Telehealth

Telehealth refers to healthcare services that are provided over technology, rather than in-person. Nurses can provide symptom management, disease management such as addressing medication concerns and explaining test results, patient education, and counseling over Telehealth. Many outpatient care goals can be met via Telehealth appointments in a cost effective, efficient manner.

The article referenced below discusses the importance and benefits of Telehealth nursing. It also highlights the key skills needed for successful triage nurses, including critical thinking, active listening, discerning when to probe for more information, and overall communication skills. A suggested outline for a Telehealth visit with patients presenting with a primary concern is as follows:

• S - symptoms
• C - characteristics
• H - history
• O - onset & duration
• L - location
• A - aggravating or associated factors
• R - relieving factors

The use of this acronym can help you identify the primary issue and quickly assess its severity.

Read more at: https://journals.lww.com/nursing/Fulltext/2019/04000/Telehealth_nursing__More_than_just_a_phone_call.3.aspx

• Avoid jumping to a conclusion. It is important that you keep an open mind and maintain objectivity throughout a Telehealth visit. Fully assess the situation and the patient's problem, considering all of the information before making a decision.
• Don't immediately accept the patient's self-diagnosis. While patients often have strong opinions regarding their problem, they may have biases or expectations hindering their ability to accurately assess the situation. It is important for the nurse to maintain an open mind and consider all possibilities.
• Whenever possible, speak to the patient directly. While caregivers are valuable, patients are the best source of information.
• Avoid interruptions and distractions. If you are fatigued, rushed, or multi-tasking, you could miss a key piece of information and compromise patient safety.
• Documentation must be thorough and complete. If you did not document a piece of the conversation, there is no legal record, and your colleagues will not understand how to follow up with the patient.
• Recognize that Telehealth brings unique challenges and complexity. Patients may have technical difficulties, so allow for plenty of time between visits especially if it is the patient's first Telehealth visit. Additionally, you will be unable to fully physically assess your patient, which means you must use critical thinking and skillful interviewing to understand the patient's condition and primary concern.
• Collaborate with the patient. Explore the patient's condition and desired outcomes, use your clinical judgement, and develop a plan with the patient.
• Consult with a provider if your patient requires new or changed orders or if you have any concerns.

*The above information was derived from the Core Curriculum for Ambulatory Care Nursing, 4th edition, by Candia Laughlin & Stephanie Witwer and Scope and Standards of Practice for Professional Telehealth nursing, editor Tabitha Angela, 2018. Used with permission of AAACN. Find more information at https://www.aaacn.org/

Other Sources

Telehealth Nursing - More than Just a Phone Call: https://journals.lww.com/nursing/Fulltext/2019/04000/Telehealth_nursing__More_than_just_a_phone_call.3.aspx

Washington State Department of Health - Telehealth/Telenursing for Registered Nurses: https://www.doh.wa.gov/portals/1/Documents/6000/Telenursing.pdf

Image: https://www.flmedical.org/Florida/Florida_Public/Docs/Telehealth.pdf