Telenursing

What is telenursing?

 

Renato Marcos Endrizzi Sabbatini, 
Full professor of Biomedical Informatics 

Telenursing can be defined as “the use of telecommunications and information technology in the provision of nursing services whenever a large physical distance exists between patient and nurse, or between any number of nurses. As a field, it is part of telehealth, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, telemonitoring, telemedicine etc.”. (Ref: Wikipedia).

It may be considered that telenursing is a branch of the more general Nursing Informatics, i.e., the application of Information and Communication Technologies (ICT) to nursing scopes and activities.

Telenursing is enjoying a fast growth in many countries, particularly in the USA, where the role of nurses in delivering primary care faces less regulatory hurdles than in other countries and is cheaper than physician-led care. The job boards of American Telemedicine Association and other specialized sites are full of job offers for attending telenurses, RN (registered nurses) coordinators for telemedicine programs, etc. Telenursing is already a hot area for professional development for nurses and there are certification programs in the USA. It may involve clinical care as well as administrative and operational roles.

The cost/benefit factor has been an important drive for the worldwide adoption of telenursing. In the United States, almost 46% of the on-site nursing visits could reasonably be replaced by telenursing. Compared to the traditional homevisits, agency costs could be cut in half. According to a 1999 study by authors Britton et al., “telenursing is cost effective in reducing the requirement for, or the length of, hospital stays; in increasing access to services to widely dispersed populations; and in expanding high-quality home care services (…) The result is a decrease in total health care costs and increased access to health care with more appropriate use of resources”.

Besides, telenursing has been important, relevant and meaningful when provided to dispersed, distant or isolated populations, to rural areas, during climatic catastrophes and disaster areas, in military situations, for imobilized patients, etc.

There are several application areas for telenursing:

• Triage and counseling of patients by medical call centers
• Telediagnostics (not only basic tele-ECG, but more advanced nursing diagnostics, as well)
• Nursing teleconsultation, both before and after admission to a hospital)
• Support to home care
• Monitoring in risk pregnancies, home-bound seniors, the physically disadvantaged, etc.
• Suport to nursing second opinion services
• Case management, personal health tutoring and follow-up of chronic and post-acute patients
• Emergency nursing, paramedic rescue
• Remote intensive care monitoring (e-ICU)
• Tele-rehabilitation
• Tele-education and training for nurses
• Tele-education for patients, particularly for informed consent
• Healthcare plans audits
• Support to nursing research

Telenursing uses most of the telemedicine ICTs, such as on-line electronic health records (EHR), PoR (Patient Owned Records, such as self-monitoring, Personal Health Records), text-, audio- and videoconferencing, support websites and portals, especialized home-based devices for home care, portable medical-grade devices for ECG, satO2/CO2, respirometry, remote patient monitoring, and so on.

References:

1. Telenursing. In: Nursing Matters Fact Sheet. International Council of Nurses (PDF).
2. Telenursing. In: ISFTeH: International Society for Telemedicine and e-Health.