Telenursing: The Future of Nursing

lilcyn, BSN, RN

Is It in My Future?

How would you like to receive medical care, education, and support without ever leaving your living room? Through telehealth services medical assistance and support can now be provided to you in the comfort of your home. Through telenursing, a registered nurse is able to provide nursing services through remote telecommunications. While aiding the patient and family with virtual learning, the telenurse provides the best practice to achieve optimal outcomes for the patient. "Telehealth nursing practice is now considered to be a subspecialty of nursing." (Hebda & Czar, 2013, p. 523). Telenursing has both advantages and disadvantages. Patients benefit from decreased hospital readmission, prevention of complications related to the disease process, and lower healthcare costs. "Hospitals increasingly are turning to telehealth as a tool to increase patient access to care, manage care better and lower healthcare costs." (Aston, 2015, p. 24). Barriers to telenursing include communication failure; disadvantages related to resources in the home environment and confidentiality concerns.

According to the Online Journal of Issues in Nursing, "patient responses to date have been extremely positive regarding telehealth nursing." (Hutcherson, 2001, para. 24). A survey conducted by American Well states, "64 percent of Americans would be willing to see a doctor via video, and 7 percent of Americans (17 million) say they would change primary care doctors for the availability of telehealth visits." (Aston, 2015, p. 24).

Benefits of Telenursing

Today's healthcare industry is changing rapidly. Technology has allowed healthcare professionals to remotely access, monitor and manage patient medical needs. Telenurses are able to case manage patients with chronic illnesses, provide counseling, and coordinate care among healthcare providers. Allowing the telenurse to collect and transmit data for clinicians to interpret so medical interventions maybe applied. "Telehealth services include health promotions, disease prevention, diagnosis, consultation, education, and therapy." (Hebda & Czar, 2013, p. 505).

The advantages to telenursing include: personal individualized attention, closer monitoring of a patient after hospital discharge, early detection of complications, increased patient satisfaction, and prevention of re-hospitalization. "Telenursing currently addresses aging populations and chronic disease problems, community and home-based care needs, geographic health services, access problems, and nursing shortage issues." (Hebda & Czar, 2013, p. 522). The main focus of the telenurse is to ensure safe, quality, low cost healthcare services.

Patients are benefiting from telenursing services as a cost effective, convenient, healthcare is being provided to patients in the home care setting. Patients are able to receive web consults, telephone based education and counseling. Patients may also benefit from being assessed and managed through remote access to home devices. A few examples of home devices include blood pressure monitoring, glucose monitoring, and EKG/cardiac monitoring. (Westra, 2012). Eliminating the need to travel for follow up appointments and therapies allow patients to save travel time and expense. Patients that reside in rural areas that have limited access to healthcare and can now benefit from remote healthcare services.

Disadvantages of Telenursing

According to Ernesater, Winbald, Engstrom, & Holmstrom (2012), there have been documented malpractice cases filed against telenurses due to poor patient outcomes. In this article, the authors discuss malpractice cases, relating the problems of communication failure. In their opinion, the telenurses were guilty of asking insufficient questions. These factors lead to patients not seeking medical attention resulting in fatal patient outcomes. As a telenurse, communication can be the key to patient safety. Communicating directly with the patient, while using open-ended questions can enhance patient safety. Ensuring patient understanding by asking a patient to repeat instructions can eliminate miscommunication and misinterpretation.

Disadvantages telenurses may experience include increased stress due to inexperience, understaffed, or insufficient support. A competent telenurse is required to have clinical expertise and experience in order to make quick decisions. Patients rely on telenurses to give adequate and up-to-date information and teaching related to their disease process and medication regime.

From a patient's perspective, one may experience disadvantages owning to the inability to acquire Internet access. Reliable telephone service would also be a key factor to provide a successful connection with the telehealth services. Lack of technological expertise along with the possibility of equipment failure may result in a patient's negative experience with virtual nursing care.

Due to telehealth members managing and storing confidential medical information and records, patients may be concerned about identity breaching or the exposure of personal information. According to Telehealth Resource Centers, "the transmission of information over communication lines lends itself to hackers and other potential exposure. Protocols must be scrupulously followed to ensure that patients are informed about all participants in a telemedicine consultation and that the privacy and confidentiality of the patient are maintained, as well as ensuring the integrity of any data/images transmitted." (Telehealth Resource Center, 2010, para. 4.

Conclusion

Healthcare is changing, are you ready to be part of the future in healthcare? As stated by The National Council of State Board of Nursing, "Telecommunications is advancing at such a rapid rate that its application to healthcare delivery and nursing practice will continue to emerge and evolve." (The National Council of State Board of Nursing, 2014, para. 5). "The rapid uptake of telehealth modalities and dynamic evolution of technologies has outpaced the generation of empirical knowledge to support nursing practice in this emerging field specifically in relation to how nurses come to know the person and engage in holistic care in a virtual environment." (Nagel, Pomerleau, & Penner, 2003, para. 2).

The position of a telelnurse is an important aspect of nursing. Telenursing provides a beneficial and supportive service to patients in a comfortable home setting. One must stay abreast of patient communication and awareness of privacy rights and ethical principals. Branching out into the teleheatlh field requires continual education while remaining aware of rules and regulations regarding HIPPA laws.

References

Hospitals & Health Networks

Malpractice claims regarding calls to Swedish telephone advice nursing: what went wrong and why?

American Nurses Association

National Center for Biotechnology Information.

Telehealth Resource Center

ncsbn.org

aacn.nche.edu