Telehealth Nursing - Research Paper Example

Telehealth Nursing With the 20th century’s advancements in digital technology and information services the field of telehealth has considerably grown. While nearly all fields of health care have witnessed increasing amounts of telehealth options, one of the most prominent areas of advancement has been witnessed in psychiatry where talk therapy and speaking engagements are oftentimes effective in diagnosing patient problems. As a nurse practitioner, it’s important to consider proper policy as related to the administration of telehealth services. The dilemma presented occurs in St. Theresa’s emergency department where as a practitioner a client is brought in with obvious psychiatric problems. There is no psychiatrist available and the nearest facility is a one-hour drive away. St. Theresa is a Tri-State Health Care Alliance Member. Tri-State has telehealth links with the regional hospital, where a psychiatrist is in the emergency department. This essay examines the steps that would be taken to initiate a productive teleconference and considers broader theoretical elements in terms of telehealth. Stages of Telehealth Care While teleconferencing or telepsychiatry is generally administered for individuals living in remote locations, it has also been noted to be effective in emergency situations. The current situation is indicative of such a high area need. In establishing the steps that must be taken to arrange a successful psychiatric teleconference the nurse or medical professional must first make an assessment of the patient’s immediate psychiatric need. While the scenario has indicated that the individual has clear psychiatric problems, the extent of these issues is not indicated. In the situation that the patient is able to have control over their actions and make sound decisions then less oversight needs be taken in the interaction between the patient and the psychiatrist. However, if the patient has demonstrated a complete lack of self-care and serious mental impairment, then it will be necessary for the nurse or caregiver to remain present during the teleconference. The medical room must adhere to patient privacy issues. Even as the situation is an out-of-the ordinary emergency situation, the hospital should have established a teleconferencing room where the patient can speak with the psychiatrist with the feeling of privacy and security. While security is important to the patient for personal matters, it’s also essential to quality psychiatric care in that the patient may be unwilling to disclose needed personal information if they do not feel secure in the teleconferencing environment. In these regards the nursing professional becomes responsible for creating the proper environment of communication and maintaining the professional nature of the psychiatric meeting based on the patient’s specific psychiatric condition. The next stage of securing an effective telehealth conference is to make contact with the Tri-State health institute. It is unknown whether St. Theresa’s have previously investigated the infrastructure elements of the Tri-State medical establishment of developed a working scenario for situations such as these, but in the instance they haven’t appropriate measures must be taken to establish appropriate connections to achieve optimum efficiency and professionalism. Within this context the nurse must act as a go-between with the two medical establishments. After the nursing professional has established communication with the Tri-State institute it’s necessary to communicate with the institute the situation. The nurse must then work to establish a timeframe for the psychiatrist to meet with the emergency patient. While telehealth is a relatively new field and approach to medical care, it’s still necessary for the nurse to approach the medical conference as they would a traditional doctor’s appointment. In these regards, after connection has been made with the psychiatrist the patient should be told to wait for the appointment time. In the mean time the room should be prepared and the teleconferencing material established. According to the patient’s needs the conference should be conducted either between the patient and psychiatrist, or with the added presence of the nurse or caregiver to ensure that the meeting is conducted in an orderly and effective way. After the completion of the teleconference the patient should leave the room and the nurse should consult with the psychiatrist to determine the needed medical intervention – whether it be medical prescription or institutionalization. The psychiatrist should also be asked to fax the needed prescription to the medical establishment. In the need of medical intervention, the nursing professional should relay the psychiatrist’s instructions to a doctor at the original institute to ensure that adequate steps are taken to treat the patient’s medical disorder in a safe and efficient way. Telehealth in Future Contexts While telehealth in the examined scenario examined and considered an emergency situation, a growing body of research attests to an understanding of broad reaching potential of telehealth for varied population and need groups. Peddle (2007) examined major implications for the institution of telehealth facilities in Labrador, Canada. While the research specifically analyzed barriers to the implementation of telehealth in this region, the research also focused on future potentials for the technology. Among the future contexts articulated in this research is the potential implementation of telehealth to answering staffing issues. For instance, doctors would not need to be on location to aid patients allowing for the potential improvement of efficiency through the balancing of doctor and patient interaction along a community medical network. Another prominent area of telehealth potential is in the realm of chronic illnesses where patient convenience could be improved through the implementation of at home teleconferencing. One such research consideration in this context was conducted by Polisena, Tran, & Cimon (2009) who examined at home teleconferencing for diabetic patients. There research demonstrated that, “more than 180 million people worldwide have diabetes. Health-care providers can remotely deliver health services to this patient population using information and communication technology, also known as home telehealth” (Polisena, Tran, & Cimon, 2009, pg. 1). In these regards, it’s theorized that in the upcoming years teleconferencing will received added infrastructure as a means of aiding populations such as individuals with diabetes. A final probable trajectory of telehealth services can be seen for disorders that are not contingent on physical examinations, as well as conditions where patient privacy is valued. Such an example is individuals with mental health issues such as anxiety, or disorders in-which social stigma remains attached. In these instances, teleconferencing can be an alternative to the oftentimes-cumbersome task of attending the doctor’s office on a regular basis. Implications of Telehealth: Nursing Profession When considering the implications of telehealth in terms of the examined scenario there are a number of notable points. One of the most overarching concerns is the establishment of regional connections through infrastructure measures that anticipate emergency situations. This involves the establishment of procedures wherein patients can be seen in emergency situations and the establishment of equipment and rooms for these practices. While a great body of research into telehealth practices has been developed one of the most comprehensive accounts for the nursing profession has been developed by Schlata-Fairchild (2006). Schlata-Fairchild (2006, pg. 4) argues that while nursing responsibilities will not change (a debatable notion), nurses will need to assume increased safety measures. In the examination of the scenario one of the key considerations was the nurse’s involvement in the actual conference. While medical privacy is an important consideration, nurses will need to increasingly determine the extent of the patient’s disorder and malaise and develop procedures and differentiating levels of involvement in the conference. One of the obvious implications is the risk of the patient harming himself or herself during the conference. There are a number of implications telehealth holds for nurses. Since the time of Florence Nightingale nursing has increasingly taken on higher levels or specialization and responsibility. With the implementation of teleconferencing one of the most notable considerations is that nurses will be required to assume increasing amounts of responsibilities in the doctor and patient relationship. One potential implication of this is that the previous dichotomy made between doctors and nurses will become increasingly blurred, as nurses will need to assist the doctor in performing functional duties in the medical office. (Schlata-Fairchild, 2006, pg. 5) indicates that telehealth has been extended to a wide-variety of medical contexts, including disease diagnosis. In these situations, nurses may need to aid the doctor in articulating specific elements, or operating medical tools. Another implication is the importance of nurses gaining increasing training in audio-visual equipment. While televisual responsibilities in larger scale institutions may necessitate an area specialist, it’s clear that in smaller contexts, such as general practitioner’s offices, the nurse may need to assume primary responsibility for ensuring sound and adequate televisual connectivity. Conclusion In conclusion, this essay has examined telehealth in the context of an emergency situation. Throughout the investigation a number of elements have been discovered and analyzed. In terms of the emergency scenario, a number of stages have been established that attest to the measures the nurse must take to ensure that the psychiatrist evaluation functions in an efficient and effective way. The essay has also considered the implications of this scenario for the nursing profession, and the future of telehealth practices. In terms of nursing implications it was established that the nurse would need to take on increasing responsibility to aid the doctor. Ultimately, research attests that telehealth practices have proved efficient for a variety of health issues and their future implementation in medical institutions is a foregone conclusion. References Peddle, K. (2007). Telehealth in Context: Socio-technical Barriers to Telehealth use in Labrador, Canada. Computer Supported Cooperative Work: The Journal of Collaborative Computing, 16(6), 595-614. Polisena, J. J., Tran, K. K., Cimon, K. K., Hutton, B. B., McGill, S. S., & Palmer, K. K. (2009). Home telehealth for diabetes management: a systematic review and meta-analysis. Diabetes, Obesity & Metabolism, 11(10), 913-930. Schlata-Fairchild, L. (Ed.). (2006). International telenursing survey. Pennsylvania: Templeton. Read More