The project is using telenursing and electronic health records. One of the most significant issues facing the healthcare sector is the shortage of skilled workers and particularly nurses. The sector is not attracting enough students to study nursing, and yet the demand for healthcare is increasing. Estimates suggest that the demand for nursing services will continue to grow as baby boomers retire. Also, the rise of chronic, lifestyle-related diseases is driving the need for the nurses. Cancer, for instance, is now one of the leading causes of mortality, and managing the condition is complicated and requires dedicated care. Type 2 diabetes is also a leading cause. Both conditions have a lifestyle component as the factors that cause them.
In this project, the objective is to offer care to patients “virtually” or without face-to-face contact with the nurse. In nursing homes or hospitals without enough qualified nurses, telenursing can play an essential role in providing care. Thus, for patients with complications for which the hospital or the nursing home has not specialists, specialist nurses working in remote locations would offer care. However, for telenursing to work, electronic health records are vital so that specialists can access a patient file over the internet during consultations or after (Abbott & Coenen, 2008). The success of the project requires an investment in the ICT, such as high-speed internet connection, sufficient bandwidth, and teleconferencing tools or technologies. Hospitals or nursing homes need to implement electronic health records where all patient records are stored in a central database.
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Stakeholders impacted by this project
The most critical stakeholder in this project is the patient. Once the project is implemented, patients suffering from certain conditions will get help from specialists operating far away. The specialists might be local or even foreign nurses, but with the right skills to help patients.
The second stakeholder is the hospital, nursing homes, or any establishment providing care. The role of such an establishment is to provide the right environment for the implementation of the project. In particular, such organizations must advocate for investment in technology to automate some tasks.
Nurses and other health workers are stakeholders as well. The role of the nurse is to provide care or support to patients. With this project, nurses will have the additional task of preparing patients for consultation with specialists operating in remote locations (Hawkins, 2012). Therefore, while the other nurses (working remotely) might lessen the burden, the technology might also add additional responsibilities.
Healthcare leaders are essential stakeholders. Any new project requires leadership. The leaders include nurse leaders, CEOs, physicians, and anybody who holds any leadership position within the organization. Healthcare organizations need their support to achieve the goals of the project or things that might prove harder than expected along the way.
Policy makers in the healthcare sector matter as well. In the last few decades, the massive progress attained in the field of ICT has not found application in healthcare, mostly due to a lack of supportive policies. Therefore, implementing telenursing or telehealth need support from policymakers, or at least, they allow organizations to experiment with technology to deliver care.
Patient outcome(s) or patient-care efficiencies this project
Tele-heath technology, which includes telenursing, presents an opportunity medical institutions are not exploiting to improve patient outcomes. The technology can help address the nursing shortage. Moreover, the technology is available at a time when many patients suffering from chronic illnesses require augmented consultations and services. Nurses with special skills can go "virtual" and provide much-needed services to patients in remote locations.
Tele-nursing is a useful technology for rural or deprived communities without access to proper care. The shortage of health workers, mostly affects poor communities and those in rural settings. Most health workers want to live in large urban environments or within prosperous communities (Bashir & Bastola, 2018). The result is a shortage of health workers where they are in high demand. Tele-nursing improves outcomes in patients living in those communities.
Tele-nursing is suitable for financial savings. In a severe case, one emergency room visit might cost as much as $1000, but telenursing visit costs 40 dollars or less. The technology lowers the cost of care for the patients and practitioners. In employers who provide telenursing, they can save millions of dollars.
With telenursing, it is possible to achieve improved bed allocation. According to Medicare, one of the leading cost drivers is re-admitted, but telenursing makes it easier and cost-effective to conduct follow-up care to high-risk clients such as those suffering from chronic conditions and recent surgical patients. Such follow up reduces the need for the re-admission in the majority of cases. Reducing re-admission minimizes the cost of care, and the patient gets convenient, quality care in the comfort of their homes.
Identify the technologies required to implement this project and explain why
Implement the project is not technically challenging, but its involving and requires some investment. Tele-nursing can be synchronous and or asynchronous. Synchronous is live or face-to-face interaction between the patient and the nurse. The mode of communication is via audio-video conferencing. The equipment needed is a video camera for bi-directional communication. The camera must have a zoom capability. Other equipment attached to the camera is digital and peripheral equipment such as the stethoscope, otoscope, and the ophthalmoscope with camera capability.
Once a patient enters the clinic, a nurse known as telepresenter handles the patients and mediates communication with the specialist. The nurse uses the equipment to conduct tests, whose results the specialist of the other end can view. For patients suffering from chronic conditions, they can be trained to use the equipment and communicate with nurses in a remote location (Darvish, Bahramnezhad, Keyhanian & Navidhamidi, 2014). In asynchronous telenursing, communication does not take place in real time, but via tools such as email, internet, and text messaging.
For electronic patient records, the most important technology is the database for securing client information. However, establishing a data connection is easy with cloud computing, such as Amazon web services. Link to the online database requires a set of technologies such as an application programming interface (API). One standard API is the rest representational state transfer (REST). The API is critical in transferring information from the client such as desktop, where patient data is being captured, to the cloud (Kvedar, Coye & Everett, 2014).
Lastly, the internet is critical for telenursing to succeed. In this case, a fast internet connection is vital. Preferably a fiber connection is ideal, although alternatives are equally good as long as the speed is substantial.
Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team
The project is a big one, so it requires a project manager. Ideally, the project managers should be a nurse informaticist, who understand technology as well as nursing as a profession. The next member of the team is the project owner, who is the organization originating the project. In this case, the owner could be a hospital or any medical center. The board of the management of such an organization is a critical player. Other roles are that of finance, chief who is responsible for the finances, planning officer for planning, and chief operating officer. The purpose of procurement managers is to purchase raw materials. Chief accountant has the role of managing the books of the project during the duration of the project.
References
Abbott, P. A., & Coenen, A. (2008). Globalization and advances in information and communication technologies: The impact on nursing and health. Nursing Outlook, 56 (5). doi:10.1016/j.outlook.2008.06.009
Bashir, A., & Bastola, D. R. (2018). Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study. JMIR Medical Informatics, 6 (2). doi:10.2196/medinform.9080
Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The Role of Nursing Informatics on Promoting Quality of Health Care and the Need for Appropriate Education. Global Journal of Health Science, 6 (6). doi:10.5539/gjhs.v6n6p11
Hawkins, S. Y. (2012). Telehealth nurse practitioner student clinical experiences: An essential educational component for todays health care setting. Nurse Education Today, 32 (8), 842-845. doi:10.1016/j.nedt.2012.03.008
Kvedar, J., Coye, M. J., & Everett, W. (2014). Connected Health: A Review Of Technologies And Strategies To Improve Patient Care With Telemedicine And Telehealth. Health Affairs, 33 (2), 194-199. doi:10.1377/hlthaff.2013.0992
