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Background Telephone nursing is expanding worldwide, but a little is known about nurses' interactions with callers and the factors that affect these interactions. Aim The purpose of this paper is to describe how telenurses experie...
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Background Telephone nursing is expanding worldwide, but a little is known about nurses' interactions with callers and the factors that affect these interactions. Aim The purpose of this paper is to describe how telenurses experience caller interactions. Methods A qualitative study designed through open telephone interviews with call centre nurses (n = 9) in 2017. The data were analysed using inductive content analysis. Ethical guidelines were followed at all stages of the study. Results Callers both enhanced and hindered interactions. Nurses' professional skills, such as communication skills, nurse-led control over the call and the nurses' capabilities, enabled positive interactions. Disturbing background sounds, communication problems and service system failures made the telephone interactions challenging. Achieving connection with callers, callers who had supportive family members and a supportive organisational structure were features of successful interactions. Study limitations As all nine participants were recruited from one call centre, the findings are not directly transferable to another environment. Conclusions The results reveal that nurse-caller interactions are affected by several issues concerning the callers and the nurses' skills. Communication problems were often present when telenurses were unable to provide the services callers expected due to lacking health and medical care resources. Family members could be considered important participants in telephone communication with nurses, though further research should examine the possible benefits of interacting with family members. Practical implications Based on the results of this study, telenurses could benefit from training that focuses on the communication skills that are needed for telephone nursing and the tools needed to meet individual callers' needs. Work environments could also better support caller-nurse interactions. Organisations should provide more resources for telephone nursing in order to promote positive interactions.
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Aims and objective To describe telenurses' experiences of monitoring calls in telephone advice nursing to parents of children with gastroenteritis. Background In previous studies, making monitoring calls is mentioned as a method u...
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Aims and objective To describe telenurses' experiences of monitoring calls in telephone advice nursing to parents of children with gastroenteritis. Background In previous studies, making monitoring calls is mentioned as a method used by telenurses to assess the need for care. MonitoringTHEterms 'care-seekers', 'care-seeker' and 'careseekers' are used inconsistently in the article. Please suggest which one to follow. We suggest Care-seeker calls in telephone advice nursing have been described as when telenurses call care-seekers back once or twice after an initial call. Calls from parents of children with gastroenteritis are common, and many of these calls result in telenurses providing self-care advice. Methods Nineteen telenurses from two healthcare call centres in Sweden were interviewed. Data were analysed using inductive qualitative content analysis. Results One main category, four generic categories and eleven sub-categories emerged. The telenurses described how working with monitoring calls aimed to provide self-care at home in a patient-safe way. Their focus on the parents aimed at increasing their feeling of security and focus on the child aimed at ensuring patient safety. Monitoring calls also provided a learning opportunity for parents and telenurses, and the possibility of relieving pressure on healthcare services. The findings indicate that the use of monitoring calls aims to provide a patient-safe form of telephone advice nursing. Conclusion This study shows that many parents feel insecure when their child has gastroenteritis, and the use of monitoring calls may be an effective approach to help them feel more secure at home with their sick child.
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The purpose of this study is to deduce and prioritize the factors affecting the implementation of telenursing in Korea. For this study, Delphi methods were used. Thirty professors and specialists in the field of nursing informatic...
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The purpose of this study is to deduce and prioritize the factors affecting the implementation of telenursing in Korea. For this study, Delphi methods were used. Thirty professors and specialists in the field of nursing informatics and telemedicine contributed to two rounds of Delphi survey. The factors necessary for the introduction of telenursing were divided into systematic, economical, societal and technical aspects. The critical factors of each aspect were prioritized to produce a guide to support the feasible implementation plan for telenursing. They are: Governmental support to control the regulatory issues, verification of telenursing as a cost-effective health care delivery system, value verification of telenursing versus on-site consultation, social trust building, and development of characteristic telenursing content which consumers willingly pay for. The results of this study will enable health professionals to understand the prospect and necessity of telenursing implementation. In addition, they will be used efficiently in a variety of e-health milieus as a practical strategy for the improvement of health care in Korea.
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Background and aims: Long term conditions are a significant health problem faced by older people worldwide. Telephone communication is often used to deliver health care to patients and is an important tool in improving access to c...
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Background and aims: Long term conditions are a significant health problem faced by older people worldwide. Telephone communication is often used to deliver health care to patients and is an important tool in improving access to care. Previous research has shown that primary health care nurses communicate with patients by telephone, but little is known about the way in which telephone communication can be used to benefit older patients with long term conditions. The aims of this review were to identify the range and scope of telephone use between practice nurses working in primary health care and older people with long term conditions, explore which elements of this communication has been successful, and determine whether older people see telephone communication as useful for their needs.
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Background: Despite being less costly than prolonged hospitalization, home parenteral nutrition (HPN) is associated with high rates of post-discharge complications, including frequent readmissions and central line-associated blood...
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Background: Despite being less costly than prolonged hospitalization, home parenteral nutrition (HPN) is associated with high rates of post-discharge complications, including frequent readmissions and central line-associated bloodstream infections (CLABSIs). Telemedicine has been associated with improved outcomes and reduced healthcare utilization in other high-risk populations, but no studies to date have supported effectiveness of telemedicine in pediatric HPN. Methods: We prospectively collected data on pediatric patients managed at a single HPN program who participated in postdischarge telemedicine visits from March 1, 2014 to March 30, 2016. We excluded patients with a history of HPN and strictly palliative care goals. Univariate analysis was performed for primary outcomes: Community-acquired CLABSI and 30-day readmission rate. Results: Twenty-six families participated in the pilot initiative with median (interquartile range) patient age 1.5 (5.7) years old, diagnosis of short bowel syndrome in 16 (62%), and in-state residence in 17 (55%). Ishikawa (fishbone) diagram identified causes of post-discharge HPN complications. Areas of focus during telemedicine visit included central venous catheter care methods, materials, clinical concerns, and equipment. Compared to historical comparison group, the telemedicine group experienced CLABSI rates of 1.0 versus 2.7 per 1,000 line days and readmission rates of 38% versus 17% ( p = 0.03, 0.02, respectively). Conclusions: Telemedicine visits identified opportunities for improvement for families newly discharged on HPN. In a small cohort of patients who experienced telemedicine visits, we found lower CLABSI rates alongside higher readmission rates compared with a historical comparison group. Further studies are needed to optimize telemedicine in delivering care to this high-risk population.
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Purpose:The vulnerability of postacute and long-term care (PA/LTC) facility residents to COVID-19 has manifested across the world with increasing facility outbreaks associated with high hospitalization and mortality rates. Systema...
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Purpose:The vulnerability of postacute and long-term care (PA/LTC) facility residents to COVID-19 has manifested across the world with increasing facility outbreaks associated with high hospitalization and mortality rates. Systematic protocols to guide telehealth-centered interventions in response to COVID-19 outbreaks have yet to be delineated. This article is intended to inform PA/LTC facilities and neighboring health care partners how to collaboratively utilize telehealth-centered strategies to improve outcomes in facility outbreaks. Methods: The University of Virginia rapidly developed a multidisciplinary telehealth-centered COVID-19 facility outbreak strategy in response to a LTC facility outbreak in which 41 (out of 48) facility residents and 7 staff members tested positive. This strategy focused on supporting the facility team remotely using rapidly deployed technologic solutions. Goals included (1) early identification of patients who need their care escalated, (2) monitoring and treating patients deemed safe to remain in the facility, (3) care coordination to facilitate bidirectional transfers between the skilled nursing facility (SNF) and hospital, and (4) daily facility needs assessment related to technology, infection control, and staff well-being. To achieve these goals, a standardized approach centered on daily multidisciplinary virtual rounds and telemedicine consultation was provided. Results:Over a month since the outbreak began, 18 out of 48 (38%) facility residents required hospitalization and 6 (12.5%) died. Eleven facility residents have since returned back to the SNF after recovering from their hospitalization. No staff required hospitalization. Conclusions:Interventions that reduce hospitalizations and mortality are a critical need during the COVID-19 pandemic. The mortality and hospitalization rates seen in this PA/LTC facility outbreak are significantly lower than has been documented in other facility outbreaks. Our multidisciplinary approach centered on telemedicine should be considered as other PA/LTC facilities partner with neighboring health care systems in responding to COVID-19 outbreaks. We have begun replicating these services to additional PA/LTC facilities facing COVID-19 outbreaks.
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The primary aim of this intervention was to assess the feasibility of using call center nurses who are experts in telephone triage to conduct post discharge telephone calls, as part of a quality improvement effort to prevent hospi...
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The primary aim of this intervention was to assess the feasibility of using call center nurses who are experts in telephone triage to conduct post discharge telephone calls, as part of a quality improvement effort to prevent hospital readmission. Families of patients with bronchiolitis were called between 24 and 48 hours after discharge. The calls conducted by the nurses were efficient (average time was 12 minutes), and their assessments helped to identify gaps in inpatient family education. Overall, the project demonstrated the efficacy in readmission prevention by using nurses who staff a call center to conduct post-hospitalization telephone calls. (C) 2015 Elsevier Inc. All rights reserved.
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Background: In Brazil, in order to train the Family Health Strategy teams, the Health Ministry implemented the Brazil Telehealth Program to provide health support and permanent health education. In Pernambuco, the Telehealth Cente...
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Background: In Brazil, in order to train the Family Health Strategy teams, the Health Ministry implemented the Brazil Telehealth Program to provide health support and permanent health education. In Pernambuco, the Telehealth Center Network of Pernambuco (RedeNUTES) offers telehealth services to 80 municipalities, supporting 154 Family Health Strategy teams. The goal of this article is to present a profile of nurses' participation in the telehealth services developed by RedeNUTES. Subjects and Methods: This article is a descriptive study of the actions taken by nurses in tele-education and in the telesupport environment, covering the period from the beginning of 2009 to the end of 2010. Results: Three-hundred forty-nine Web conferences in tele-education, which included nurses both as lecturers and as members of the audience, were analyzed. The median average number of participants was 50 per course during the 2-year period. The participation in the training courses, among the higher-education professionals, was mainly composed of nurses. In telesupport, nurses participated as teleconsultants, answering questions received by electronic forms and by remote Web conference consultations. The most popular categories found in the requests for second opinion, submitted by nursing professionals, were obstetrics, gynecology, and pediatrics. Conclusions: We conclude that nurses have participated in telehealth services as members of the audience, as lecturers, and as teleconsultants. We also consider that the active participation of nurses could bring benefits to the quality of the telehealth services provided to the community. These practices could help predict how healthcare will look like in the next few years.
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Coronavirus disease 2019 (COVID-19) has drastically changed health-care delivery models within primary-care settings. Primary-care providers are limiting routine care face-to-face office visits while triaging COVID-19 symptomatic ...
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Coronavirus disease 2019 (COVID-19) has drastically changed health-care delivery models within primary-care settings. Primary-care providers are limiting routine care face-to-face office visits while triaging COVID-19 symptomatic patients to hospital emergency rooms. Primary-care providers are rapidly adopting telehealth modalities for care provisions during this unprecedented pandemic to allow practices to continue delivering primary care while preventing community spread of COVID-19. Federal legislation has responded to emergent public-health needs by removing barriers that have impeded widespread adoption of telehealth modalities. This legislation has omitted professional registered nurses (RNs) from delivering reimbursable telehealth services, which is problematic for primary-care practice. RNs historically have led telehealth service delivery and should therefore be included in new legislation as eligible health professionals permitted to provide reimbursable telehealth services. RNs improve quality outcomes in primary care within innovative team-based care models and are essential clinicians capable of providing ongoing care coordination and disease management for patients needing to stay on track with their usual care needs.
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Background:Delivering healthcare using remote robotic telepresence is an evolving practice in medical and surgical intensive critical care units and will likely have varied implications for work practices and working relationships...
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Background:Delivering healthcare using remote robotic telepresence is an evolving practice in medical and surgical intensive critical care units and will likely have varied implications for work practices and working relationships in intensive care units. Our study assessed the nurse-physician collaboration satisfaction about care decisions from surgical intensive critical care nurses during remote robotic telepresence night rounds in comparison with conventional telephone night rounds.Materials and Methods:This study used a randomized trial to test whether robotic telerounding enhances the nurse-physician collaboration satisfaction about care decisions. A physician randomly used either the conventional telephone or the RP-7 robot (InTouch((R)) Health, Santa Barbara, CA) to perform nighttime rounding in a surgical intensive care unit. The Collaboration and Satisfaction About Care Decisions (CSACD) survey instrument was used to measure the nurse-physician collaboration. The CSACD scores were compared using the signed-rank test with a significant p value of 0.05.Results:From December 1, 2011 to December 13, 2012, 20 off-shift nurses submitted 106 surveys during telephone rounds and 108 surveys during robot rounds. The median score of surveys during robot rounds was slightly but not significantly higher than telephone rounds (51.3 versus 50.5; p=0.3). However, the CSACD score was significantly increased from baseline with robot rounds (51.3 versus 43.0; p=0.01), in comparison with telephone rounds (50.5 versus 43.0; p=0.09). The mediators, including age, working experience, and robot acceptance, were not significantly (p>0.1) correlated with the CSACD score difference (robot versus telephone).Conclusions:Robot rounding in the intensive care unit was comparable but not superior to the telephone in regard to the nurse-physician collaboration and satisfaction about care decision. The working experience and technology acceptance of intensive care nurses did not contribute to the preference of night shift rounding method from the aspect of collaboration with the physician about care decision-making.
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