Telenursing Research Paper
Order Instructions:
Telenursing…the Future Is Now Paper
Guidelines and Grading Rubric
PURPOSE
The purpose of this assignment is to explore the specialty of telenursing as one example of the use of technology in various practice settings. Advantages and disadvantages for the patient and legal and ethical principles for the nurse of this technology will be explored.
COURSE OUTCOMES
This assignment enables the student to meet the following course outcomes:
CO #2: Investigate safeguards and decision-making support tools embedded in patient care technologies and information systems to support a safe practice environment for both patients and healthcare workers. (PO #4)
CO #6: Discuss the principles of data integrity, professional ethics, and legal requirements related to data security, regulatory requirements, confidentiality, and client’s right to privacy. (PO #6)
POINTS
This assignment is worth a total of 200 points.
DUE DATE
Your completed Telenursing…the Future Is Now paper is due at the end of Week 4. Submit it to the basket in the Dropbox by Sunday at 11:59 p.m. mountain time. Post your questions to the weekly Q & A Forum. Contact your instructor if you need additional assistance. See the Course Policies regarding late assignments. Failure to submit your paper to the Dropbox on time will result in a deduction of points.
BACKGROUND
Our text (Hebda, 2013) provides us with a broad perspective on telehealth. However, the specialty of telenursing is only briefly discussed. Healthcare is readily embracing any technology to improve patient outcomes, streamline operations, and lower costs. This technology includes the use of various applications based in various environments where registered nurses indirectly provide professional nursing care.
SCENARIO
The following scenario serves as the basis for your paper:
Manuel, one of your colleagues, is considering leaving his medical-surgical position where both of you have worked for the past 12 years. In fact, he has an interview in two weeks for a Telenurse Specialist position at a nurse-owned home health agency. This agency monitors the elderly and those with chronic illnesses to keep them from being readmitted to the hospital. Manuel is doing some research on his own and knows that the hours sound great and the pay is comparable. One advantage is that he can work from home (telecommute) most of the time and only interface with the agency for required meetings.
Manuel knows you are enrolled in this course. You have discussed various concepts that you noted in your Syllabus including technology, privacy, confidentiality, interoperability, legal and ethical issues, and patients’ access to the World Wide Web, just to name a few. Manuel has shared that he does not know much about telehealth and the role of nursing in this “new” technology. He has asked you to educate him on the advantages and disadvantages to patients of telenursing. Frankly, he does not understand what he might be doing on a day-to-day basis. One concern is the technology that may be involved.
Manuel has indicated that he realizes the final decision about a career move will be his choice, but he is seeking your knowledge based on concepts presented in this course. He wants to be knowledgeable about the role of the professional nurse in this practice setting prior to his interview.
You tell Manuel that you will need to do some research and that you will get back to him about your conclusion and recommendation. You have heard of telenursing and how it can prevent patients with COPD (chronic obstructive pulmonary disease) and CHF (congestive heart failure) from being readmitted to the hospital, but you recognize that you will need to do much more investigation.
DIRECTIONS
1. You are to research (find evidence), compose, and type a scholarly paper based on the scenario described above. Reflect on what you have learned in this class to date about technology, privacy rights, ethical issues, interoperability, patient satisfaction, consumer education, and other topics. Your text by Hebda (2013, Chapter 25) discusses telehealth in detail. However, your focus should be on the professional nurse’s role in telehealth, such as telenursing. Therefore, do not limit your review of the literature to your text. Nurses in various specialties need to know about the advantages and disadvantages of telenursing as it applies to their patients. For example, when you discharge a patient from an acute care setting, will a telenursing service assist that individual with staying out of the hospital? You may need to apply critical thinking skills to development of your paper.
2. Use Microsoft Word and APA formatting to develop your paper. Consult the Publication manual of the APA, 6th edition if you have questions, for example, margin size, font type and size (point), use of third person, and so forth. Take advantage of the writing service, Smarthinking, which is accessed by clicking on the link called the Tutor Source, found under the Course Home tab. Also, review and use the various documents in Doc Sharing related to APA.
3. The length of the paper should be 4–5 pages, excluding the title page and the reference page. Limit your references to key sources.
4. The paper should contain an Introduction that catches the attention of the reader with interesting facts and supporting sources of evidence, which need to be mentioned as in-text citations. The Body should present the advantages and disadvantages of telenursing from a patient perspective. The Conclusion and Recommendations should summarize your findings and state your position on whether Manuel should accept the position should it be offered to him.
5. NOTE: Review the section on Academic Honesty found in the Chamberlain Course Policies. All work must be original (in your own words) unless properly cited. This assignment will automatically be submitted through Turnitin, a plagiarism detection system.
6. Submit the completed paper to the Telenursing…the Future Is Now Dropbox by Sunday, 11:59 p.m. mountain time at the end of Week 4. Please post questions about this assignment to the weekly Q & A Forum so that the entire class may view the answers.
GRADING CRITERIA
Category Points % Description
Introduction 50 25% The Introduction provides evidence of an information search including in-text citations of the sources of evidence. It catches the reader’s attention with interesting facts and supporting sources.
Body 100 50% Appropriate headings are used to delineate when the introduction ends. More than three advantages and three disadvantages are identified, discussed briefly, and supported by citations.
Conclusion and Recommendations 25 12.5% Appropriate headings are used, making clear the conclusion and recommendations based on solid evidence, privacy rights, and ethical principles, and so forth. Writing in the third person, state your position regarding whether your colleague should consider this position.
Scholarly Writing and APA Format 25 12.5% • Title page, running head, and page numbers. (3 pts.)
• Introduction, body, and conclusion/recommendations sections are clearly labeled. There is a logical flow between the sections. (10 pts.)
• Grammar, punctuation, and sentence structure are correct. (2 pts.)
• Citations throughout demonstrate support of student’s ideas and opinions. (5 pts.)
• Reference page includes all citations. (3 pts.)
• Evidence of spell and grammar check. (2 pts.)
Total 200 100%
A quality assignment will meet or exceed all of the above requirements.
GRADING RUBRIC
Assignment Criteria A
Outstanding or Highest Level of Performance B
Very Good or High Level of Performance C
Competent or Satisfactory Level of Performance F
Poor or Failing or Unsatisfactory Level of Performance
Introduction
50 points Evidence of information search. Catches the reader’s attention with interesting facts and supporting sources that include citations to three or more scholarly sources.
46–50 points Evidence of information search. Catches the reader’s attention with interesting facts and supporting sources that include citations to two scholarly resources.
42–45 points Evidence of information search includes only one citation to scholarly resource.
No attention catching “hook” noted.
38–41 points Little or no evidence of information search. No citations provided and/or there is no attention-catching “hook.”
0–37 points
Body
100 points More than 3 advantages and 3 disadvantages from a patient perspective are identified and supported by citations.
92–100 points At least 3 advantages and 3 disadvantages from a patient perspective are identified and supported by citations.
84–91 points At least 2 advantages and 2 disadvantages from a patient perspective are identified and supported by citations.
76–83 points Only one advantage and one disadvantage from a patient perspective is identified and supported by citations.
0–75 points
Conclusion and Recommendation
25 points Conclusion is presented with recommendation based on solid evidence, personal privacy rights, and ethical principles supported by citations.
23–25 points Conclusion contains evidence for recommendation, but may lack persuasive use of privacy rights and/or ethical principles. Includes citations.
21–22 points Indicates conclusion and recommendation but does not address privacy rights and/or ethical principles.
19–20 points Fails to include conclusion or recommendation.
0–18 points
Scholarly Writing & APA Format
25 points • Title page, running head, and page numbers. (3 pts.)
• Minimum of three sections including the Introduction, Body, and Conclusions and Recommendations. Each section has at least three sentences. (10 pts.)
• Grammar, punctuation, and sentence structure are correct. (2 pts.)
• Citations throughout demonstrate support of student’s ideas and opinions. (5 pts.)
• Reference page includes all citations and no errors in format are noted. (3 pts.)
• Evidence of spell and grammar check. (2 pts.)
23–25 points • Minimal error in APA title page noted.
• Minimal errors in grammar, spelling, punctuation, and/or sentence structure noted.
• Citations are present but not in correct format.
• References are present, with minimal errors in format.
• Minimal red or green wavy lines within document.
21–22 points • Some errors in APA title page noted.
• Some errors in grammar, spelling, punctuation, and/or sentence structure noted.
• Citations are present but not in correct format.
• References are present, with some errors in format.
• Some red or green wavy lines within document.
19–20 points • Multiple errors in APA formatting.
• Multiple grammar, spelling, and punctuation errors noted.
• Citations are missing.
• References are missing or incomplete.
• No evidence of proofreading prior to submitting paper.
0–18 points
Total Points Possible = 200 points
Please, in the references include the book that we work on in the class
Hebda, T., & Czar, P., (2013). Handbook of informatics for nurses & healthcare professionals (5th ed.). Upper Saddle River, NJ: Pearson.
In the guidelines it is requested to explain my position as a nurse.
I work as a Care Manager in the city hospital and providing education to the patients with chronic diseases like COPD, CHF, Diabetes to prevent re-admissions. And the patienst with CHF disease I refer to TeleHealth program to monitor and help to prevent re-admissions within 30days. Aslo, if the patient referred to home care agency after discharge , this agency provide TeleHealth services.
SAMPLE ANSWER
Telenursing
Technology advancement has largely contributed improved quality of service deliver in healthcare, which has rapidly driven its adoption. Many countries such as the United States and Sweden have embraced technology in their healthcare, and many others are following suit with an aim of enhancing quality and reducing the cost of accessing healthcare (Peeters et al., 2012). Telenursing has become popular in rendering healthcare to patients in various settings to improve patient outcomes, lower costs and streamline operations. Telenursing involves use of technology in provision of professional care. Telenurses who have multiple clinical experience are expected to work independently, make decisions about need for further care, and give self care advice or refer patients to another caregiver (Madoc-Jones et al., 2007). The paper deliberates on specialty of telenursing incorporating case study involving Manuel. It further deliberates on advantages and disadvantages and legal, ethical principles for telenurses.
Case Scenario
Manuel plans to leave his medical surgical position for a telenurse specialist position to work for an agency that monitors the elderly and people with chronic illnesses, so as to help them from being readmitted. However, he has no knowledge and experience as a telenurse. Therefore, the discussion explores on the various aspects in telenursing as well as benefits and drawbacks to help Manuel become familiar with the role awaiting him. Manuel works as a Care Manager in the city hospital and providing education to the patients with chronic diseases like COPD, CHF, Diabetes to prevent re-admissions and patients with CHF disease. He will use TeleHealth program to monitor and help to prevent re-admissions within 30 days. In addition, if the patient referred to home care agency after discharge this agency will provide TeleHealth services.
Call System Software
One of the technologies that telenurses employ in executing their mandate is the telephone. Telephone calls allow the telenurse to provide support and advice to patients at their remote locations. It is important therefore for telenurse to understand how to use this software to impact on their healthcare (Ernesäter, Holmström & Engström, 2009). There are different communication gadgets that are essential in facilitating communication. Telenurse understand the functionality of these systems, understand, the etiquette when communicating with clients. Some of the technologies that relates to telephone call system include central scheduling that permits certain patients to call and schedule their appointments and simplify tests.
Others such as speech-assisted automated attendant systems recognize voices and reduce staff overtime and other problems such as dropping of calls or negative patient interactions (Boye, 2006). Other types of telephone technologies in health setting include self-registered kiosks, wireless connectivity, master patient index computer terminals and online bill pay. Other useful technologies that a telenurse must understand how to use include, electronic health records, social media, tablets, Smartphone and computerized physician/provider order entry and clinical decision support among many others.
Advantages of Telenursing
Since inception and introduction of the concept of telenursing, various benefits have become evident in healthcare delivery. Researchers indicate that telenursing technologies have proved efficient in promoting quality healthcare especially in management of chronic conditions such as diabetes and chronic heart failure among others (Joseph, 2006). The rate of mortality and re-admission has also improved through telenursing services. Patients are able to access vital information and advice that helps them to manage their health conditions. Computerized decision support system is one of the valuable sources of information as it allows users to search and gather relevant information that impacts on the quality of health care (Ernesäter, Holmström & Engström, 2009). Through the decision support systems, accurate information is accessed and important tips on management of different patient situations is addressed helping in assessing the condition of patients in the best way.
Telenursing has become one of the most cost efficient approaches to rendering quality patient care. A patient will not have to travel to a health facility to receive care as this is done through the telephone calls. The patients, therefore, save money that otherwise they could have used to move from one point to another. Another advantage of telenursing from the perspective of the patient is that it is one way of saving time (Ernesäter, Holmström & Engström, 2009). A patient will just be required to receive a phone at their remote locations. This therefore, saves them time that they could have spent moving to and from a health facility. The other advantage of telenursing is that it improves or rather increases patients self-care ability (Hebda & Czar, 2013). The patient is given an opportunity to take care of themselves through the advices they are given through the call. A medical practitioner does not necessarily have to encounter the patient and this makes the patients to take initiative to manage their health conditions.
Use of home telecare is instrumental in improving patient independence and safety as well as provides support for those with chronic illness. Patients need not to worry about the shortage of nurses, as through the technology, many patients can be accessed (Ernesäter, Holmström & Engström, 2009). Patients as well have an opportunity to call and inquire about various issues such as medication to enhance their healthcare.
Disadvantages of Telenursing
Even though telenursing has a number of advantages, it as well has some disadvantages that nurses must look out for when delivering healthcare assistance to their patients. One of the disadvantages is that there is a risk of miscommunication between the caller and the receiver, which is likely to impact on the patient outcome. This is experienced especially when there are some barriers in the communication processes. For instance, when the patient is in a noisy environment, this is likely to affect the communication process leading to inappropriate medical advice (Ström, Marklund & Hildingh, 2009). This requires that the caller and the receiver/ patient communicate in a noise-free environment. Other forms of barriers such as semiotic, language can be avoided by ensuring that telenurses improve on their listening and communication skills to enhance the process of their patient assessment.
Another problem is that telenurses cannot see the patient to whom they are providing care (Pettinari & Jessop, 2001). This may have negative implication on their assessments and formation of opinion about the credibility of the caller as well as on the health condition of the patient. A patient may not be able to ascertain whether the caller is specialized and experienced in rendering the health care services or not. Therefore, these perceptions are likely to impact on the quality of care as sometimes the patient may develop negative attitude that may affect their recovery process. The caller as well may not be in a position to understand the exact health condition of the patient trough cellphone conversation.
Further disadvantage is the likelihood of conflicts ensuing between what is best for the patient and limited healthcare resources available. Nurses fear making wrong decisions, but if the resources available are not adequate, it may lead to ethical dilemma as some of the health providers may be referred to the healthcare system compromising on the patient care quality (Holmstrom & Hoglund, 2007).
Telenursing technologies are prone to security threats and other communication problems such as network problems that are likely to interfere with the communication process. During such instances, patients are likely to experience problems especially when they require assessment and advice from their telenurses and this may jeopardize the patient health outcome.
Conclusion
Telenursing is one of the professions that have taken healthcare to another level. With telenursing, various benefits have become evident. Patients save time, costs, and it promotes quality healthcare. Some disadvantages that nurses must look into include security threats and communication barriers among many others.
It is important for telenurses to understand legal and ethical practices in their duties. Even though technology is beneficial, it requires adherence to ethical practices such as respect, independence, autonomy, honesty, and integrity. When communicating, it is important for telenurses to be respectful to enhance communication. They are as well required to providw appropriate assessment based on evidence research to impact on the healthcare of the patient. There are a number of legal aspects that are important that telenurses need to consider in rendering their care, such as confidentiality and privacy. They must protect the privacy of their patients when communicating (Bohnenkamp, McDonald, Lopez, Krupinski, Blackett, 2004). They must not disclose information about their patients to third parties without the consent of the patient. Telenurses must also consider legal implications that relate to in appropriate use of telephone and communication gadgets. They are required to use the systems in an appropriate manner to provide accurate and sincere information to avoid any legal implications/consequences.
The opportunity before Manuel, even though is complex and challenging, it is recommended that he accepts it. Having experience in clinical settings serving as a medical surgeon for 12 years indicates that he has requisite skills and competence to provide care to patients suffering from COPD (chronic obstructive pulmonary disease) and CHF (congestive heart failure). Furthermore, he has a passion and if he is determined, he is going to learn how to use technology to render care. As a nurse, he should as well be ready to face challenging scenarios and yearn to grow in his career. I, therefore, support that he goes ahead and takes the job to help promote quality of healthcare and impact on patient outcome among his target population.
References
Berger, S. (2007). Treating technology as a luxury? 10 necessary tools: if you have been thinking that technology for improving healthcare financial management is a luxury, think again. In: Healthcare Financial Management, 61(2):40-70.
Bohnenkamp, S., McDonald, P., Lopez, A., Krupinski, E., Blackett, A. (2004).Traditional Versus Telenursing Outpatient Management of Patients With Cancer With New Ostomies. Oncology Nursing Forum, 31(5):1005-1010.
Boye J. (2006). Wireless technologies and patient safety in hospitals. Telemed J E Health, 9:373–82.
Ernesäter, A., Holmström, I., & Engström, M. (2009). Telenurses’ experiences of working with computerized decision support: supporting, inhibiting and quality improving. Journal of Advanced Nursing, 65(5):1074-1083.
Hebda, T., & Czar, P., (2013). Handbook of informatics for nurses & healthcare professionals (5th ed.). Upper Saddle River, NJ: Pearson.
Holmstrom, I., & Hoglund, A. (2007) The faceless encounter: ethical dilemmas in telephone nursing. Journal of Clinical Nursing, 16: 1865–1871.
Joseph, A. (2006). Care coordination and telehealth technology in promoting self-management among chronically ill patients. Telemed J E Health, 12(2):156–9
Madoc-Jones, I et al. (2007). Planned telephone support for disadvantaged parents in North Wales: perceptions of service users. Child & Family Social Work, 12(4): 316-325.
Peeters, J et al. (2012). Factors influencing the adoption of home telecare by elderly or chronically ill people: a national survey, Journal of Clinical Nursing, 21(21/22): 3183-193.
Pettinari C.J. & Jessop L. (2001) ‘Your ears become your eyes’: Managing the absence of visibility in NHS Direct. Journal of Advanced Nursing, 36: 668–675.
Ström, M., Marklund, B., & Hildingh, C. (2009). Callers’ perceptions of receiving advice via a medical care help line. Scandinavian Journal of Caring Sciences, 23(4): 682-690.
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