Introduction
Telenursing is the utilization of technology to conduct nursing practice and deliver nursing care. The use of technology has changed the delivery medium of nursing care. It has necessitated competencies related to its use to deliver nursing care. Practitioners engaged in telenursing plan, assess, evaluate and intervene the outcomes of nursing care. Technologies commonly used in this practice include computers, Internet, telephones, telemonitoring equipment and digital assessment tools. The term telehealth is used to describe the breadth of health services provided through communication technologies. The paper will explore telenursing as a specialty of telehealth. Advantages and disadvantages for the patient and legal and ethical principles for the nurse of this technology will be explored. These will be used as the basis for decision-making and whether it is a good fit for me.
Advantages and disadvantages for the patient
Advantages
Diagnosis and Consultation
Research evidence shows increased success of diagnosis of diseases. Telenursing has productively been used as a tool for diagnosing acute conditions including leukemia. In addition to diagnosis, nurses can provide educational sessions or other patient education efforts. Telenursing has been shown to be a successful undertaking for nurses in patient education as it offers two-way video and audio technology. Nurses also have benefited from consultations through telehealth tools. Just as in patient education, nurses can use the two-way audio and video technology to consult with other providers. For example, home health nurses may use technology to consult with physicians or specialists regarding a particular patient (Hebda & Czar, 2013).
Monitoring and Surveillance
Adherence and compliance problems are among the various issues that are essential to achieving patient safety. After patients leave a facility, they take responsibility for their own health care at home. Patients may not always follow treatment plans as directed by providers or physician due to various factors, including wrong understanding and miscommunication of the treatment plan, complex treatment schedule that requires additional guidance for the patients to comprehend and the lack of access to facilities required for the treatment plan. This can cause negative outcomes and creates safety issues for the patient. Therefore, these technologies provide nurses with efficient tools of caring for patients. The use of these technologies improves adherence or compliance to the prescribed regimen of care. They also allow effective symptom management. Telenursing is one strategy that nurses currently use to monitor and communicate with patients beyond the acute care setting. It also reduces health care utilization rates for acute care services by reducing visits to the Emergency Department (Hebda & Czar, 2013).
Clinical and Health Services outcomes
Telenursing has been associated with an improvement in clinical and health service outcomes. Technologies have been used in the management of chronic conditions such as chronic obstructive pulmonary disease, congestive heart failure and diabetes. Mortality and morbidity are the outcomes measured for these patients. Telenursing shows better outcomes in these areas. More specifically, telenursing technology has been shown to be an important tool in health intervention. For example, nurses can induce communication to help patient reduce HbA1c levels. They may also offer assistance to patients with traumatic brain injury in their transitioning from the hospital to the community. In addition to these technologies, other devices and applications are also making a difference in patient health care and safety. Essentially, telehealth technologies have replaced traditional care as practical alternatives (Hebda & Czar, 2013).
Reduction of cost
With telephone-based telenursing, there is relatively no technical setup required for interaction or cost to the patient. Many individuals own a cell phone in their home that can be utilized during sessions. Often, nurses limit telephone discussions to education or counseling as there are no visual cues for the telenurse. Technologies offer more and broader potential for telenursing practice. With telehealth technologies, patient access to care is improved; adherence to care increases and providers network with each other improves. Nurses can also closely monitor safety of patients at homes or alternative living facilities. The evident improvement in patient’s outcome has an indirect impact on cost of delivery of services (Hebda & Czar, 2013).
Disadvantages
As the use of technology increases in nursing profession, cost, privacy, autonomy, security and confidentiality issues have emerged. Facilities invest heavily in the security of patient information. These measures call for significant allocation of resources interms of human resources and money. Thus, the use of telecommunication increases the costs of purchase and operations of these equipments. These costs are passed on to consumers of health. Patients meet these costs through charges to health services. Health organizations are also faced with continued threat of as the need for confidentiality and security of patient data remain in the forefront of telenursing. On the other hand, Laws and regulations continue to place requirements for the protection of personal information. Data breach incidents have more impact than government fines, publicized lawsuits, and labor or union disputes. Breaches also have an impact on patients. Another disadvantage of telenursing is the technicality associated with the use of specific technologies. Telehealth technology differs and can range from telephone calls postoperatively to live, interactive voice and video patient education to using a popular video game system and downloadable data devices (Schlachta et al., 2010).
Legal and ethical principles for the nurse
With telenursing, confidentiality remains a concern that must always be addressed. Telehealth sessions must remain confidential interaction between a provider and a patient. Information privacy is the relationship between technology, collection and sharing of data, the public expectation of privacy, and the legal and related issues surrounding them. Privacy concerns exist when there is sensitive information or personally identifiable information that might be of interest to other parties. Maintenance of information privacy is a risk management issue for any organization (Greenberg, 2000).
The security risks increase with the extraordinary utilization of internet services due to the advent of cloud computing. Hence, training is a necessary component of an organization’s security practices. Hospitals are forced to instead focus on making information system users intrinsic to the security processes through awareness, training and information rather than focusing purely on implementing technologies. Technologies such as firewalls, intrusion detection system, intrusion prevention system, antivirus content filtering and encryption are commonly implemented to reduce the risk of cyber attacks. While such technologies are widely available to help hospitals mitigate the risk of intentional and unintentional threats, their effectiveness is limited if security threats and risks fail to focus on user intrinsic components of the organization’s ICT system. Computer dependency, false sense of entitlement and ethical flexibility increases the security risk to the disadvantage of the medical facility. This exposes health facilities to risks of security and data breach. In the long run, this may compromise patients’ safety (Greenberg, 2000).
Conclusion and Recommendations
Innovative technologies are employed in nursing practice to improve patient care and thus improve safety. Technologies range from the ubiquitous computing to simple telephone and only promise more in the future. The research on telenursing practice shows significant benefits related to consultations, diagnosis surveillance and monitoring of patients, technology advancement and clinical and health services outcomes. These areas have considerable patient safety concerns. On the other hand, special concerns in relation to patient safety have emerged with this method of health care delivery. As the use of technology increases in nursing profession, cost, privacy, autonomy, security and confidentiality issues have emerged. A job in telenursing is in my future. The pro of this decision is that I will get to work in a field that has shown high potential of growth in the future. The con of this decision is that ability to safeguard data is important as personal information increasingly continues to be collected.