Question 1

A staff nurse working on the medical-surgical unit of an acute care facility is considering a transfer to a new telehealth center the facility is creating. The nurse engages in some background research about telehealth nursing to determine if this position would be a good fit. Which information would the nurse most likely find about this concept? Select all that apply.

A)It is a brand-new type of nursing practice.
B)It primarily occurs in large healthcare organizations.
C)It involves the use of telecommunication technology.
D)It may be referred to as connected care.
E)It focuses solely on individual follow-up after discharge.

It involves the use of telecommunication technology.
It may be referred to as connected care.

Accepted Answer

Telehealth nursing is the delivery of nursing care and services over distance using some form of telehealth technology, also referred to as telecommunications technology. Telehealth services are also referred to as "connected care" and "virtual care." Such services are wide-ranging and not solely focused on individual follow-up after discharge. In addition, telehealth nursing services can vary from one-on-one care to population health; from a brief one-time interaction to an ongoing long-term relationship; and from technology as simple as the telephone to more sophisticated home or wearable monitoring devices and video conferencing. Telehealth nursing, that is, telephone triage, initially arose in the 1980s to help decrease costs in a capitated payment system. This telephone triage, now known as telehealth triage, took place entirely within the ambulatory care arena. However, services have expanded to a myriad of settings.

Question 2

A telehealth nurse has been invited by a local community health center to give a presentation about telehealth to the group. The nurse plans to describe the effects of this type of practice. Which effect(s) would the nurse likely include? Select all that apply.

A)Increased emergency department visits
B)Improved healthcare provider satisfaction
C)Better use of resources
D)Provision of safe care
E) Increased healthcare costs

Improved healthcare provider satisfaction
Better use of resources
Provision of safe care

Accepted Answer

Telehealth nursing has demonstrated safe care, reductions in unnecessary urgent care (UC) and ED visits, positive individual and provider satisfaction, and more efficient use of resources. For organizations providing telehealth nursing services, these outcomes have resulted in improved quality of care and reduced healthcare costs.

Question 3

The nurse manager at a telehealth center is orienting a new group of nurses to their role. As part of the orientation, the nurse manager describes the use of decision support tools. The nurse manager determines that additional follow-up is needed based on which statement by the group?

A)"When we use the tool, we know that the individual is definitely safe."
B)"These tools are a helpful reminder for managing an individual's care."
C)"We need to make sure to analyze the information even with the tools."
D)"The tools can help us ensure we do a complete assessment."

"When we use the tool, we know that the individual is definitely safe."

Accepted Answer

Decision support tools (DSTs) add an element of safety in that they provide a comprehensive list of assessment questions that are relevant to the primary symptom of the individual. The use of DSTs is a standard of practice for managing symptom-based calls. The use of DSTs does not ensure safety. Rather they are a useful reference and act as a reminder and an aid, but it is the RN who must analyze, contextualize, and draw conclusions from the individual's responses. They provide significant support by serving as a checklist to ensure adequate assessment and help standardize decision-making.

Question 4

A 69-year-old individual with type 2 diabetes was discharged home after being hospitalized for acute heart failure. The individual was sent home with a scale and blood pressure device that are linked to the healthcare provider's office and are to track weight and blood pressure every morning after waking. This morning the nurse calls the individual after seeing the blood pressure reading is elevated and the scale shows the individual gained 3 lb since yesterday. The nurse is engaging in which activity?

A)Telehealth triage
B)Remote care management
C)Telephone consultation
D)Remote monitoring

Accepted Answer

The nurse is engaging in remote monitoring, which allows the individual to remain in the home or the community knowing that not only is their health data being reviewed and monitored, but they also are connected to a nurse. The nurse's role in remote monitoring is to interpret the data, intervene when appropriate, and provide individualized education and support. Telehealth triage is primarily conducted over the telephone, although some organizations are introducing a visual component that may be conducted over the computer using an application such as Skype or FaceTime. With telehealth triage, nurses assist callers to access the appropriate level of care according to their symptoms or healthcare concerns. Telephone consultation may be a component of telehealth triage, remote monitoring, or remote care management. Remote care management focuses on developing and/or continuing implementation of a plan for continuity of care, identifying and addressing any gaps in care, and ensuring individuals or their families understand and can participate in the individual care plan.

Deck 7: Telehealth and Virtual Care Nursing