Telenursing
Encyclopedia
Telenursing refers to the use of telecommunications and information technology
for providing nursing
services in health care
whenever a large physical distance exists between patient and nurse, or between any number of nurses. As a field it is part of telehealth
, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, telemonitoring, etc.
Telenursing is achieving a large rate of growth in many countries, due to several factors: the preoccupation in driving down the costs of health care, an increase in the number of aging and chronically ill population, and the increase in coverage of health care to distant, rural, small or sparsely populated regions. Among its many benefits, telenursing may help solve increasing shortages of nurses; to reduce distances and save travel time, and to keep patients out of hospital. A greater degree of job satisfaction has been registered among telenurses.
. For example, patients who are immobilized, or live in remote or difficult to reach places, citizens who have chronic ailments, such as chronic obstructive pulmonary disease
, diabetes, congestive heart disease
, or disabilitating diseases, such as neural degenerative diseases (Parkinson's disease
, Alzheimer's disease
, ALS
), etc., may stay at home and be "visited" and assisted regularly by a nurse via videoconferencing
, internet
, videophone
, etc. Still other applications of home care are the care of patients in immediate post-surgical situations, the care of wound
s, ostomies, handicapped
individuals, etc. In normal home health care, one nurse is able to visit up to 5-7 patients per day. Using telenursing, one nurse can “visit” 12-16 patients in the same amount of time. [Needs source]
A common application of telenursing is also used by call centers operated by managed care organizations, which are staffed by registered nurses who act as case managers or perform patient triage
, information and counseling as a means of regulating patient access and flow and decrease the use of emergency rooms.
Telenursing can also involve other activities such as patient education
, nursing teleconsultations, examination of results of medical test
s and exams, and assistance to physicians in the implementation of medical treatment protocols
.
and regulatory issues, as it happens with telehealth as a whole. In many countries, interstate and intercountry practice of telenursing is forbidden (the attending nurse must have a license both in her state/country of residence and in the state/country where the patient receiving telecare is located). Legal issues such as accountability
and malpractice
, etc. are also still largely unsolved and difficult to address.
In addition, there are many considerations related to patient confidentiality
and safety
of clinical data.
Information technology
Information technology is the acquisition, processing, storage and dissemination of vocal, pictorial, textual and numerical information by a microelectronics-based combination of computing and telecommunications...
for providing nursing
Nursing
Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death....
services in health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
whenever a large physical distance exists between patient and nurse, or between any number of nurses. As a field it is part of telehealth
Telehealth
Telehealth is the delivery of health-related services and information via telecommunications technologies. Telehealth could be as simple as two health professionals discussing a case over the telephone or as sophisticated as doing robotic surgery between facilities at different ends of the...
, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, telemonitoring, etc.
Telenursing is achieving a large rate of growth in many countries, due to several factors: the preoccupation in driving down the costs of health care, an increase in the number of aging and chronically ill population, and the increase in coverage of health care to distant, rural, small or sparsely populated regions. Among its many benefits, telenursing may help solve increasing shortages of nurses; to reduce distances and save travel time, and to keep patients out of hospital. A greater degree of job satisfaction has been registered among telenurses.
Applications
One of the most distinctive telenursing applications is home careHome care
Home Care, , is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as domiciliary care or social care), is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as...
. For example, patients who are immobilized, or live in remote or difficult to reach places, citizens who have chronic ailments, such as chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease , also known as chronic obstructive lung disease , chronic obstructive airway disease , chronic airflow limitation and chronic obstructive respiratory disease , is the co-occurrence of chronic bronchitis and emphysema, a pair of commonly co-existing diseases...
, diabetes, congestive heart disease
Heart disease
Heart disease, cardiac disease or cardiopathy is an umbrella term for a variety of diseases affecting the heart. , it is the leading cause of death in the United States, England, Canada and Wales, accounting for 25.4% of the total deaths in the United States.-Types:-Coronary heart disease:Coronary...
, or disabilitating diseases, such as neural degenerative diseases (Parkinson's disease
Parkinson's disease
Parkinson's disease is a degenerative disorder of the central nervous system...
, Alzheimer's disease
Alzheimer's disease
Alzheimer's disease also known in medical literature as Alzheimer disease is the most common form of dementia. There is no cure for the disease, which worsens as it progresses, and eventually leads to death...
, ALS
Amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis , also referred to as Lou Gehrig's disease, is a form of motor neuron disease caused by the degeneration of upper and lower neurons, located in the ventral horn of the spinal cord and the cortical neurons that provide their efferent input...
), etc., may stay at home and be "visited" and assisted regularly by a nurse via videoconferencing
Videoconferencing
Videoconferencing is the conduct of a videoconference by a set of telecommunication technologies which allow two or more locations to interact via two-way video and audio transmissions simultaneously...
, internet
Internet
The Internet is a global system of interconnected computer networks that use the standard Internet protocol suite to serve billions of users worldwide...
, videophone
Videophone
A videophone is a telephone with a video screen, and is capable of full duplex video and audio transmissions for communication between people in real-time...
, etc. Still other applications of home care are the care of patients in immediate post-surgical situations, the care of wound
Wound
A wound is a type of injury in which skin is torn, cut or punctured , or where blunt force trauma causes a contusion . In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.-Open:...
s, ostomies, handicapped
Disability
A disability may be physical, cognitive, mental, sensory, emotional, developmental or some combination of these.Many people would rather be referred to as a person with a disability instead of handicapped...
individuals, etc. In normal home health care, one nurse is able to visit up to 5-7 patients per day. Using telenursing, one nurse can “visit” 12-16 patients in the same amount of time. [Needs source]
A common application of telenursing is also used by call centers operated by managed care organizations, which are staffed by registered nurses who act as case managers or perform patient triage
Triage
Triage or ) is the process of determining the priority of patients' treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately. The term comes from the French verb trier, meaning to separate,...
, information and counseling as a means of regulating patient access and flow and decrease the use of emergency rooms.
Telenursing can also involve other activities such as patient education
Patient education
Patient education is the process by which health professionals and others impart information to patients that will alter their health behaviors or improve their health status...
, nursing teleconsultations, examination of results of medical test
Medical test
A diagnostic test is any kind of medical test performed to aid in the diagnosis or detection of disease. For example:* to diagnose diseases, and preferably sub-classify it regarding, for example, severity and treatability...
s and exams, and assistance to physicians in the implementation of medical treatment protocols
Guideline (medical)
A medical guideline is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare...
.
Legal, ethical and regulatory issues
Telenursing is fraught with legal, ethicalEthics
Ethics, also known as moral philosophy, is a branch of philosophy that addresses questions about morality—that is, concepts such as good and evil, right and wrong, virtue and vice, justice and crime, etc.Major branches of ethics include:...
and regulatory issues, as it happens with telehealth as a whole. In many countries, interstate and intercountry practice of telenursing is forbidden (the attending nurse must have a license both in her state/country of residence and in the state/country where the patient receiving telecare is located). Legal issues such as accountability
Accountability
Accountability is a concept in ethics and governance with several meanings. It is often used synonymously with such concepts as responsibility, answerability, blameworthiness, liability, and other terms associated with the expectation of account-giving...
and malpractice
Malpractice
In law, malpractice is a type of negligence in, which the professional under a duty to act, fails to follow generally accepted professional standards, and that breach of duty is the proximate cause of injury to a plaintiff who suffers harm...
, etc. are also still largely unsolved and difficult to address.
In addition, there are many considerations related to patient confidentiality
Confidentiality
Confidentiality is an ethical principle associated with several professions . In ethics, and in law and alternative forms of legal resolution such as mediation, some types of communication between a person and one of these professionals are "privileged" and may not be discussed or divulged to...
and safety
Safety
Safety is the state of being "safe" , the condition of being protected against physical, social, spiritual, financial, political, emotional, occupational, psychological, educational or other types or consequences of failure, damage, error, accidents, harm or any other event which could be...
of clinical data.
External links
- Post discharge follow-up calls. TeleNurse First.
- Telenursing. AllHealth.net
- Telehealth: Issues for Nursing. American Nursing Association.
- New nursing technologies: What you need to know. By Simpson, Roy L. Nursing. August 1997.
- Telehome Care Clinical Guidelines^. American Telemedicine Association.
- Telenursing and Licensure. Board of Nursing Examiners.
- Interstate Licensure for Telenursing . By Glenn W. Wachter, May, 2002. TIE.
- Telehealth: Are you at risk? By Georgia A. Martin. Nursing Risk Management 2002. AFIP.
- Telemedicine Applications in Telenursing 2003 and Telemedicine Applications in Telenursing 2004. Powerpoint presentations during the Annual Conference of the American Telemedicine Association.
- Telenursing Fact Sheet. International Council of Nurses.
- Nurse Triage site specializing in personalized health information and support
- The National Council of State Boards of Nursing Position Paper on Telenursing: A Challenge to Regulation. The National Council of State Boards. August 1999.
- International Society for Telemedicine & eHealth (ISfTeH) - Telenursing Working Group