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Telenursing
Telenursing refers to the use of information technology in the provision of nursing services whenever physical distance exists between patient and nurse, or between any number of nurses. As a field, it is part of telemedicine, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, and telemonitoring. The field, however, is still being developed as the information on telenursing isn't comprehensive enough.
Telenursing is growing in many countries because of 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.
Nursing informatics, a branch of health informatics, has been defined by Judith Rae Graves and Sheila Corcoran as "a combination of computer science, information science, and nursing science designed to assist in the management and processing of nursing data, information, and knowledge to support the practice of nursing and the delivery of nursing care". Telenursing is a potential application of nursing informatics and as such, nursing informatics has served as a critical background concept its development.
One of the most distinctive telenursing applications is home care. 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 debilitating diseases, such as neural degenerative diseases (Parkinson's disease, Alzheimer's disease or ALS), may stay at home and be "visited" and assisted regularly by a nurse via videoconferencing, internet or videophone. Other applications of home care are the care of patients in immediate post-surgical situations, the care of wounds, ostomies or disabled individuals. 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.
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.
Telephone triage refers to symptom or clinically based calls. Clinicians perform symptom assessment by asking detailed questions about the patient's illness or injury. The clinician's task is to estimate and/or rule out urgent symptoms. They may use pattern recognition and other problem-solving process as well. Clinicians may utilize guidelines, in paper or electronic format, to determine how urgent the symptoms are. Telephone triage requires clinicians to evaluate symptoms and provide health advice which guides patients to the appropriate level of care, (emergent, urgent, or nonurgent) according to their condition and symptoms. Telephone triage staff also provides advice for self‐care at home for nonurgent patients. It may involve educating and advising clients, and making safe, effective, and appropriate dispositions—all by telephone. Telephone triage takes place in settings as diverse as emergency rooms, ambulance services, large call centers, physician offices, clinics, student health centers and hospices.
Telephone triage services are beneficial in decreasing the amount of nonemergent patient visits to emergency departments. Emergency departments typically experience high patient volumes, many of which are nonemergent. Emergency department waiting areas may become overcrowded with patients due to the high patient volumes, resulting in many patients leaving without being seen. The telephone triage staff has access to the electronic health records generated by a health system encounters. The ability to access patients' health records helps the triage staff evaluate the patient more efficient due to the provided information such as allergies and comorbidities. Having access to patients' health records provides demographic information which allows the triage staff to send emergency services to the patient if necessary. Telephone triage service can help to decrease lower-acuity patient visits to an emergency department by properly evaluating patients symptoms and guiding them to the appropriate level of care.
An international telenursing survey was completed in 2005, reporting that the 719 responding full-time and part-time registered nurses and advanced practice nurses worked as a telenurse in 36 countries around the world. 68% were reported to be working in the United States, compared to only 0.6% in Finland. Some of these 36 countries include Australia, Canada, Norway, United Kingdom, New Zealand, Iran, Sweden, and the Netherlands.
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Telenursing
Telenursing refers to the use of information technology in the provision of nursing services whenever physical distance exists between patient and nurse, or between any number of nurses. As a field, it is part of telemedicine, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, and telemonitoring. The field, however, is still being developed as the information on telenursing isn't comprehensive enough.
Telenursing is growing in many countries because of 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.
Nursing informatics, a branch of health informatics, has been defined by Judith Rae Graves and Sheila Corcoran as "a combination of computer science, information science, and nursing science designed to assist in the management and processing of nursing data, information, and knowledge to support the practice of nursing and the delivery of nursing care". Telenursing is a potential application of nursing informatics and as such, nursing informatics has served as a critical background concept its development.
One of the most distinctive telenursing applications is home care. 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 debilitating diseases, such as neural degenerative diseases (Parkinson's disease, Alzheimer's disease or ALS), may stay at home and be "visited" and assisted regularly by a nurse via videoconferencing, internet or videophone. Other applications of home care are the care of patients in immediate post-surgical situations, the care of wounds, ostomies or disabled individuals. 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.
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.
Telephone triage refers to symptom or clinically based calls. Clinicians perform symptom assessment by asking detailed questions about the patient's illness or injury. The clinician's task is to estimate and/or rule out urgent symptoms. They may use pattern recognition and other problem-solving process as well. Clinicians may utilize guidelines, in paper or electronic format, to determine how urgent the symptoms are. Telephone triage requires clinicians to evaluate symptoms and provide health advice which guides patients to the appropriate level of care, (emergent, urgent, or nonurgent) according to their condition and symptoms. Telephone triage staff also provides advice for self‐care at home for nonurgent patients. It may involve educating and advising clients, and making safe, effective, and appropriate dispositions—all by telephone. Telephone triage takes place in settings as diverse as emergency rooms, ambulance services, large call centers, physician offices, clinics, student health centers and hospices.
Telephone triage services are beneficial in decreasing the amount of nonemergent patient visits to emergency departments. Emergency departments typically experience high patient volumes, many of which are nonemergent. Emergency department waiting areas may become overcrowded with patients due to the high patient volumes, resulting in many patients leaving without being seen. The telephone triage staff has access to the electronic health records generated by a health system encounters. The ability to access patients' health records helps the triage staff evaluate the patient more efficient due to the provided information such as allergies and comorbidities. Having access to patients' health records provides demographic information which allows the triage staff to send emergency services to the patient if necessary. Telephone triage service can help to decrease lower-acuity patient visits to an emergency department by properly evaluating patients symptoms and guiding them to the appropriate level of care.
An international telenursing survey was completed in 2005, reporting that the 719 responding full-time and part-time registered nurses and advanced practice nurses worked as a telenurse in 36 countries around the world. 68% were reported to be working in the United States, compared to only 0.6% in Finland. Some of these 36 countries include Australia, Canada, Norway, United Kingdom, New Zealand, Iran, Sweden, and the Netherlands.
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