TelenursingTelenursing TelenursingTelenursing

Presented by:Joan Ribbons, RN

Objectives:Objectives:Objectives:Objectives:

• Describe Telenursing• Describe and evaluate the hardware and software utilized with

telenursing• Describe and evaluate the information system used with telenursing• Assess the role and functions of the nurse informaticist when

working with telenursing • Examine related legal/ethical issues• Discuss the Advantages/Disadvantages from nursing perspective

• Describe Telenursing• Describe and evaluate the hardware and software utilized with

telenursing• Describe and evaluate the information system used with telenursing• Assess the role and functions of the nurse informaticist when

working with telenursing • Examine related legal/ethical issues• Discuss the Advantages/Disadvantages from nursing perspective

Telenursing

• health services delivered by telecommunications-ready tools supervised or directed by a nurse

• concerns itself with client outcomes: acute care, chronic care, disease management, and quality of life

Telenursing

• health services delivered by telecommunications-ready tools supervised or directed by a nurse

• concerns itself with client outcomes: acute care, chronic care, disease management, and quality of life

Telenursing HardwareTelenursing Hardware::Telenursing HardwareTelenursing Hardware::

• telephone, internet, server, electricitytelephone, internet, server, electricity

• provider station, video patient provider station, video patient station,monitoring station station,monitoring station

• telephone, internet, server, electricitytelephone, internet, server, electricity

• provider station, video patient provider station, video patient station,monitoring station station,monitoring station

Hardware used Hardware used inin Telenursing Telenursing::Hardware used Hardware used inin Telenursing Telenursing::

• equipment that captures objective vital sign equipment that captures objective vital sign datadata

• equipment that captures objective vital sign equipment that captures objective vital sign datadata

Telenursing SoftwareTelenursing SoftwareTelenursing SoftwareTelenursing Software

• goalgoal

• customized customized

Software Software ExampleExample Software Software ExampleExample

NX Server •

NX Server •

UsabilityUsability of NX Server of NX Server UsabilityUsability of NX Server of NX Server • easy to use/user-friendly/user satisfactioneasy to use/user-friendly/user satisfaction

• efficient with efficient with standardized electronic health recordsstandardized electronic health records

• Interactive visual technology is limitedInteractive visual technology is limited

• more realistic data, reflective of usual circumstances at more realistic data, reflective of usual circumstances at home.home.

• Interactive visual technology is Interactive visual technology is limitedlimited

• costcost

• easy to use/user-friendly/user satisfactioneasy to use/user-friendly/user satisfaction

• efficient with efficient with standardized electronic health recordsstandardized electronic health records

• Interactive visual technology is limitedInteractive visual technology is limited

• more realistic data, reflective of usual circumstances at more realistic data, reflective of usual circumstances at home.home.

• Interactive visual technology is Interactive visual technology is limitedlimited

• costcost

Usability of Usability of SoftwareSoftwareUsability of Usability of SoftwareSoftware

• user interface design• customer support • software updates

• user interface design• customer support • software updates

American TeleCare’s American TeleCare’s ® NX Server NX Server SystemSystemAmerican TeleCare’s American TeleCare’s ® NX Server NX Server SystemSystem

Web-based, using:Web-based, using:

- Video station- Video station - Monitoring - Monitoring stationstation

Web-based, using:Web-based, using:

- Video station- Video station - Monitoring - Monitoring stationstation

Review of American TeleCare’s Review of American TeleCare’s ® NX Server SystemNX Server SystemReview of American TeleCare’s Review of American TeleCare’s ® NX Server SystemNX Server System

• To gather and manage data by NursesTo gather and manage data by Nurses

• for Patient-specific thresholds.for Patient-specific thresholds.

• To gather and manage data by NursesTo gather and manage data by Nurses

• for Patient-specific thresholds.for Patient-specific thresholds.

Advantages of Advantages of TelenursingTelenursing Advantages of Advantages of TelenursingTelenursing

• increases patients’ ability to self-care, in a range of patients, and settings

• nursing care at homenursing care at home

• timesaving

• cost efficient

• increases patients’ ability to self-care, in a range of patients, and settings

• nursing care at homenursing care at home

• timesaving

• cost efficient

DisadvantagesDisadvantages of Telenursing of TelenursingDisadvantagesDisadvantages of Telenursing of Telenursing

• In a medication administration example, In a medication administration example, patients made medication administration patients made medication administration errorserrors

• Stress and potential for errorStress and potential for error

• In a medication administration example, In a medication administration example, patients made medication administration patients made medication administration errorserrors

• Stress and potential for errorStress and potential for error

Ethical Issues of TelenursingEthical Issues of Telenursing

Central concept in nursingCentral concept in nursing

Communication skillsCommunication skills

Competing interestsCompeting interests

Ethical Issues of TelenursingEthical Issues of Telenursing

Central concept in nursingCentral concept in nursing

Communication skillsCommunication skills

Competing interestsCompeting interests

Legal IssuesLegal IssuesLegal IssuesLegal Issues

• licensinglicensing

• scope of practicescope of practice

• safetysafety

• security and HIPAAsecurity and HIPAA

• accountabilityaccountability

• legal competencieslegal competencies

• licensinglicensing

• scope of practicescope of practice

• safetysafety

• security and HIPAAsecurity and HIPAA

• accountabilityaccountability

• legal competencieslegal competencies

Informatics CompetenciesInformatics CompetenciesInformatics CompetenciesInformatics Competencies

• Computer skillsComputer skills

• Informatics knowledgeInformatics knowledge

• Informatics skillsInformatics skills

• Communication skillsCommunication skills

• Computer skillsComputer skills

• Informatics knowledgeInformatics knowledge

• Informatics skillsInformatics skills

• Communication skillsCommunication skills

Role of Professional Nurse Role of Professional Nurse Informaticist and Informaticist Informaticist and Informaticist Nurse Specialist in TelenursingNurse Specialist in Telenursing

Role of Professional Nurse Role of Professional Nurse Informaticist and Informaticist Informaticist and Informaticist Nurse Specialist in TelenursingNurse Specialist in Telenursing

•System SpecialistSystem Specialist

•System ManagerSystem Manager

•Patient SafetyPatient Safety

•Membership in Professional OrganizationsMembership in Professional Organizations

Summary: Summary: TelenursingTelenursing Summary: Summary: TelenursingTelenursing Telenursing is virtual nursingTelenursing is virtual nursing

• safesafe

• cost effectivecost effective

• HIPAA compliantHIPAA compliant

• provides quality careprovides quality care

Telenursing is virtual nursingTelenursing is virtual nursing

• safesafe

• cost effectivecost effective

• HIPAA compliantHIPAA compliant

• provides quality careprovides quality care

ReferencesReferencesReferencesReferences

• Academic Psychiatry. (2009). Computer Simulation and Virtual Reality in the Diagnosis and Academic Psychiatry. (2009). Computer Simulation and Virtual Reality in the Diagnosis and Treatment of Psychiatric Disorders. Retrieved 2/26/10 from Treatment of Psychiatric Disorders. Retrieved 2/26/10 from http://ap.psychiatryonline.org/cgi/content/full/33/5/413http://ap.psychiatryonline.org/cgi/content/full/33/5/413

• American Telecare,Inc. (2002)Announces Partnership with VNA of the Inland Counties. American Telecare,Inc. (2002)Announces Partnership with VNA of the Inland Counties. Retrieved April 12, 2010 from Retrieved April 12, 2010 from http://www.americantelecare.com/aboutus_PR_Inland.html

• American Telecare, Inc. (2004) NX Server Software Retrieved from http://www.americantelecare.com/prod_NXserver.html

• Bartz, C., PhD. Octobr. (2009). Telenursing and Global Health. Retrieved 4/14/2010 fromhttp://tie.telemed.org/articles/article.asp?path=articles&article=telenursingLicensure_gw_tie02.xml

• Clinical Trials. (2009) virtual nurse,.Retrieved 2/26/10 from http://clinicaltrials.gov/ct2/results?Clinical Trials. (2009) virtual nurse,.Retrieved 2/26/10 from http://clinicaltrials.gov/ct2/results?term=virtual+nurseterm=virtual+nurse

• Google Answers: Personal Computer Penetration in US.Retrieved 2/5/10 from Google Answers: Personal Computer Penetration in US.Retrieved 2/5/10 from https:answers.google.com/answersthreadview?id=248043https:answers.google.com/answersthreadview?id=248043

• Höglund, A., & Holmström, I. (2010). Ethical issues in Telenursing. (2010). Ethical issues in Telenursing.Retrieved4/14/2010 from Retrieved4/14/2010 from

file:///Users/joanribbons/Downloads/Telenursing2010/ethical%20issuesswede

• IHE-ONLINE.COM (2008). Ethical issues in telenursing. Retrieved 4/14/2010 fromhttp://www.ihe- online.com/index.php?id=2695

• JAMIA.( 2008).Patient-centered Applications: Use of Information Technology to Promote JAMIA.( 2008).Patient-centered Applications: Use of Information Technology to Promote Disease Management and Wellness.Retrieved 2/21/10 from Disease Management and Wellness.Retrieved 2/21/10 from http://jamia.bmj.com/content/15/1/8.fullhttp://jamia.bmj.com/content/15/1/8.full

• Academic Psychiatry. (2009). Computer Simulation and Virtual Reality in the Diagnosis and Academic Psychiatry. (2009). Computer Simulation and Virtual Reality in the Diagnosis and Treatment of Psychiatric Disorders. Retrieved 2/26/10 from Treatment of Psychiatric Disorders. Retrieved 2/26/10 from http://ap.psychiatryonline.org/cgi/content/full/33/5/413http://ap.psychiatryonline.org/cgi/content/full/33/5/413

• American Telecare,Inc. (2002)Announces Partnership with VNA of the Inland Counties. American Telecare,Inc. (2002)Announces Partnership with VNA of the Inland Counties. Retrieved April 12, 2010 from Retrieved April 12, 2010 from http://www.americantelecare.com/aboutus_PR_Inland.html

• American Telecare, Inc. (2004) NX Server Software Retrieved from http://www.americantelecare.com/prod_NXserver.html

• Bartz, C., PhD. Octobr. (2009). Telenursing and Global Health. Retrieved 4/14/2010 fromhttp://tie.telemed.org/articles/article.asp?path=articles&article=telenursingLicensure_gw_tie02.xml

• Clinical Trials. (2009) virtual nurse,.Retrieved 2/26/10 from http://clinicaltrials.gov/ct2/results?Clinical Trials. (2009) virtual nurse,.Retrieved 2/26/10 from http://clinicaltrials.gov/ct2/results?term=virtual+nurseterm=virtual+nurse

• Google Answers: Personal Computer Penetration in US.Retrieved 2/5/10 from Google Answers: Personal Computer Penetration in US.Retrieved 2/5/10 from https:answers.google.com/answersthreadview?id=248043https:answers.google.com/answersthreadview?id=248043

• Höglund, A., & Holmström, I. (2010). Ethical issues in Telenursing. (2010). Ethical issues in Telenursing.Retrieved4/14/2010 from Retrieved4/14/2010 from

file:///Users/joanribbons/Downloads/Telenursing2010/ethical%20issuesswede

• IHE-ONLINE.COM (2008). Ethical issues in telenursing. Retrieved 4/14/2010 fromhttp://www.ihe- online.com/index.php?id=2695

• JAMIA.( 2008).Patient-centered Applications: Use of Information Technology to Promote JAMIA.( 2008).Patient-centered Applications: Use of Information Technology to Promote Disease Management and Wellness.Retrieved 2/21/10 from Disease Management and Wellness.Retrieved 2/21/10 from http://jamia.bmj.com/content/15/1/8.fullhttp://jamia.bmj.com/content/15/1/8.full

References (continued)References (continued)References (continued)References (continued)

• Lucas, A., (may, 2004). Welcome to the World of Nursing Informatics. Retrieved Lucas, A., (may, 2004). Welcome to the World of Nursing Informatics. Retrieved 4/20/2010 from 4/20/2010 from http://www.angelfire.com/al4/annielrnc/

• McGonigle,D.,& Mastrian, K., (2009). Nursing Informatics and the Foundation of ,D.,& Mastrian, K., (2009). Nursing Informatics and the Foundation of Knowledge. Sudbury, MA: Jones and Bartlett Publishers. Knowledge. Sudbury, MA: Jones and Bartlett Publishers.

• New York Times,March 24, 2010, Washington Edition,p.A1New York Times,March 24, 2010, Washington Edition,p.A1

• --Nurs Health Sci. (2007), Mar;9(1):23-8. Decision aid software programs in telenursing: not used as intended? Experiences of Swedish telenurses.Retrived from http:www.ncbi.nlm.nih.gov/pubmed/17300541

• Pinzari, G.., (2003)Software update. Retrieved 4/20/2010 from http://www.nomachine.com/news-read.php?idnews=92

• Polycom.(2010)VideoHealthcare.Montana.Retrieved 3/31/10 from http://response.polycom.com/forms/SearchRegForm_Health_MontanaCS

• Staggers, N. (2003). Human factors imperative concepts for information systems in critical care. AACN Critical Issues, 14(3)

• Wachter, G. W.,( May, 2002). Interstate Licensure for Telenursing.Retrieved4/14/2010fromfile:///Users/joanribbons/Downloads/Telenursing2010/article.asp.html

• Wachter, G., (May, 2002) . Retrieved 4/14/2010 from http://tie,telemed.org/citations_t2.asp?citation=9915

• Lucas, A., (may, 2004). Welcome to the World of Nursing Informatics. Retrieved Lucas, A., (may, 2004). Welcome to the World of Nursing Informatics. Retrieved 4/20/2010 from 4/20/2010 from http://www.angelfire.com/al4/annielrnc/

• McGonigle,D.,& Mastrian, K., (2009). Nursing Informatics and the Foundation of ,D.,& Mastrian, K., (2009). Nursing Informatics and the Foundation of Knowledge. Sudbury, MA: Jones and Bartlett Publishers. Knowledge. Sudbury, MA: Jones and Bartlett Publishers.

• New York Times,March 24, 2010, Washington Edition,p.A1New York Times,March 24, 2010, Washington Edition,p.A1

• --Nurs Health Sci. (2007), Mar;9(1):23-8. Decision aid software programs in telenursing: not used as intended? Experiences of Swedish telenurses.Retrived from http:www.ncbi.nlm.nih.gov/pubmed/17300541

• Pinzari, G.., (2003)Software update. Retrieved 4/20/2010 from http://www.nomachine.com/news-read.php?idnews=92

• Polycom.(2010)VideoHealthcare.Montana.Retrieved 3/31/10 from http://response.polycom.com/forms/SearchRegForm_Health_MontanaCS

• Staggers, N. (2003). Human factors imperative concepts for information systems in critical care. AACN Critical Issues, 14(3)

• Wachter, G. W.,( May, 2002). Interstate Licensure for Telenursing.Retrieved4/14/2010fromfile:///Users/joanribbons/Downloads/Telenursing2010/article.asp.html

• Wachter, G., (May, 2002) . Retrieved 4/14/2010 from http://tie,telemed.org/citations_t2.asp?citation=9915