Presentation
Preparing RNs for Interprofessional Telehealth
Emswiller Interprofessional Symposium
(2022)
Abstract
Background:
In response to COVID-19, supplemental funding was provided to an ongoing HRSA grant to meet the program goal to prepare registered nurses (RNs) to implement the enhanced primary care RN role via telehealth to respond to patients’ needs to access primary care.
Methods/Process/Activity:
A needs assessment survey for PIONEER clinical partners revealed that only two of five clinical partners were using RNs to provide telehealth, and at best, telehealth training was provided “on the job.” Partners requested training, equipment for remote patient monitoring and management, and access to translation services. To meet the goal of preparing RNs to implement enhanced interprofessional primary care, our team developed site-specific telehealth in-service education. Due to COVID-19, these could not be delivered in person; thus, an innovative online telehealth curriculum based on national telehealth nursing standards was developed and launched. Additionally, a novel telehealth simulation activity from SentinelU was embedded into the curriculum. Our team provided headsets and telehealth carts to facilitate virtual encounters with patients as well as HIPAA-compliant telehealth peripheral equipment and training.
Results/Learning Outcomes:
The online telehealth curriculum was launched in September, 2020. A total of 18 RNs in the clinical partner sites accessed the curriculum. A total of 6 RNs and one Advanced Practice Registered Nurse completed the first two required modules and received badges and CEU’s.
Novel telehealth peripherals were deployed across the clinical partners based on each clinics’ identified needs. These included bluetooth cardiac monitors, BP cuffs, glucometers, otoscopes and stethoscopes. In general, resistance from team members (providers, RN’s, and administrators) and extensive training of the technologies were significant barriers to implementing sustainable practice changes. Ultimately, offering digital scales and automated BP monitors for patients to take home offered more immediate assistance to our partners and we deployed 40 digital scales and 50 BP monitors for hypertension and heart failure management.
To assist in providing linguistically appropriate services, each clinical partner was offered limited use of medical translation services. Two of our clinical partner sites used CyraCom and one site hired bilingual staff including one administrator and one RN.
At the completion of the project, all five clinical partners were successfully offering telehealth and a total of 1706 independent telehealth nursing visits were conducted between November 1, 2020 and April 30, 2021.
Discussion/Implications/Lessons Learned:
In response to the COVID-19 pandemic, clinic-specific training and coaching were provided to all our partners via an online platform. However, despite proactively transitioning planned in person telehealth education to self-paced online learning, the impact of COVID-19 on
partner sites significantly reduced the capacity for RNs to complete the course or institute the more complex telehealth equipment, particularly the StethIO and Qardio BP cuff. Set up and training on these devices was significantly labor- intensive, despite the increase in effort of our IT specialist as well as support from the companies, full implementation could not be accomplished given the demands of COVID-19 during the grant period. Further, we did not anticipate the amount of resistance from physician providers at most of our clinical partner sites. The reasons for this are not entirely clear but included concerns about RNs using the telehealth equipment, e.g., when using the AnyKit to visualize the tympanic membrane, the eardrum might be damaged. Despite these experiences, a key lesson learned was that with education and support, RNs productively expanded their roles in alignment with telehealth nursing standards in each of the clinical practice settings.
Keywords
- nursing,
- nursing education,
- telehealth,
- primary care
Disciplines
Publication Date
Winter February 5, 2022
Location
Richmond, VA
Citation Information
Hallel Basco, Tamara Zurakowski, Dawn Goldstein, Pamela Biernacki, et al.. "Preparing RNs for Interprofessional Telehealth" Emswiller Interprofessional Symposium (2022) Available at: http://works.bepress.com/tamara-zurakowski/5/