Tele nursing: opputunities and challenges

this will help nursing officers to learn scope of telenursing in short

1. Maj Neelam Chand Title of the presentation : Telenursing: Opportunities & Challenges

2. TELENURSING : OPPORTUNITY AND CHALLENGES INTRODUCTION Tele-nursing refers to the use of telecommunications and information technology for providing nursing services in health care whenever a large physical distance exists between patient and nurse, or between any numbers of nurses. As a field it is part of tele health, and has many points of contacts with other medical and non-medical applications, such as tele - diagnosis, tele consultation, tele monitoring, tele care etc.

3. TELENURSING DEFINITION “Telenursing is the delivery ,management and coordination of care and services provided via technology within the domain of nursing .” - AAA CN 2004 Telenursing is not a new mode of health care delivery rather it is an evolving mode of health care delivery that begun from the advent of telephone use in 1876.

4. TYPES OF TELENURSING Remote Monitoring. The nurse monitors the patient remotely from his/her house. Patient collect and transmit data to nurses ; the nurse plans the intervention. Used for handling chronic diseases like heart disease, diabetes, asthma etc. Interactive Telenursing Services. It involves series of interactive sessions with client via phone conversations and online communication. Used to obtain history, physical tests, psychiatric assessments, ophthalmology evaluation Store and Forward Telenursing. Used to obtain medical images, audio or video data that can be forwarded to a nurse at a suitable time for evaluation offline. Areas utilized are dermatology, radiology and pathology Specialist and Primary Care Consultations. Patient sees a nurse over a live video connection or using diagnostic images/video along with patient data to a specialist for viewing later   Imaging Services. Used in radiology, pathology and in cardiology.

5. ADVANTAGES OF TELENURSING Decrease wait time Increase public access Decreases healthcare costs Increase continuity of care Increase patient compliance with aftercare Reduction in travel costs

6. DISADVANTAGES OF TELENURSING Decreased face-to-face interaction Risk of decreasing quality of care May increase liability Concerns with security Concerns with maintaining confidentiality

7. BENEFITS OF THE TELENURSING FOR THE PATIENT Monitoring vital signs on daily basis at home setting and informing the care specialist provides opportunity for early intervention. Reduces the number of visits to the doctor or emergency department .Avoids unnecessary visits to or by providers .Provides patient education Removes geographic barrier - Nursing can be provided to remote locations. FOR THE PROVIDER Increases the Competencies and scope of practice .More venue for monitoring Client safety in home care facilitates easy client decision-making .Creates Professional practice environment .Able to provide expert and specialized care from experienced staff and care managers .Able to take joint decisions regarding care by consultation with staff even at far of places FOR THE HEALTH CARE SETTING Initial expense up front but as health improves the system will save money .Decreased number of in-hospital days for patients with chronic illness who have access to supportive tele health. Decrease number of in-hospital days reduces the required number of staff . Remove barriers of time and distance .Proper training and administrative support is an vital responsibility for the system

8. OPPURTUNITIES IN TELENURSING Home care Patient consultations Telephone triage Remote monitoring Chronic disease management

9. CHALLENGES FOR NURSES Non acceptance by nurses - Older nurses who are not computer literate Feeling of being replaced with computers . Reimbursement issues -Patient confidentiality and security to private information may be difficult to safe guard utilization Financial issues- cost of establishment, coat of transferring videos, audio, files

10. ETHICAL AND LEGAL ISSUES SURROUNDING TELENURSING Confidentiality and the law: involvement of non clinical personnel, hackers and cyber theft, vulnerability of transmission lines to security breaches Patient-nurse relationship: it is difficult to establish when a nurse- patient relationship has been established. To know when a duty of care is owed to a patient Patient consent to disclosure of information Consent to treatment

11. ROLE OF NURSE IN TELENURSING Role of nurses in telenursing . Ensure proper and accurate documentation in electronic or paper format Carry out only the activities you are competent and authorized to perform Ensure the privacy, security of patient information Establish client-nurse relationship so as to establish a duty of care Take into account client’s spiritual and psychosocial needs and preferences as everybody is unique