Telenursing in Clinical Practise and Education
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International Journal of Caring Sciences May-August 2020 Volume 13 | Issue 2| Page 781 Editorial Telenursing in Clinical Practise and Education Evanthia Asimakopoulou. RN, MSc, PhD Lecturer, Department of Nursing, School of Health Sciences, Frederick University, Nicosia, Cyprus The science of technology has offered humanity a services using new technology applications to multitude of applications, in many aspects of life, enhance care whenever a physical distance exists including social, professional and personal life. It between patient and nurse, or between any number has allowed people to communicate with each other of nurses. (WHO, 2009) Telecare is another term in an audio-visual way, even if they are in distant for providing distance care and is divided to three places. Information and communications generations. Since early 1980, technological technology (ICT) is now applied not only from applications have allowed the elderly and disabled experts but also from everyone, covered childhood people to call a call center or a family member, for to elderly adults, through high speed internet help via a portable device with personal alarm access, computers, smartphones, and tablets. The systems. This period of telecare has introduced as new technological applications have also entered the first generation telecare. A series of upgrades, the healthcare field and are increasingly used in the including the use of drop, smoke and temperature provision of care (Dorsey and Topol, 2016). sensors allowing automatic call for health care services, has brought the second generation The COVID-19 pandemic lockdown has led us to telecare. In case of an emergency, these telecare the use of some new and some already existing systems are based on infrastructure of personal systems of ICT in the field of public administration, alarm systems with additional teleconference professional business, communication, commercial, services. Nowadays, the third generation telecare is education and health care. Countries policies are occurred, which is based on new emerging ICT responsible to decrease and eliminate the spread of with the ability to identify potential user problems virus, by testing and treating patients and taking before even these occur and intervene strict measures, such as putting citizens in precautionary. Such systems use sophisticated quarantine, limiting movements or activities, monitoring methods and identifying types of lockdown schools and cancelling community- behavior developing personalized and predictive wide mass gatherings , sporting events and concerts healthcare. Other aspects of telehealth systems are (WHO, 2020). Most of us have been familiarized telecounselling, telediagnosis, and telemonitoring. with working and studying from home, via Moreover, health teleducation is defined as the electronic platforms, through email and video distance education of patients, health professionals conferencing since March 2020. Many public or health care students. Accessing a medical services, which remained closed for COVID-19 database from distance could be considered also a prevention, are now available online and most of telehealth application. The telehealth care is not the students have trained and practised to distance limited to medicine and nursing, but includes also learning methods. Although telehealth, which is other health care fields such as psychology, used as a broader concept, refers to healthy pharmacy, and radiology. These disciplines also population and bases on the access to care, lately provide care-using ICT and are accordingly has expanded to almost all health care services. called telepsychology, telepharmacy, teleradiology “Tele” is a prefix meaning “at a distance”, (Tuckson, Edmunds and Hodgkins, 2017). and when combined with a term like health, medicine, nursing, has the following meaning: the The application of ICT in health care services is a delivery and management of health care at a very promising effort to deal with problems caused distance using the ICT. Telehealth systems were by the aging population, the reduced family care developed to meet increasing needs that may have but also the reduction of the working population. more specifically forms. Telemedicine is health Therefore, the initially aim for access to care has care services from distance using ICT for exchange transformed to low cost healthcare, the use of ICT valuable information on diagnosis, treatment, for chronic diseases has expanded also to acute disease prevention, continuous training, research conditions and epidemics and telehealth systems and education, but also for upgrading society's “immigrate” from hospitals to homes and health services. Telenursing refers to nursing smartphones (Dorsey & Topol, 2020). Telehealth www.internationaljournalofcaringsciences.org International Journal of Caring Sciences May-August 2020 Volume 13 | Issue 2| Page 782 applications have been already described in for the development of e-learning in nursing, literature in case of a disaster or a public health telenursing simulation, evidence based nursing emergency, with which an organized and structured practice and nursing research. The integration of care is provided from distance (Lurie & Carr, telenursing and the principles of nursing telecare in 2018). In the time of COVID-19, these technology academic programs of study lies in the application methods have been expanded and put into practice, of distance learning methods in education and by monitoring and caring patients in hospitals and research. It is also necessary to expand the community. From the hemodynamic monitoring of documentation bases for nursing telehealth care and patients in ICUs and the use of electronic files to to develop, if necessary, a new nursing theory for both clinical nursing and the community, new the impact of nursing telehealth on the patient, technologies have become an integral part of family, community, health care system and nursing. Telenursing aims to the delivery, research protocols (Taylor et al, 2015). Therefore, management, and coordination of care, using the the expansion of telehealth into the nursing telenursing care plan and process as in the curriculum, under- and postgraduate, is required to traditional way. Nurses follow the steps of extend nursing students’ awareness and provide the assessment, nursing diagnosis, planning, dynamic development of nursing. implementation and evaluation using ICT within Considering the coronavirus pandemic as the the domain of nursing science (Taylor et al, 2015). greatest crisis in our time, it is widely accepted the Despite the nurses’ concerns about the necessity of new technology to seek and receive consequences of improvements in telehealth and reliable medical guidance and care through a the potential impact on nursing roles, the reliable telehealth system. The future challenges in and flexible technology helped to overcome the telehealth could be the technological advantage in barriers to acceptance. Through telenursing, nurses health care systems and the training of future health provide distance nursing care, by monitoring, care providers based on clinical simulation and education, follow-up, remote data collection and online courses in order to upgrade the nature of interventions, pain management, family support, care, to distance-based but still patient centered and multidisciplinary care in an innovative care. way (Bashir & Bastola, 2018). A number of References telehealth nurses act as “tele-agents”, who work in the same area with patients and participate in Bashir A, Bastola DR. (2018). Perspectives of Nurses telematics consultations with other healthcare toward Telehealth Efficacy and Quality of Health Care: professionals. The nursing staff of primary health Pilot Study. JMIR Med Inform, 6(2): e35. Dorsey ER, Topol EJ. (2020). Telemedicine 2020 and the care and especially the health centres assist the next decade. The Lancet, 395(10227):859. digital monitoring of patients. Others provide Dorsey ER, Topol EJ. (2016). State of Telehealth N Engl J distance nursing care based on technological, Med, 375:154-61. communication equipment, and take place in a Lurie N, Carr BG. (2018). The role of telehealth in the variety of settings, such as hospitals, homes or medical response to disasters. JAMA Intern Med, communities. In this way, patients who don’t need 178:745-746. Taylor J, Coates E, Brewster L, Mountain G, Wessels B & to go to the hospital, either because their symptoms Hawley MS. (2015). Examining the use of telehealth in are mild or they belong to vulnerable groups, will community nursing: identifying the factors affecting be able to communicate directly with various frontline staff acceptance and telehealth adoption. medical specialties and have a first nursing Journal of Advanced Nursing, 71(2):326-337. evaluation through audio-visual media. The role of WHO (2020). WHO announces COVID-19 outbreak a telenursing has been emerged as it makes a pandemic. Retrieved from: http://www.euro.who.int/en/health-topics/health- significant difference in providing patient care, emergencies/coronavirus-covid “flattening the curve” in COVID-19 pandemic and 19/news/news/2020/3/who-announces-covid-19- afterwards, in similar health care conditions using outbreak-a-pandemic the same technological tools. WHO (2009). Telemedicine: opportunities and developments in Member States: report on the second Telenursing care, in addition to health and safety global survey on eHealth. 2009. Retrieved from: benefits, can provide quality of life and financial https://www.who.int/goe/publications/goe_telemedicine benefits to the patient, the family and health and _2010.pdf welfare services. It creates the necessary conditions www.internationaljournalofcaringsciences.org .