COMMENTARY

Telehealth, Telenursing, and Advanced Practice Nurses

Marilyn W. Edmunds, PhD, CRNP

Disclosures

April 05, 2010

Telehealth and Telenursing Are Live: APN Policy and Practice Implications

Schlachta-Fairchild L, Varghese SB, Deickman A, Castelli D
J Nurse Pract. 2010;6:98-106

Article Summary

"Telenursing is the use of telemedicine technology to deliver nursing care and conduct nursing practice. Broader than telenursing, telehealth is the removal of time and distance barriers for the delivery of health care services or related health care activities." Telemedicine uses a variety of telecommunication technologies and computers to provide medical and healthcare information and services to patients at another site. How and why these services have developed has evolved over the years.

Components of telenursing have existed for 35 years, beginning in 1974 with Mary Quinn, who documented her care with patients at Logan Airport via telemedicine while she worked from a hospital in Boston, Massachusetts. Since that time, creative nurses have used technology to advance healthcare in a variety of ways. Many advanced practice nurses are now leaders in telenursing practice. This article emphasizes some of the important policy issues about which nurses should be aware if they intend to further the use of telehealth.

Much of what is known about how clinicians practice telenursing comes from Internet surveys conducted in 2000 and 2005. Survey responses came from 719 nurses in 36 countries who practiced in a variety of settings. Details about practice sites, patients, and nursing care were obtained via these surveys. One finding was that respondents believed that telenursing could alleviate the nursing shortage and that important caring behaviors can be maintained during telenursing interactions just as they are in face-to-face encounters. The article explored caring and provided evidence-based strategies for demonstrating caring using technology in patient interactions before, during, and after a virtual patient visit.

The article also examined practice policy considerations for advanced practice telenursing and explored key issues such as technology selection and implementation principles, interstate licensure, malpractice, and telehealth reimbursement and why these issues are important to the future of telenursing.

Viewpoint

One of the contributions of this article is a discussion about how telenursing can help alleviate the nursing shortage in the United States, providing access to care irrespective of the geographic location of the provider and patients. We have all heard the statistics about the predicted nursing shortage in the next 5-10 years. This article provides some positive news in a world where there are fewer nurses to care for patients. If the use of technology increases at the same rate as the loss of nurses from the workforce, then telenursing will be imperative if nurses are to continue to meet the needs of clients.

I have found nurses to be extremely creative, particularly when it comes to finding ways to meet the needs of their patients. At the same time, my own review of the literature and anecdotal experience suggests that for every nurse with a growing interest in telenursing, there are many more nurses who still are not using the Internet at all, and telenursing care is far from their minds. If nursing is to embrace telenursing and realize its potential, concerted effort needs to be made to help nurses become computer literate. Although many undergraduate nursing programs use computers in their courses and require students to use computers for study and assignments, we have to find ways for experienced nurses in the workforce to make this transition as well, if we are to prepare more nurses to function in a telehealth world.

Abstract

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