad kommunikation digitalt, och relationen sjuksköterska-patient visades vara viktigare än vårdformen. Upplevelser av socialt stöd belyste hur kontakten minskade ensamhet, lindrade jobbiga känslor och uppmuntrade patienter. Upplevelser av digital funktionalitet visade nackdelar som var relaterade till svårigheter med användningen och känslor kring säkerheten. Fördelar som togs upp var att öva på digitala kunskaper, säkerhet, enkel användning och att data kan delas mellan vårdpersonal. Upplevelser av bekvämlighet beskrev varför digital kontakt upplevdes bekvämt. Slutsats I arbetet framkommer att en bra relation mellan sjuksköterskan och patienten bidrar till att identifiera och lindra lidande vid digital kontakt. Vidare framkommer att det är mindre relevant om det handlar om fysisk eller digital kontakt. Det viktigaste är sjuksköterskans skicklighet och empati. Sjuksköterskans finkänsla och uppmärksamhet är väsentlig vid digital kontakt, därmed bör den utvecklas. Digital kontakt är betydelsefullt för patientens bekvämlighet. / Background Digitization has increased, and digital healthcare contacts have been implemented. Sweden's municipalities and regions see digitized care services as part of future services. Nurses need to work in accordance with their area of responsibility in healthcare and nursing, also with digital contacts. Compiled knowledge of patients' experiences is therefore needed, for nurses to work in accordance with their areas of responsibility. Objective To describe adult patients' experiences of digital contact in health care.  - How did the patients experience the digital contact with nurses? - What advantages and disadvantages did patients experience in healthcare with digital contact? Methods The design method was a non-systematic literature review. Ten original articles were selected from the databases Pubmed and CINAHL. Articles were peer-reviewed, approved from ethics review, in English and published between 2013-2024. Integrated analysis was used to compile results. The work strongly distanced itself from fabrication, distortion and plagiarism. Results Four main categories were identified. Experiences of the communication showed what details contributed to good or poor digital communication, and the nurse-patient relationship was noticed as more important than the form of healthcare itself. Experiences of social support highlighted how digital contact reduced loneliness, alleviated difficult feelings and encouraged patients. Experiences of digital functionality showed disadvantages of user-experiences and feelings of security. Raised benefits were practicing digital skills, feelings of security, ease of use and shared data between healthcare professionals. Experiences of convenience described why digital contact felt comfortable. Conclusion Good relationship between the nurse and the patient contributes to identifying and alleviating suffering in digital contact. It appears that it’s less relevant if the contact is physical or digital, but instead the nurses' skill and empathy. The nurses' sensitivity and attention are essential in digital contact and should be developed. Digital contact is important for patient comfort.

Abstract Background Data about the effectiveness of digital contact tracing are based on studies conducted in countries with predominantly high- or middle-income settings. Up to now, little research is done to identify specific problems for the implementation of such technique in low-income countries. Methods A Bluetooth-assisted GPS location-based digital contact tracing (DCT) app was tested by 141 participants during 14 days in a hospital in Monrovia, Liberia in February 2020. The DCT app was compared to a paper-based reference system. Hits between participants and 10 designated infected participants were recorded simultaneously by both methods. Additional data about GPS and Bluetooth adherence were gathered and surveys to estimate battery consumption and app adherence were conducted. DCT apps accuracy was evaluated in different settings. Results GPS coordinates from 101/141 (71.6%) participants were received. The number of hours recorded by the participants during the study period, true Hours Recorded (tHR), was 496.3 h (1.1% of maximum Hours recordable) during the study period. With the paper-based method 1075 hits and with the DCT app five hits of designated infected participants with other participants have been listed. Differences between true and maximum recording times were due to failed permission settings (45%), data transmission issues (11.3%), of the participants 10.1% switched off GPS and 32.5% experienced other technical or compliance problems. In buildings, use of Bluetooth increased the accuracy of the DCT app (GPS + BT 22.9 m ± 21.6 SD vs. GPS 60.9 m ± 34.7 SD; p = 0.004). GPS accuracy in public transportation was 10.3 m ± 10.05 SD with a significant (p = 0.007) correlation between precision and phone brand. GPS resolution outdoors was 10.4 m ± 4.2 SD. Conclusion In our study several limitations of the DCT together with the impairment of GPS accuracy in urban settings impede the solely use of a DCT app. It could be feasible as a supplement to traditional manual contact tracing. DKRS, DRKS0 00293 27. Registered 20 June 2020 - Retrospectively registered.

Digitala kontaktvägar är en del av e-hälsa och omfattar all digital kontakt mellan vårdpersonal och patient. Det innefattar bland annat telefoni, videolänk och chatt och kommunikationen kan ske synkront eller asynkront. Som ett led i detta har distriktssköterskor fått arbeta fram nya arbetssätt. Syftet med denna litteraturöversikt var att undersöka distriktssköterskors erfarenheter av att möta patienter i en digitalt medierad primärvård. Erfarenheten hos distriktssköterskorna var att arbetet blev mer effektivt samtidigt som det upplevdes ge en ökad tillgänglighet för patienterna. Distriktssköterskorna uppmärksammade även att kommunikationen med patienterna var annorlunda i den digitala miljön. Utifrån litteraturöversiktens 13 kvalitativa artiklar, från Norden, framkom tre kategorier: den digitala vägen till vården, tolkning av patientens situation och digitalisering - inget val. Det geografiska närområdet borde kunna stärka överförbarheten till vårt eget land. De samlade erfarenheterna från distriktssköterskor i primärvården skulle kunna bidra till att utveckla arbetssätt samt öka förståelsen och medvetenheten om hur relationen distriktssköterskor och patienterförändras i en digitalt medierad primärvård. Framtida forskning bör vara en större enkätundersökning baserad på våra fynd för att skapa en nationell bild avdistriktssköterskors erfarenheter av att möta patienter i en digital miljö. / Digital contact paths are part of e-health and include telephone contact, video link and chat. Communication can be done synchronously or asynchronously. As part of this district nurses have had to work out new ways of working. The aim of this literature review was to investigate district nurses' experiences of meeting patients in a digitally mediated primary care. The experience of the district nurses was that the work became more efficient while it was perceived to provide increased accessibility for the patients. The district nurses also noted that communication with patients was different in the digital environment. Based on the literature review's 13 qualitative articles, from the Nordic countries, three categories emerged: the digital path to healthcare, interpretation of the patient's situation and digitization - no choice. The close geographic proximity may strengthen the transferability to our own country. The accumulated experience from district nurses in primary care could contribute to development of working methods and increase understanding of how the relationship between district nurses and patients changes in digitally mediated primary care. Future research should be a larger survey based on our findings to create a national picture of district nurses' experiences of meeting patients in a digital environment

Bakgrund: Digitala kontaktvägar har fått en framträdande roll inom primärvården. Genom digitala kontaktvägar ska individen stå i centrum och öka förmågan att hantera sin sjukdom. Egenvårdsråd är högt prioriterade för patienter med kroniskt obstruktiv lungsjukdom och syftar till att minska symtom, förebygga exacerbationer, öka fysisk aktivitet, förhindra sjukdomsprogression och minskad dödlighet. Syftet: var att belysa vilka erfarenheter patienter med KOL har av egenvårdsråd genom en digitaliserad kontakt med vården. Utifrån litteraturöversiktens 14 kvalitativa artiklar framkom tre huvudkategorier: från fysiska till digitala kontaktvägar, erfarenheter av att möta distriktssköterskan på skärmen och digitala egenvårdsråd. Metod: Studien genomfördes som en systematisk litteraturstudie med induktiv ansats. Resultat: Digitala egenvårdsråd ansågs vara ett användbart komplement, inte som en ersättning till fysiska besök hos distriktssköterskan. Konklusion: Den samlade kunskapen från föreliggande studie kan ligga till grund för att distriktssköterskor och verksamhetschefer inom primärvården får en bättre förståelse kring hur egenvårdsråd uppfattas av patienterna, i takt med att deras kunskaper och upplevelser förändras med den digitala utvecklingen. Det vetenskapliga underlaget är begränsat och framtida forskning bör fokusera på en större enkätundersökning för att kunna dra slutsatser av hur digitala egenvårdsråd påverkar patienter med kroniskt obstruktiv lungsjukdom. / Backround: Digital contact path have gained a prominent role in primary care. Through digital contact path, the individual should be at the center of attention and increase the ability to manage their illness. Self-management is a high priority in COPD care and aims to reduce symptoms, prevent exacerbations, increase physical activity, prevent disease progression and reduce mortality. The aim: was to investigate COPD patients' experiences of self-management advice through digitally mediated care. Based on the literature review's 14 qualitative articles, three main categories emerged: from physical to digital contact paths, experiences of meeting the district nurse on the screen and digital self-management advice. Methods: The method used was a systematic literature review with an inductive approach. Results: Digital self-management advice was considered a useful supplement, but never a substitute for physical visits to the district nurse. Conclusion: The collected knowledge from the study could contribute to district nurses and operational managers within primary care gaining a better understanding of how patients perceive self-management advice, as their knowledge and experiences change with digital development. The scientific basis is limited, future research should focus on a larger survey to be able to draw conclusions about how digital self-management advice affects COPD patients.

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