JMIR Publications

ABSTRACT

Background:

In Quebec, the shortage of nurses during night shifts compromises the safety and quality of resident care, especially in small residential and long-term care centres (CHSLDs) located in semi-remote or remote areas. This situation, which is exacerbated by the current overall shortage, exacerbates nurse staffing problems in these facilities. The need to ensure the continuous presence of nurses 24 hours a day in CHSLDs has become more pressing, forcing some facilities to implement exceptional measures such as on-call telephone services to ensure access to a nurse. In light of these challenging circumstances, the Direction nationale des soins et des services infirmiers (DNSSI) of Quebec’s Ministère de la Santé et des Services sociaux (MSSS) has rolled out a teleconsultation pilot project.

Objective:

This study aimed to explore nurses’ and nursing assistants’ lived experience of the integration of teleconsultation during night shifts in rural CHSLDs with fewer than 50 residents.

Methods:

The six-month pilot project was rolled out sequentially in three rural CHSLDs located in two administrative regions of Quebec, between July 2022 and March 2023. A total of 16 semi-structured interviews were conducted with eight nurses and nursing assistants between February and July 2023.

Results:

Participants’ testimonials revealed that teleconsultation provided significant added value by improving clinical, administrative, and organizational practices. Some practices remained unchanged, indicating stable workflows. Workflow optimization through an expanded scope of practice ensured efficient and safe continuity of care. Enhanced collaboration between nurses and nursing assistants led to improved care coordination and communication. Leadership played a significant role in clarifying professionals’ roles and in supporting effective adaptation to teleconsultation.

Conclusions:

This pilot project represents a significant step forward in improving care for CHSLD residents in Quebec. Teleconsultation not only makes it possible to overcome recruitment challenges and ensure the continuous presence of nurses during night shifts, it also optimizes professional practices while ensuring the safety and quality of care provided to residents.