Areas Well Understood and not Well Understood
The use of telehealth in the outpatient contexts is becoming a norm rather than a novelty. It has been acknowledged that nursing professionals provide care with the help of technology, which has multiple positive effects, including but not confined to improved patient outcomes, better symptom control, enhanced medication adherence, higher patient satisfaction (Asiri et al., 2018; Song et al., 2020). However, some gaps in research are apparent as the cost-effectiveness of the method is still a concern, especially for low-income communities (Correia et al., 2021). It is also necessary to continue investigation into the most effective components of training programs for registered nurses.
Consistencies
Advanced nurses, as well as registered nurses, have been involved in the provision of telehealth care for a while, and this practice has proved to lead to positive outcomes for patients and facilities. Patients expressed increased satisfaction with such services and reported improved health status and psychological and emotional state (Gannon et al., 2019). Interprofessional collaboration is also an important component of telehealth as nurses can provide better care if they work in teams with physicians, mental health professionals, and other practitioners (Delaney & Vanderhoef, 2019). Patient education is one of the areas associated with the most pronounced benefits as patients develop the necessary self-care skills as a result of telehealth care.
Stumbling Blocks
- Cost-effectiveness is one of the primary stumbling blocks related to the incorporation of telehealth into the healthcare system. Low- and middle-income communities have low access to high-quality health care, and the facilities located in such environments have limited budgets (Correia et al., 2021). Healthcare facilities often lack the software and human resources to ensure the provision of telehealth services.
- Nurses’ overload is an influential stumbling block as nursing professionals have to complete diverse tasks in numerous settings, work long hours, manage job-related stress, and try to attain an appropriate work-life balance (Qureshi et al., 2019).
- The lack of training among nurses is another challenge to be addressed.
Limitations to the Use of Registered Nurses in Telehealth in Outpatient Settings
- Some health issues and patient states need a closer examination, so telehealth-based communication can be insufficient.
- Many people, especially older ones, have limited or no necessary skills to use this technology.
- Many states have an inappropriate legislative basis that prevents registered nurses from providing telehealth services (Lew & Sikka, 2019).
Inconsistencies
As mentioned above, legislation can be seen as one of the primary concerns to be addressed. On the one hand, the benefits of telehealth and nurses’ involvement in this practice have been acknowledged and favorably accepted. On the other hand, no proper legislative ground has been developed in many states and on the federal level so far (Lew & Sikka, 2019). In addition, although telehealth is seen as a helpful initiative, nurses still have no needed skills to provide telehealth services, and effective training programs are not sufficient (Rutledge et al., 2021). Hence, although telehealth has been widely employed in the U. S. healthcare system for years and numerous studies have been implemented to explore its effects, certain inconsistencies exist.
Recommendations for Practice
In order to ensure the effective incorporation of telehealth into the American healthcare system, it is important to address certain issues and undertake several steps. Advocacy is a key to the further development of practice as nurses should advocate for telehealth and address policymakers to ensure the development of the corresponding legislative grounds (Lew & Sikka, 2019). Healthcare facilities should also provide training to registered nurses so that these professionals can provide high-quality telehealth services. Finally, registered nurses should educate patients (especially older ones) on the benefits and peculiarities of telehealth.
References
Asiri, A., AlBishi, S., AlMadani, W., ElMetwally, A., & Househ, M. (2018). The use of telemedicine in surgical care: A systematic review. Acta Informatica Medica, 26(3), 201-206.
Correia, J. C., Meraj, H., Teoh, S. H., Waqas, A., Ahmad, M., Lapão, L. V., Patakya, Z., & Golaya, A. (2021). Telemedicine to deliver diabetes care in low- and middle-income countries: A systematic review and meta-analysis.Bulletin of the World Health Organization, 99(3), 209–220B.
Delaney, K. R., & Vanderhoef, D. (2019). The psychiatric mental health advanced practice registered nurse workforce: Charting the future.Journal of the American Psychiatric Nurses Association, 25(1), 11-18.
Gannon, J., Atkinson, J. H., Chircop-Rollick, T., D’Andrea, J., Garfin, S., Patel, S., Penzien, D. B., Wallace, M., Weickgenant, A. L., Slater, M., Holloway, R., & Rutledge, T. (2019). Telehealth therapy effects of nurses and mental health professionals from 2 randomized controlled trials for chronic back pain.Clinical Journal of Pain, 35(4), 295–303.
Lew, S. Q., & Sikka, N. (2019). Operationalizing telehealth for home dialysis patients in the United States. American Journal of Kidney Diseases, 74(1), 95-100.
Qureshi, S. M., Purdy, N., Mohani, A., & Neumann, W. P. (2019). Predicting the effect of nurse–patient ratio on nurse workload and care quality using discrete event simulation.Journal of Nursing Management, 27(5), 971-980.
Rutledge, C. M., O’Rourke, J., Mason, A. M., Chike-Harris, K., Behnke, L., & Melhado, L., Downes, L., & Gustin, T. (2021). Telehealth competencies for nursing education and practice: The four p’s of telehealth. Nurse Educator, 46(5), 300-305.
Song, Y. Reifsnider, E., Zhao, S., Xie, X., & Chen, H. (2020). A randomized controlled trial of the effects of a telehealth educational intervention on medication adherence and disease activity in rheumatoid arthritis patients.Journal of Advanced Nursing, 76(5),1172-1181.