NURS-FPX4040 Evidence-Based Proposal and Annotated Bibliography Paper

NURS-FPX4040 Evidence-Based Proposal and Annotated Bibliography Paper

NURS-FPX4040 Evidence-Based Proposal and Annotated Bibliography Paper

Evidence-Based Proposal and Annotated Bibliography On Technology in Nursing

Introduction

With the ongoing COVID-19 Pandemic, Telehealth visits have become increasingly popular to expand access to care, reducing disease exposure and reducing the staffing demands on offices or hospital settings. Telehealth is the use of digital information and communication technologies, such as computers and mobile devices, to access health care services remotely and manage your health care (Mayo Clinic Staff, 2020). These apps or websites allows the patient to speak to a Physician or APRN to discuss symptoms of minor illnesses and receive treatment, or serve as a standard appointment for Primary Care or specialty offices.

NURS-FPX4040 Evidence-Based Proposal and Annotated Bibliography Paper

Telehealth appointments have been adapted by a widespread of healthcare organizations and continues to drive successful patient care. For this assignment, I used Capella’s Library, Summon, to research telehealth and telemedicine services, using Peer-reviewed articles within the last 5 years. These annotated bibliographies provide insight of the successes of telehealth visits and the direct impact they have made on healthcare professionals and patients.

Annotated Bibliography (NURS-FPX4040 Evidence-Based Proposal and Annotated Bibliography Paper)

This article discusses the need and importance of telehealth services during the COVID- 19 Pandemic for patients with behavioral health and substance abuse disorders. National data concludes that 7.8% of people in the last year met criteria for a substance use disorder. Because of the increase in mental health disorders, the author states there is also an increase in overdose and suicide. Because treatments and psychosocial services were disrupted by COVID-19, it became imperative to use telehealth services to address mental health needs. Because of the pandemic, there have been many 5 major changes which have reduced barriers in using telehealth services: 1. The allowance of physicians to prescribe controlled substances without patients first coming to a clinic in person, 2. The US Department of Health and Human Services announced it will waive Health Insurance Portability and Accountability Act penalties for “good faith uses of telehealth”,

  1. Disclosure of patient identifying information applying to behavioral health could not apply in medical emergencies determined by a physician, 4. The allowance of providers to prescribe Buprenorphine (used to treat opioid disorders) without a in person visit, and
  2. Medicare covers costs for telehealth services for behavioral health. The author contributes these changes to creating effective medication and psychotherapy treatments and reducing the spread of COVID-19 as well. Patients also reported they felt their care were patient-centered, personalized and effective.

This article discusses the ways in which telemedicine and telehealth have improved access of care in rural areas. The author recognizes that there are many rural areas within the United States which have been affected by socioeconomic factors, geographic circumstances and workforce shortages which have proven to be barriers to receiving care. Telehealth services provide a broad variety of services – clinical and nonclinical often provided by Nurses or APRN’s, which include: education, help with medications and troubleshooting other health issues. Telemedicine refers to other technologies such as diagnostic testing or monitoring post-treatment, and these services are usually provided by a Physician.

Because of these services, patients in rural areas, typically those far from hospitals or clinics, are able to receive supportive care, especially during the Pandemic, and during winter months, where weather may pose a barrier to care. The author notes the widespread variety of telehealth services has also aided those who are uncomfortable with face-to-face interaction to seek care; they can stay within their own homes or communities and avoid unnecessary travel or expense. The article notes the most substantial barrier to telehealth/telemedicine helping in rural communities are the lack thereof these services. These hospitals face barriers such as startup equipment, training and maintenance costs which delay them from expanding their telehealth services.

This article capsules a study using a randomized controlled trial design to determine if telehealth visits impacted outcomes of patients with Diabetes Mellitus (type 1 and 2). The author recognizes that telehealth provides a unique opportunity for primary healthcare professionals to reach socially disadvantaged groups who have a limit on healthcare access due to location, cost or accessibility. During the COVID-19 Pandemic, more physicians were forced to embrace the use of technology and telehealth services to continue to render care, while also combatting the spread of the virus. The study deep dives into diabetes, recognizing it affects over 463 million people, and is expected to affect over 578 million by 2030.

Telehealth services have allowed providers to focus on diabetes management and prevention by having 1:1 conversations with patients at their convenience to discuss disease management, diet, exercise, medication administration, glucose monitoring and overall wellbeing. The patients involved in this study participated in monitoring of their glucose levels, HgBA1C, LDL and HDL levels, planned and unplanned hospital visits. They were monitored throughout the trial via video and telephone visits with a physician. The conclusion of the study was that telehealth interventions addressed type 1 and 2 diabetes management behaviors, had a significant effect on lowering A1C levels compared to usual care alone and patients understood long term behavioral changes for their disease management.

The COVID-19 Pandemic has created a surge of Palliative Care and hospice patients who, their preferred place of care is their own home. This article summarizes the increase in patient and family satisfaction in regard to quality and accessibility of care due to telehealth services. Typically, palliative care patients are uncertain about the urgency of their needs, who they should contact in times of need, what the response may be and what follow up will be required.

Telehealth services are mentioned to be useful for conditions that require closer monitoring, clinical assessment, preventing unwanted hospital admissions and improved quality of life in EOL situations. Patients interviewed for this study felt that the use of telehealth increased and improved their access to healthcare professionals at home and felt they had increased access to healthcare professions in case of an emergency (such as in the middle of the night). They also noted they felt like they were “being cared for at home, felt connectedness, relief, tranquility and extra security”.

Providers also noted they felt they were able to create a more trusted connection with their patients, as well as their families. The results indicate that the use of telehealth improved access to health care professionals, although patients remained at their own homes. The use of telehealth seems to support the patient’s choice of living at home for as long as possible, which is important for many patients. Patients may feel more comfortable, in control, and in a safer place at home compared with being in hospitals.

Conclusion

With advancements in technology and healthcare services, telehealth and telemedicine has proven to be an effective resource for providing healthcare services to patients. This technology has the potential to improve the quality of healthcare and make is accessible to patients in rural areas, facing comorbidities, end of life and is aiding in reducing the spread of COVID-19. Telehealth services allows providers to connect to patients, providing a variety of services ranging from primary care, to specialization, behavioral health and various other services. Patients are able to receive personalized, quality care at their best convenience, while hospitals are also able to reduce healthcare costs and admissions/readmissions. Furthermore, telehealth services continues to prove itself to be a value to the healthcare system and will allow for growth and improved accessibility and quality of care for patients.

References for NURS-FPX4040 Evidence-Based Proposal and Annotated Bibliography Paper

  • Lin L, Fernandez AC, Bonar EE. Telehealth for Substance-Using Populations in the Age of Coronavirus Disease 2019: Recommendations to Enhance Adoption. JAMA Psychiatry. 2020;77(12):1209–1210. doi:10.1001/jamapsychiatry.2020.1698.
  • Mayo Clinic Staff. (2020, May 15). Managing your health in the age of wi-fi. Mayo Clinic. Retrieved December 31, 2021, from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-20044878
  • Nelson, R. (2017). Telemedicine and Telehealth. AJN, American Journal of Nursing, 117 (6), 17- 18. doi: 10.1097/01.NAJ.0000520244.60138.1c.
  • Robson, N., & Hosseinzadeh, H. (2021). Impact of telehealth care among adults living with type 2 diabetes in primary care: A systematic review and meta-analysis of randomised controlled trials. International Journal of Environmental Research and Public Health, 18(22), 12171. doi:http://dx.doi.org/10.3390/ijerph182212171.
  • Steindal, S. A., Andréa Aparecida, G. N., Godskesen, T. E., Dihle, A., Lind, S., Winger, A., & Klarare, A. (2020). Patients’ experiences of telehealth in palliative home care: Scoping review. Journal of Medical Internet Research, 22(5) doi:http://dx.doi.org/10.2196/16218.