Telenursing

Description of Telenursing Technology used in Telenursing Information system used in Telenursing Role and function of nurse informatics in

Telenursing Legal and ethical issues surrounding Telenursing Advantages/Disadvantages of Telenursing

Objectives

The practice of nursing over a distance using telecommunication

technology (National Council of State Boards of Nursing NCSBN, 1997)

Nurse/Patient interaction through a telecommunication device

Telenursing

Phone Interactive Video Phone Triage Internet Support Remote Telemonitor

Telenursing Examples

Hardware (physical computer body) Computers (laptops, desktops) Palm computers Telephones Graphic’s card Sound cards Internal Memory ( RAM) External Memory ( flash drives)

Technology Used

Wireless technology increases a computer’s portability

May be used in hospitals or other community nursing settings

Allow nurses remote access to medical records

Allows electronic documentation in remote locations

May be used in two way audio/video conference

Portable Computers (Laptops/Palm Computers)

Software (programs to operate a computer)

Monitor, keyboards, mouse, printer Web cameras, speakers, microphone Email, database, word-processing, internet,

browsing, conference calls

Example: Digiscope-program to collect patient info related to diabetes.

Provides wireless networking between hospital computers

Allows for wireless Internet access Used in Video conferencing between nurse

and patient Used in emails, Instant messaging, and

Wireless Network

Efficiency strongly depends on server Software design varies between medical

facilities Usability is dependant on internet access at

home

Software Evaluation

Ring sensor worn by patient 24hrs/day Transmits wireless data Home computer analyzes data Sends warning signals to telenursing center Signal provides diagnostic information

Telemonitoring Ring Sensor

Review of System Used for clinical purposes Used by medical professionals (doctors,

nurses, ect) Monitoring and diagnostic function Local Area Network

Telemonitoring Ring Sensor

Nurse Informatics

Collecting data from Patient Assessing data using knowledge Document all retrieved data Utilize critical thinking skills Provide nursing interventions Continue to monitor and utilize

available technology

Increase public access to health care Provide access in rural areas Decrease wait times Decrease unnecessary hospital visits Decrease Healthcare costs Increase continuity of care Increase patient compliance with aftercare

Advantages

Decreased face-to-face interaction Risk of decreasing quality of care May increase liability Concerns with security Concerns with maintaining confidentiality

Disadvantages

Maintaining patient privacy Verifying consent Compliance with HIPAA regulations Nursing Licensure across state lines Maintaining compliance with scope of

practice

Legal Issues

Maintaining autonomy (identity, privacy) Maintaining patient’s integrity Prevent harm to a patient

Ethical Concerns

Ongoing development of new Technologies provides endless Possibilities in the future of Nursing care.

Future of Telenursing

Bohnenkamp, Sk., McDonald, P., Lopez, AM. Krupinski, E., & Blackett, A., (2004). Traditional versus telenursing outpatient management of patients with cancer with new ostomies. Oncology Nursing Forum, 31(5), 1005-10. Retrieved on June 1, 2010, from http://www.medscape.com/medline/abstract/15378102

Yang, B., Rhee, S., & Asada, H., (1998). A twenty-four hour tele-nursing system using a ring sensor. Robotics and Automation. Retrieved from http://www.sokwoo.com/ICRA98paper.pdf

Hoglund, A., & Holmstrom, I. (2004-2010). Ethical Issues In Telenursing. Retrieved June, 1, 2010 from http://www.ihe-online.com/index.php?id=2695

McGonigle, D., & Mastrian, K. (2009). Nursing informatics and the foundation of knowledge. Sudbury, MA: Jones and Bartlett Publishers.

Refererences

National Council of State Boards of Nursing ( NCSBN). (1997). Retrived June 1, 2010 from https://www.ncsbn.org/TelenursingPaper.pdf

Registered Nurses’s Association of Nova Scotia. (2000, November). Guidelines for Telenursing Practice. Retrived June1, 2010 from http://www.rnans.ns.ca

Schlachta-Fairchild, L., Elfrink, V., & Deickman, A., ( 2008, April). Patient Safety, Telenursing and Telehealth. Patient Safety and Quality: An Evidenced-Based Handbook for Nurses, 3(48). Retrieved June 1, 2010 from http://www.ahrq.gov/qual/nurseshdbk/docs/SchlachtaL_PSTT.pdf

Wachter, G., (2002, May). Interstate licensure for telenursing. Telemedicine and Telehealth Articles. Retrieved June 1, 2010 from http://www.tie.telemed.org/articles/article.asp?path=article&article=telenur