DOCSLIB.ORG

Use of a Telerehabilitation Delivery System for Fall Risk Screening Robert W

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Use of a Telerehabilitation Delivery System for Fall Risk Screening Robert W Nova Southeastern University NSUWorks Department of Physical Therapy Student Theses, Department of Physical Therapy Dissertations and Capstones 1-1-2018 Use of a Telerehabilitation Delivery System for Fall Risk Screening Robert W. Nithman Nova Southeastern University This document is a product of extensive research conducted at the Nova Southeastern University College of Health Care Sciences. For more information on research and degree programs at the NSU College of Health Care Sciences, please click here. Follow this and additional works at: https://nsuworks.nova.edu/hpd_pt_stuetd Part of the Physical Therapy Commons All rights reserved. This publication is intended for use solely by faculty, students, and staff of oN va Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher. NSUWorks Citation Robert W. Nithman. 2018. Use of a Telerehabilitation Delivery System for Fall Risk Screening. Doctoral dissertation. Nova Southeastern University. Retrieved from NSUWorks, College of Health Care Sciences - Physical Therapy Department. (77) https://nsuworks.nova.edu/hpd_pt_stuetd/77. This Dissertation is brought to you by the Department of Physical Therapy at NSUWorks. It has been accepted for inclusion in Department of Physical Therapy Student Theses, Dissertations and Capstones by an authorized administrator of NSUWorks. For more information, please contact [email protected]. The Use of a Telerehabilitation Delivery System for Fall Risk Screening By: Robert W. Nithman, PT, DPT, MPT, GCS A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Nova Southeastern University College of Health Sciences Department of Physical Therapy 2018 Signature Page We hereby certify that this dissertation, submitted by Robert W. Nithman conforms to acceptable standards and is fully adequate in scope and quality to fulfill the dissertation requirement for the degree of Doctor of Philosophy. _______________________________________________ _____________________ Dr. Cheryl J. Hill, PT, DPT, PhD Date Chairperson of Dissertation Committee _______________________________________________ _____________________ Dr. M. Samuel Cheng, PT, MS, Sc.D Date Dissertation Committee Member _______________________________________________ _____________________ Dr. Alan Chong W. Lee, PT, PhD, DPT, GCS, WCS Date Dissertation Committee Member Approved: _______________________________________________ ___________________ Dr. M. Samuel Cheng, PT, MS, Sc.D Date Associate Professor Director, PhD in Physical Therapy Program _______________________________________________ ___________________ Dr. Shari Rone-Adams, PT, MHSA, DBA Date Associate Professor Chair, Department of Physical Therapy _______________________________________________ ___________________ Dr. Stanley Wilson, PT, Ed.D, CEAS Date Dean, Dr. Pallavi Patel College of Health Care Sciences Abstract Problem: The Centers for Disease Control and Prevention indicates that falls are the “leading cause of injury death and the most common cause of nonfatal injuries and hospital admission for trauma among people ages 65 and older.”1 Falls can have significant economic consequences to the individual and payer sources. To address these consequences, telerehabilitation was hypothesized to be a suitable supplement for fall screening efforts. Several sources concluded that support for synchronous telerehab was underdeveloped in the literature. Purpose: The purpose of this study was to explore the acceptability, feasibility, reliability, and validity of telehealth-delivered fall screening among community-dwelling older adults. Procedures: This investigation implemented an experimental, quantitative, cross-sectional design employing both pretest-posttest control group and quasi-experimental static group comparisons using non- probability sampling. This study assembled a panel of experts to provide content validation for a survey tool developed to quantify an older adult’s behavioral intension to use and attitudes towards a telerehabilitation delivery system. Seven fall screening tools were investigated for agreement among remote and face-to-face raters, and for comparison with the face-to-face reference standard (Mini-BEST). Results: All three null hypotheses were rejected. Results indicate that a telerehabilitation delivery system is a reliable and valid method of screening and determining fall risk in community-dwelling older adults. This study produced a content validated, internally consistent survey instrument designed to determine attitudes and beliefs about telerehabilitation. An experimental design was able to demonstrate a positive significant change in 4 of 7 survey constructs among the intervention group after exposure to telerehabilitation as compared to post-test controls. Overall, no significant difference was calculated between face-to-face or telerehab raters, and both environments produced equivalency with scoring, fall risk classification, and ability to discern fallers from non-fallers. Results from the telerehab STEADI fall risk conclusions were calculated to be concurrently valid with the face-to-face reference standard screening tool, the Mini-BEST. Conclusions: This investigation expanded the array of remote healthcare delivery options for clinicians and clients. Further investigation in residential and community settings are recommended. Keywords: Telerehabilitation, Elderly falls, Telehealth, Technology acceptance Acknowledgements First, I would like to thank my dissertation Chair, Dr. Cheryl Hill, for her understanding, patience, and excellent guidance through the stages and challenges of the dissertation process. To the members of my doctoral committee, Dr. Mingshun Cheng and Dr. Alan Lee, my sincerest thanks and appreciation for your input and support during this challenging journey. I would also like to thank my colleagues, mentors, and friends for sharing their wisdom, enthusiasm, and willingness to listen to my ideas, experiences, and challenges. I am grateful for my study participants, student volunteers, as well as members of my panel of experts for sharing their time and interest in my research. I would like to acknowledge my wife and three children. Your love and support saw me through this trying time and helped me see the triumph that we can all share when we set goals, stick together, and persevere through adversity. Your smiles and hugs have carried me through many long nights in front of my computer. To my mother and father, both of whom gave this orphan a new start on life at a young age, I know you too will be sharing in the joy of this accomplishment from heaven above. Earning this fourth college degree is a testament to your encouragement to be the first college graduate in our family. Thank you for allowing me to dream and for always implicitly saying, “Yes you can.” Lastly, I want to thank my Lord and Savior, Jesus Christ, for guiding me through this journey and for seeing my potential as an educator and researcher. I look forward to seeing what you have planned for me next! Table of Contents List of Tables .................................................................................................................................. x List of Figures .............................................................................................................................. xiii CHAPTER ONE: INTRODUCTION Introduction ......................................................................................................................... 1 Problem Statement and Purpose ......................................................................................... 2 Relevance and Significance ................................................................................................ 3 Practical Application of the Findings ................................................................................. 9 Barriers and Issues ............................................................................................................ 12 Research Questions / Hypotheses ..................................................................................... 16 Operational Definition of Terms ....................................................................................... 17 Summary ........................................................................................................................... 19 CHAPTER TWO: LITERATURE REVIEW Introduction ....................................................................................................................... 20 Historical Overview of the Theory and Research Literature ............................................ 21 The Theory and Research Literature Specific to the Topic .............................................. 24 Literature Related to Technology Acceptance Theories…………………………24 Literature Related to Elderly Falls……………………………………………….41 Balance Evaluation System’s Test (BESTest) .................................................................. 45 Berg Balance Scale (BBS) ................................................................................................ 47 Clinical Test of Sensory Interaction and Balance (CTSIB) .............................................. 49 Dynamic Gait Index (DGI) ..............................................................................................
Load more

Recommended publications
  • Programme Enhancing Clinical Research Across the Globe
    RCN International Nursing Research Conference and Exhibition 2019 Tuesday 3 - Thursday 5 September 2019 Sheffield Hallam University, UK Conference brochure kindly supported by media partner Accrue up to 27 hours #research2019 of CPD PATIENT STATUS Visit EDGE on stand 8 THE POWER OF DATA For everyone. Anywhere. In real-time. EDGE. Intelligent Research ManagementTM An innovative programme enhancing clinical research across the globe [email protected] www.edgeclinical.com Welcome 5 Acknowlegements and thanks 6 International Scientific Advisory Panel 7 General information 8 Venue Plan 10 Exhibitor listing 11 Programme Tuesday 3 September 13 Wednesday 4 September 18 Thursday 5 September 23 Posters Tuesday 3 September 28 Wednesday 4 September 29 Thursday 5 September 30 Royal College of Nursing 20 Cavendish Square London W1G 0RN rcn.org.uk 007 698 | August 2019 3 Library and Archive Service Exhibitions and events programme 24-hour access to thousands of e-books and e-journals at rcn.org.uk/library Help and advice on searching Libraries in Belfast, for information Cardiff, Edinburgh and London www.rcn.org.uk/library 0345 337 3368 @rcnlibraries @rcnlibraries 4 Library and Archive Service Welcome The theme of this year’s conference is the impact of nursing research. This is very fitting as 2019 is the Exhibitions and 60th year in which there has been a meeting of nurses to share their research and meet like-minded events programme colleagues. The first such meeting took place in the RCN headquarters in London in 1959 as a research discussion group attended by Doreen Norton, Winifred Raphael, Gertrude Ramsden, Muriel Skeet and Lisbeth Hockey.
    [Show full text]
  • Informing PTAC's Review of Telehealth and Pfpms
    Informing PTAC’s Review of Telehealth and PFPMs: We Want to Hear from You Responses On September 18, 2020, the Physician-Focused Payment Model Technical Advisory Committee (PTAC) requested input from the public on information that could help inform their review of the use of telehealth to optimize health care delivery under physician-focused payment models (PFPMs) and alternative payment models (APMs). PTAC received nine responses from the following stakeholders that are listed below in the order in which their responses were received: 1. Eitan Sobel, MD 2. Center for Healthcare Quality & Payment Reform 3. American Physical Therapy Association 4. American Academy of Family Physicians 5. National Committee for Quality Assurance 6. National Association of Pediatric Nurse Practitioners 7. OCHIN 8. Jean Antonucci, MD 9. Partnership to Empower Physician-Led Care For additional information about PTAC’s request, see PTAC’s solicitation of public input. 9/24/2020 Physician-Focused Payment Model Technical Advisory Committee (PTAC) c/o US DHHS Asst. Secretary of Planning and Evaluation Office of Health Policy 200 Independence Ave., SW. Washington DC 2O20I TITLE: THE ‘MONEY-PIT’ BUSINESS OF REMOTE CARE (TELEHEALTH). Are there experiences and lessons learned?: Not long ago, we were inspired by the ​ emergence of EMR technologies. The promise of better care, cost-saving, error reduction, and better communication prompted us to heavily invest in those technologies. EMR technologies indeed improved care delivery but the results were nowhere close to what we hoped to achieve. Many small entities like private physicians and small clinics did not survive the technology revolution and had to close.
    [Show full text]
  • Dental Care Access and the Elderly: What Is the Role of Teledentistry? a Systematic Review
    International Journal of Environmental Research and Public Health Review Dental Care Access and the Elderly: What Is the Role of Teledentistry? A Systematic Review Luca Aquilanti 1 , Andrea Santarelli 1,2,* , Marco Mascitti 1 , Maurizio Procaccini 1,2 and Giorgio Rappelli 1,2 1 Department of Clinical Specialistic and Dental Sciences, Polytechnic University of Marche, 60126 Ancona, Italy; [email protected] (L.A.); [email protected] (M.M.); m.procaccini@staff.univpm.it (M.P.); g.rappelli@staff.univpm.it (G.R.) 2 Dentistry Clinic, National Institute of Health and Science of Aging, IRCCS INRCA, 60126 Ancona, Italy * Correspondence: andrea.santarelli@staff.univpm.it; Tel.: +39-071-2206226 Received: 10 November 2020; Accepted: 2 December 2020; Published: 4 December 2020 Abstract: A high level of unmet oral health needs is very common among elderly people. In a society that is getting older and that has been hit so hard by the coronavirus pandemic, the development of new strategies aimed at enhancing general and oral health status should be crucial in order to promote healthy aging. The aim of this systematic review is to assess the feasibility of Teledentistry in communities or in a domiciliary setting where elderly people live. A structured and systematic research was performed on the major electronic databases for studies published in English until 30 June 2020: the PubMed, Cochrane Library, Web of Science, Scopus, and CINAHL databases. A total of 13 articles were identified through database searching using combinations of keywords. Out of 13 papers, eight abstracts were reviewed to assess if they were coherent with the aim of the study, and full texts were retrieved.
    [Show full text]
  • The Barriers Encountered in Telemedicine Implementation by Health Care Practitioners
    Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2015 The aB rriers Encountered in Telemedicine Implementation by Health Care Practitioners Olantunji Obikunle Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Business Commons, and the Health and Medical Administration Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Management and Technology This is to certify that the doctoral study by Olatunji Obikunle has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Kenneth Gossett, Committee Chairperson, Doctor of Business Administration Faculty Dr. Roger Mayer, Committee Member, Doctor of Business Administration Faculty Dr. Charles Needham, University Reviewer, Doctor of Business Administration Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2015 Abstract The Barriers Encountered in Telemedicine Implementation by Health Care Practitioners by Olatunji Obikunle Project Management Professional (PMP), 2001 MSc Business Systems Analysis and Design, City University, London,
    [Show full text]
  • Telerehabilitation Services
    May 2021 Toolkit Series Telerehabilitation Services This toolkit addresses the use of telehealth across the professions of Occupational Therapy (OT), Physical Therapy (PT) and Speech Language Pathology (SLP). Included are aspects of practice as it relates to Occupational Therapists, Certified Occupational Therapy Assistants, Physical Therapists, Physical Therapy Assistants, and Speech Language Pathologists. Each profession uses their professional organizations to establish telehealth guidelines and all are heavily involved in advocating for clinical integration and reimbursement of rehab services. The three professional organizations that cover these professions are: American Physical Therapy Association (APTA), American Occupational Therapy Association (AOTA), and American Speech-Language-Hearing Association (ASHA). All three organizations also participate in and guide the work of the American Telemedicine Association (ATA). The terms telehealth, telerehabilitation, telepractice, virtual, and digital are used throughout this document to represent services delivered remotely using technology. The term “telerehab/telerehabilitation” will be used going forward. While OT, PT and SLP each offer distinct rehabilitation expertise, they are typically addressed together as “rehabilitation services” in the areas of policy and reimbursement. More terms and This toolkit will address telehealth as it applies to common themes of practice for these definitions found in professions while calling out specific uses for each profession and client group served. For in-depth guidance, we direct the reader to resources from each professional Appendix A. organization, state and local licensing entity, and reimbursement sources, as payers’ reimbursement policy impacts each practice area differently. Five Foundational Concepts in Telerehabilitation These five concepts give each therapist a good foundation to begin building services delivered through telehealth.
    [Show full text]
  • Efficacy, Feasibility, Adherence, and Cost
    International Journal of Environmental Research and Public Health Study Protocol Efficacy, Feasibility, Adherence, and Cost Effectiveness of a mHealth Telerehabilitation Program in Low Risk Cardiac Patients: A Study Protocol José-Manuel Pastora-Bernal 1,* , Joaquín-Jesús Hernández-Fernández 2, María-José Estebanez-Pérez 3, Guadalupe Molina-Torres 4 , Francisco-José García-López 5 and Rocío Martín-Valero 3,* 1 Department of Physiotherapy, Faculty of Health Science, University of Granada, 18071 Granada, Spain 2 Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain; [email protected] 3 Department of Physiotherapy, Faculty of Health Science, University of Malaga, 29071 Málaga, Spain; [email protected] 4 Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; [email protected] 5 Department of Physiotherapy, University of Osuna, 41640 Seville, Spain; [email protected] * Correspondence: [email protected] (J.-M.P.-B.); [email protected] (R.M.-V.) Abstract: Individual and group cardiac rehabilitation (CR) programs reduce cardiovascular morbidity and mortality by reducing recurrent events, improving risk factors, aiding compliance with drug treatment, and improving quality of life through physical activity and education. Home-based Citation: Pastora-Bernal, J.-M.; programs are equally effective in improving exercise capacity, risk factors, mortality, and health- Hernández-Fernández, J.-J.; related quality of life outcomes compared to hospital-based intervention. Cardio-telerehabilitation Estebanez-Pérez, M.-J.; Molina-Torres, (CTR) programs are a supplement or an alternative to hospital rehabilitation programs providing G.; García-López, F.-J.; Martín-Valero, similar benefits to usual hospital and home care.
    [Show full text]
  • Interventions to Reduce Unplanned Hospital Admission:A Series of Systematic Reviews Page 3
    Interventions to reduce unplanned hospital admission: a series of systematic reviews Funded by National Institute for Health Research Research for Patient Benefit no. PB-PG-1208-18013 Sarah Purdy, University of Bristol Shantini Paranjothy, Cardiff University Alyson Huntley, University of Bristol Rebecca Thomas, Cardiff University Mala Mann, Cardiff University Dyfed Huws, Cardiff University Peter Brindle, NHS Bristol Glyn Elwyn, Cardiff University Final Report June 2012 Acknowledgements Advisory group Karen Bloor Senior research fellow, University of York Tricia Cresswell Deputy medical director of NHS North East Helen England Vice chair of the South of England Specialised Commissioning Group and chairs the Bristol Research and Development Leaders Group Martin Rowland Chair in Health Services Research, University of Cambridge Will Warin Professional Executive Committee Chair, NHS Bristol. Frank Dunstan Chair in Medical Statistics, Department of Epidemiology, Cardiff University Patient & public involvment group In association with Hildegard Dumper Public Involvement Manager at Bristol Community Health With additional support from Rosemary Simmonds Research associate University of Bristol Library support Lesley Greig and Stephanie Bradley at the Southmead Library & Information Service, Southmead Hospital, Westbury-on-Trym, Bristol and South Plaza library, NHS Bristol and Bristol Community Health, South Plaza, Marlborough Street, Bristol. Additional support David Salisbury assistance with paper screening. Funding This research was funded by the National Institute for Health Research, Research for Patient Benefit programme (grant PB-PG-1208-18013). This report presents independent research commissioned by the National Institute of Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
    [Show full text]
  • Telerehabilitation Approach for Patients with Hand Impairment
    Acta of Bioengineering and Biomechanics Original paper Vol. 18, No. 4, 2016 DOI: 10.5277/ABB-00428-2015-03 Telerehabilitation approach for patients with hand impairment ARLETA STASZUK1, BENITA WIATRAK2*, RYSZARD TADEUSIEWICZ1, EWA KARUGA-KUŹNIEWSKA3, ZBIGNIEW RYBAK4 1 Faculty of Electrical Engineering, Automatics, Computer Science and Biomedical Engineering, AGH University of Science and Technology, Kraków, Poland. 2 Department of Basic Medical Sciences, Wrocław Medical University, Poland. 3 Division of Infectious Diseases of Animals and Veterinary Administration, Department of Epizootiology and Clinic of Bird and Exotic Animals, Wrocław University of Environmental and Life Sciences, Poland. 4 Department of Experimental Surgery and Biomaterials Research, Wrocław Medical University, Poland. Purpose: Telerehabilitation is one of the newest branches of telemedicine which has been developed because patients need regular trainings outside the medical institution but still under specialist supervision. It helps maintain regularity of exercises and reduces costs. The professional and advanced systems for telerehabilitation are presented in papers, however, there is still lack of development of minor systems which provide therapeutic values and are more accessible to people. Therefore we focus on a solution for hand telerehabilitation of post- stroke patients, based solely on a personal computer and camera. Methods: We focused on the manipulative hand (fingers, metacarpus, wrist) movements trainings for patients with cerebral palsy. The contact between patient and physiotherapist is provided by using web cameras and web service. Additionally, the camera can be used to monitor the effectiveness of performed exercises. Computer vision system keeps track of the patient’s hand movement. The digital image processing is used to detect if the patient performs exercises correctly.
    [Show full text]
  • The Ethical Necessities and Principles in Telerehabilitation Telerehabilitasyonda Etik Gereklilikler Ve İlkeler
    Journal of Health Services and Education; 3(2): 35-37 ISSN: 2636-8285 DOI: 10.35333/JOHSE.2020.130 The Ethical Necessities and Principles in Telerehabilitation Telerehabilitasyonda Etik Gereklilikler ve İlkeler Fatih ÖZDEN1 , Yassine LEMBARKİ2 ÖZ INTRODUCTION Teknolojik gelişmelerin artmasıyla birlikte sağlık hizmetlerinde teknolojik uygulamaların kullanımı artmıştır. Rehabilitasyon Basic concepts and the necessity of ethical rules in kapsamında hizmetlerinde kullanılan teknolojik uygulamaların telerehabilitation başında telerehabilitasyon gelmektedir. Telerehabilitasyon uygulamalarının etik prensipler çerçevesinde uygulanması hasta Between the bloodletting techniques of the 18th century mahremiyetinin korunması adına büyük önem taşımaktadır. and now days robot-assisted surgery that allows surgeons Telerehabilitasyon etiği hususunda uluslararası standartlardaki to perform many types of complex procedures with eksiklik ve uygulanabilecek yasal hükümlerin bulunmaması, pratikte bu uygulamaların kullanımının ve etkili bir şekilde yaygınlaşmasının more precision and from hundreds of miles of distance, önündeki en büyük engellerden biridir. Maliyet, zaman ve kullanım medicine practice has advanced significantly (1). In the kolaylığı sağlayan bu uygulamaların kullanımının olumsuz sonuçlar last decade, technology and telehealth in particular, has ortaya koymasını önlemek adına etik prensiplerin net bir şekilde become increasingly used in global health service delivery ortaya koyulması ve yasalarla birlikte ele alınması gereklidir. Bu derlemede
    [Show full text]
  • Dental Informatics: Integrating Technology Into Dentistry
    Open Access Austin Dental Sciences Review Article Dental Informatics: Integrating Technology into Dentistry Marya CM, Swati S*, Nagpal R, Kataria S and Taneja P Abstract Department of Public Health Dentistry, Sudha Rustagi Advances in technology have incredibly changed our regular day to College of Dental Sciences and Research, India day lives by bringing everything within our reach. Healthcare industry has *Corresponding author: Swati Singroha, Department additionally observed major developments such as digitization of health records, of Public Health Dentistry, Sudha Rustagi College of virtual patient visits, high resolution digital imaging, etc. These advances have Dental Sciences and Research, Faridabad, Haryana, India improved the quality of dental care as well as the efficiency and predictability of procedures Health informatics is a combination of information science, Received: February 06, 2020; Accepted: March 02, computer science and cognitive science to assist in the management of 2020; Published: March 09, 2020 healthcare information. It deals with the resources, devices, and methods, which are required to improve the acquisition, storage, retrieval, and use of information in health and biomedicine. Health informatics helps doctors with their decisions and actions, and improves patient outcomes by making better use of information making more efficient the way patient data and medical knowledge is captured, processed, communicated, and applied. These challenges have become more important since the internet made access to medical information easier for patients. Keywords: “Informatics” Health Informatics; Dental Informatics; Public Health Informatics Introduction public health data collection, analysis and actions [5]. Informatics is an applied information science that designs the In collaboration with technical and public health skill set, public blue prints for the complex data systems that keep information secure, health informaticians refine data from IT applications within and usable and responsive to the user’s needs.
    [Show full text]
  • Telehealth/Telenursing for Registered Nurses 1
    Nursing Care Quality Assurance Commission PO BOX 47864 i Olympia Washington 98504-7864 Tel: 360-236-4725i Fax: 360-236-4738 Telehealth/Telenursing For Registered Nurses 1. Telephone triage and nursing consultation by telephone or other electronic technology, incorporates unique knowledge, skill and competencies. Nurses employ the full range of the nursing process to gather data, make assessments, and generate plans for care via telephone encounters with patients. 2. Protocols are appropriate tools for implementing treatment plans. A registered nurse may use a protocol that has been written and approved by a physician to initiate a standing order for a medication or treatment. Assuming an appropriate patient-prescriber relationship exists, authorized standing orders may be implemented without consulting an authorized prescriber for a particular patient. The registered nurse should implement only standing orders which include a target population, exclusions, the population served, contraindications, special considerations, a specific order, a description of who has the authority to implement the order, physician signature, and review and approval by nursing as well as other involved disciplines. 3. Practice guidelines and protocols for care should be developed based on scientific/empirical evidence and outcomes data or expert opinion. Methods for periodic review of these tools to evaluate care effectiveness and currency of information should be in place. 4. Practice guidelines should evolve through collaboration and professional consensus among all involved health care disciplines. 5. When functions of the nurse involve complex decision making, even when driven by algorithm and protocol, telenursing should be limited to the practice of registered nursing. Licensed practical nursing activities within this context may include information gathering and the provision of patient education.
    [Show full text]
  • Building Standard-Based Nursing Information Systems
    Building Standard-Based Nursing Information Systems Pan American Health Organization World Health Organization Division of Health Systems and Services Development Essential Drugs and Technology Organization and Management of Health Systems and Services Human Resource Development December 2000 PAHO Library Cataloguing in Publication Data Pan American Health Organization. Building Standard-Based Nursing Information Systems. Washington, D.C. : PAHO, © 2000. 141 p. ISBN 92 75 12364 0 I. Title. 1. INFORMATION SYSTEMS. 2. NURSING. 3. NURSING PRACTICE CLASSIFICATIONS. 4. QUALITY OF HEALTHCARE. 5. MANUALS NLM W26.55.I4.p187 2001 ISBN 92 75 12364 0 The Pan American Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. Applications and inquiries should be addressed to the Publications Program, Pan American Health Organization, Washington, D.C., which will be glad to provide the latest information on any changes made to the text, plans for new editions, and reprints and translations already available. © Pan American Health Organization, 2000 Publications of the Pan American Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the Pan American Health Organization concerning the legal status of any country, territory, city, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the Pan American Health Organization in preference to others of a similar nature that are not mentioned.
    [Show full text]