What is Telenursing?

Telenursing refers to the use of information technology in the provision of nursing services whenever physical distance exists between patient and nurse, or between any number of nurses. As a field, it is part of telemedicine, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, and telemonitoring. The field, however, is still being developed as the information on telenursing isn't comprehensive enough.

Telenursing is growing in many countries because of the preoccupation in driving down the costs of health care, an increase in the number of aging and chronically ill population, and the increase in coverage of health care to distant, rural, small or sparsely populated regions. Among its many benefits, telenursing may help solve increasing shortages of nurses; to reduce distances and save travel time, and to keep patients out of hospital. A greater degree of job satisfaction has been registered among telenurses.

Telenursing is the use of “technology to deliver nursing care and conduct nursing practice”. Although the use of technology changes the delivery medium of nursing care and may necessitate competencies related to its use to deliver nursing care, the nursing process and scope of practice does not differ with telenursing. Nurses engaged in telenursing practice continue to assess, plan, intervene, and evaluate the outcomes of nursing care, but they do so using technologies such as the Internet, computers, telephones, digital assessment tools, and telemonitoring equipment. Bearing in mind that health services now provided via teletechnologies have expanded, the term telehealth is used to capture the breadth of services. For the purposes of this review, the Health Resources and Services Administration defines telehealth as “the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.” Telemedicine, the original term, is defined as the practice of health care delivery, diagnosis, consultation, treatment, transfer of medical data, and education using interactive audio, visual, and data communications. The American Nurses Association has defined telenursing as a subset of telehealth in which the focus is on the specific profession’s practice (i.e., nursing)

The delivery of telehealth care is not limited to physicians and nurses; it includes other health disciplines such as radiology, pharmacy, and psychology. These disciplines also deliver care using electronic information and telecommunications technologies and are accordingly called teleradiology, telepharmacy, telepsychology, and so forth. Although they are not the focus of this review, these disciplines are selectively included here for two reasons: the safety issues associated with care delivered using electronic and telecommunications technologies are more similar than they are different among the various health disciplines, and  the dearth of research on safety and quality in the telenursing literature led the authors to include important research in other health disciplines. By including the research findings on safety and quality from varied health disciplines, the body of telenursing knowledge is expected to expand.

Nurses remain highly regarded as the foundation that permits health care organizations to function. However, the institutions that rely on these professionals face a potentially critical talent shortage. As early as 2025, the approaching talent gap will affect all healthcare institutions across the nation.

Telehealth technology may help medical institutions sidestep this nursing shortage altogether. The technology has arrived at a time when patients suffering from chronic illnesses require augmented consultations and services. This presents an opportunity for nurses with enhanced skills to ‘go virtual’ and increase their value as health care professionals. Furthermore, telenursing provides the following seven benefits for patients and nurse practitioners.

Remote Service Delivery

Telehealth technology allows nurse practitioners (NPs) to deliver medical services via the Internet and landline phone equipment. Practitioners deliver services using various tools such as computers, remote monitoring devices, cellular devices, delivery companies and surgical robots. Telenursing blends audio, video and text-based digital information.

Practitioners have come to recognize that the quality of telehealth service parallels that of in-person office visits. Telehealth tools greatly increase efficiency for nurse practitioners who deliver service to clients in rural communities and sparsely populated areas.

The same technology allows practitioners to monitor the health conditions of patients continuously. For this, NPs employ peripheral devices that replace traditional medical devices such as stethoscopes, thermometers and blood pressure cuffs.

Patient Comfort

Three in four patients already feel comfortable with telemedicine, with more warming up to the idea every day. Clients especially like the idea of freely accessing invaluable specialists that might typically remain heavily scheduled with other patients.

Nurse practitioners use telehealth technology to assess client comfort levels and respond accordingly. The tool allows NPs to restore the personal touch once provided by home physician visits. Care providers also use the technology to deliver services to patients’ offices, to satellite clinics or to any location that offers convenience.

Accessibility by Patients in Remote Areas

As physicians forgo locating to rural areas, and as patient transportation logistics grow increasingly complex, problems with care quality and coverage shortages are escalating. However, many believe that telenursing services can go a long way in solving this dilemma. With telehealth services, rural hospitals can reduce costs, cover larger areas and eliminate most of the time it takes to deliver services. Incidentally, this same logic applies to delivering services to patients in developing nations.

Despite the amazing advancements facilitated by telenursing, nurse practitioners as health care advocates must join forces to integrate telenursing as a standard practice in an effort to meet the value-added reform mandated by the Affordable Care Act (ACA).

 Nursing traps and chronic diseases

Chronic diseases as defined have long standing periods and slowly progress. These conditions are very costly for patients and countries health care systems. The Patients need long-term care and ongoing training and guidance about the treatment from the team. Tele nursing has the capacity to facilitate the access of the patients to these services at the lowest cost. The purpose of this study was to evaluate some common types of chronic disease in which tele nursing has been used and the outcomes of this type of care is reported. We have evaluated the feasibility of a telenursing system for patients with a chronic condition who are in receipt of home care services. The Internet-based system allows patients (equipped with a laptop computer), nurses and physicians to access information from a central database through a wireless network (128 kbit/s). Email and video-mail messages as well as vital signs data can be sent daily by the patient to a server at a regional health-care centre, and can be accessed by a nurse or physician, who can then decide on appropriate care. The system was tested by a male patient with type 2 diabetes mellitus, to see whether it would enhance his own management of his condition. During a 73-day baseline introductory period, no specific educational material was provided on the system Website about the management of diabetes (during this time the technical operation of the system was tested). During a second, 71-day period, educational material was provided. The telenursing system helped the patient to manage his condition, as shown by significant improvements in his levels of blood glucose and glycosylated haemoglobin (HbA(1c)) and in his blood pressure. Our findings suggest that the system is feasible.