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 • 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.
21–22 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.
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 note the length of the paper should be 4-5 pages, excluding the title page and the reference page. Limit references to key sources.
SAMPLE ANSWER
Telenursing
The use of technology in healthcare has been of great impact in healthcare. This is particularly in relation to telenursing. However, there are challenges that should be solved early so as to avoid risks (Schlachta-Fairchild, Elfrink & Deickman, 2008). Although a nurse is required to communicate with her patients with the use of the internet or telephone, she is also supposed to assess, plan, evaluate, and intervene. In addition to this, there might be a need to use audio feeds, videos, telemonitoring tools, and digital assessment equipment. However, the key thing to note is that nursing care remains the same where the guidelines and the expected outcomes should be met.
In the global healthcare environment, the use of telenursing is increasing at an alarming rate (Snooks et al., 2008). However, it is worth noting that the work involved in telenursing is knowledge-intensive and complex. Nurses are required to be able to operate independently, make decisions regarding the patient’s need for more care, offer self-care advice, and refer patients to proper help sources. As telenurses triage the conditions their patients are suffering from, their assessments are normally founded on verbal communication (Snooks et al., 2008). As such, there is a high need for high communication skills’ level as well as the ability of listening. Telenurses face a major limitation in that they are unable to see their patients. Nurses feel that they possess considerable responsibility towards the patients and fear making improper decisions. In addition, telenurses may think of the relationship with their patients in telenursing as a conflict between acting as a gatekeeper and care provider.
Safeguards and decision-making support tools
When engaging in telenursing, there is likely to be the emergence of constant and new challenges such as potential liability issues. Regardless of the fact that the absence of legal precedents brings about uncertainty regarding telenursing liability, vividly defined accountabilities can go a long way in addressing various recognized liability categories. This is more so in cases dealing with the health professionals involved, particular applications or technologies, the involved organizations, and training and human resources. Telenurses should be key participants in the documentation and development of the risk management plans as well as the related policies (Snooks et al., 2008). There is a great need for telenurses to discuss liability issues with the legal counsel and employers (Schlachta-Fairchild, Elfrink & Deickman, 2008).
Telenurses possess the primary accountability of ensuring that their technical and clinical competencies are current. This is closely related to the need of telenurses to evaluate and identify their learning needs regularly; come up with as well as implement the learning plans, in addition to evaluating the learning impact on their practice. It is advisable for telenurses to utilize the ‘Building Your Profile’ as well as other performance management and professional development systems in their practice so as to promote the delivery of competent, safe, ethical, and compassionate telenursing practice.
Consumer education, patient satisfaction, interoperability, ethical issues, privacy rights, and technology
There is a great need for telenurses to network and collaborate with other professionals readily. This goes a long way in ensuring that ethical issues on record keeping, patient care, and confidentiality are worked out as needed. Clinical safety is extremely vital when practicing telenursing. Considering the limitations of technology, higher chances for incomplete and inaccurate information, and the fact that no face-to-face interaction is involved, providing telenursing services may be accompanied by immense risks. Although the patient-nurse encounter during telenursing is a bit different from the traditional setups, the nurse still remains responsible of promoting the delivery of safe, ethical, and appropriate care and services. Promoting and maintaining security, privacy, and confidentiality in telenursing settings is basically extremely challenging as opposed to ordinary health-care environment. Principally, this is because of factors like electronic information transfer (client data as well as video imaging) between the sites. This is in addition to the increasing number of people participating in the care. In this regard, nurses as well as employers have the responsibility of developing, implementing, as well as adhering to telenursing policies. This goes a long way in promoting privacy, security, and security in all interactions. Nurses should also obey all relevant legislation. It is also very important for nurses to participate in measures that are aimed at improving quality including audits (Snooks et al., 2008).
The professional role of nurses in telehealth
In the present technological era, nurses are also acknowledged to be knowledge workers. As such, they possess an increased role in coming up with telehealth solutions that is very essential in increasing client benefit. Telenurses are also participants in data collection that includes outcome data as well as system utilization. In addition, telenurses are required to support the evidence-based practice by leading as well as participating in research. This goes a long way in evaluating and informing telehealth practice. This is particularly in areas such as accessibility, the clinical impacts of the clients, and cost-effectiveness of services.
Advantages and disadvantages to patients
Telenursing is beneficial to patients as well as the physicians (Snooks et al., 2008). Patients benefit from quick and immediate care access in addition to information. The second benefit is that patients get education chances, and this enables them to know more regarding the conditions they are suffering from. Through telenursing, nurses are involved more in making decisions about their care. Patients are also empowered since as they are getting healed from operations and managing chronic diseases such as asthma and diabetes, they take up dedication to self-care more enthusiastically (Snooks et al., 2008). The patients become increasingly knowledgeable and can care for themselves even better. This is based on the assurance that assistance is only a call away. Patients also save time and money considering that no travelling is involved.
On the other hand, patients may have the attitude telenursing brings about dehumanizing impacts. This is based on the fact that regardless of the fact that care of different conditions goes on, physical interaction is absent (Snooks et al., 2008). As a result, some may opt not to use the telenursing services. With the use of telenursing, patients are forced to remain lonely and there is no chance to connect with as well as share experiences with patients ailing from similar conditions. This may greatly contribute to delayed healing or even depression from the loneliness, which may complicate the condition.
Additional costs come in the form of the extra payments for the communication forms in use. There may also be challenges as the patient tries to utilize the care equipments. This is usually very technical as it indicates delayed care. There are high chances of the equipment malfunctioning and as such, care is also delayed (Schlachta-Fairchild, Elfrink & Deickman, 2008).
Ethical and legal principles
When practicing telenursing, telenurses should obey the registered nurses’ code of ethics, relevant legislation, relevant practice guidelines, as well as the professional practice standards (Williams et al., 2012). When the patient begins offering telenursing services to a patient, she should introduce her name, provincial and territorial regulatory body, place of work, and professional designation. This is usually the starting point towards creation of rapport and a lasting relationship that is based on trust and confidentiality. The healthcare professional should also be keen on knowing the details about the patient (medical and personal history). This gives the patient an insight that the professional is really concerned and cares about him. When a positive relationship exists between the patient and provider, this permits the provision of high quality care (Schlachta-Fairchild, Elfrink & Deickman, 2008). On the same note, if the patient is aware about his provider’s details, he can follow up in case of clarifications and when seeking more information. The same case applies when filing for a complaint. Similar to the telenursing setup, the normal settings are also required to offer high quality care. As such, nurses are required to promote nonmaleficence, confidentiality, and autonomy. In telenursing, the most ethically troubling areas are autonomy, integrity, documentation, information prioritizing, confidentiality, security, and privacy (Schlachta-Fairchild, Elfrink & Deickman, 2008).
Telenurses experience an ethical dilemma involving the conflict between the relative’s and patient’s autonomy, in addition to the ambition of the nurse to assist the patient. In this regard, the beneficence and autonomy principles are in conflict (Jerant et al., 2003). There is an ethical question regarding the manner of ensuring the identity of the caller within telenursing (Kuriakose, 2011).
Conclusions and recommendations
It is highly advisable and recommendable that Manuel should seek extensive and high-quality training. This will be essential in making telenursing productive, preparing him for the role, and preventing the risks involved with it. There is also a great need for him to network with more experienced as well as the new telenurses for more learning.
References
Jerant, A. F., Azari, R., Martinez, C., & Nesbitt, T. S. (2003). A randomized trial of telenursing to reduce hospitalization for heart failure: patient-centered outcomes and nursing indicators. Home health care services quarterly, 22(1), 1-20. (Googlescholar)
Kuriakose, J. R. (2011). Telenursing an emerging field. International Journal of Nursing Education, 3 (2), 52. (http://connection.ebscohost.com/c/articles/77635007/telenursing-emerging-field) (EBSCO)
Schlachta-Fairchild, L., Elfrink, V., & Deickman, A. (2008). Patient Safety, Telenursing, and Telehealth. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK2687/?report=reader (NCBI- PUBMED)
Snooks, H. A., Williams, A. M., Griffiths, L. J., Peconi, J., Rance, J., Snelgrove, S., … & Cheung, W. Y. (2008). Real nursing? The development of telenursing. Journal of advanced nursing, 61(6), 631-640. (Googlescholar)
Williams, L., Hubbard, K. E., Daye, O., & Barden, C. (2012). Tele-ICU Enhancements. Telenursing in the Intensive Care Unit: Transforming Nursing Practice. Critical Care Nurse, 32 (6), 62 (http://connection.ebscohost.com/c/articles/83835228/tele-icu-enhancements-telenursing-intensive-care-unit-transforming-nursing-practice) (EBSCO)
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