Telehealthcare and nursing refer to the utilization of information technology and telecommunications in the provision of nursing services thus delivery of healthcare to remote areas and over distances. Telehealth nursing is also known as telenursing which is a branch of telehealthcare. Telehealth is a broader reference to telemedicine which is defined as the application of medical information and data transmitted and shared electronically with an aim ensuring improved health conditions. Telehealthcare uses clinical information systems which are a computer network. These systems collect, store, manipulate and present clinical data and information which is significant for the provision of healthcare services.
Telehealth covers remote healthcare which does not necessarily include clinical services. Telemedicine and telehealth are terms that can be used interchangeably at many times. They both involve electronic sharing of pictures, video conferencing as well as the remote exchange of significant signs and other patient information. Telehealth, unlike telemedicine, also incorporates promotive, preventive, caring and healing aspects which include both the non-clinical and the clinical services for holistic use (Fong, Li & Fong, 2013).
One of our patients was diagnosed with kidney (renal) failure. This condition is characterized by a waste build-up in the blood as well as excess fluids in the body. Typically, the patient experienced breath shortness, weakness, swelling, lethargy and confusion. The inabilities of the kidney to get rid of potassium from the bloodstream can result in abnormal heartbeats and can cause eventual death. At its initial stages, the patient had observed no signs or symptoms. We explained to him that the disease could have been caused by a variety of issues and the treatments underlying this condition marks the initial steps in rectifying the kidney abnormality. While some kidney failure causatives could be curable and successfully restore the kidney to its standard functions, there are some stages at which the problem could be progressed and thus making it difficult to reverse the situation.
This condition affected the family and caregivers of the patient. One of the impacts was a stigma. This was a result of the societal perception that the patient cannot improve his health leave alone healing. The shame had caused stress among the family members taking into account the patient was their sole breadwinner. Consequently, the family suffered financial constraints. After exhausting their savings and family reserves, the family members had to look for alternative means of raising money to cater for the hospital expenses. This included soliciting money from friends and relatives as well as obtaining loans from banks. Such moves were difficult taking into the financial independence the family had been enjoying earlier.
After careful diagnosis and evaluation of the patient, hemodialysis was recommended. This is an option where the patients who require acute dialysis obtain renal replacement therapy. This method is, however, also applicable to many patients as a maintenance therapy due to its ability to offer excellent and rapid removal of solutes (Eren & Webster, 2016)..
The neurologist assigned this case was responsible for any therapeutic decisions made regarding the patient and also a range of parameters that were necessary for the dialysis treatment. He was to advise the patient on the frequency regarding the therapies to attend every week, the duration of each treatment as well as the rates of blood and dialysis solution flow. Additionally, the specialist decided on the appropriate dialyzer to be used.
One of the most captivating concerns of this case was the fact that the components of the dialysis solution could be adjusted at times regarding its potassium, sodium and bicarbonate levels. I also learnt that the larger the body size of the patient, the more dialysis would be required. Under normal conditions, the patients were subject to three to four hours of treatment, but the duration could extend up to five hours for larger patients. The therapy was held a week thrice. However, I learnt that larger patients were prescribed to attend four sessions every week, a case also applicable to patients who had problems with fluid overloads in their body systems.
Consequently, there is the launch of a new program which encompasses short daily home dialysis often conducted from home. These therapies take one and a half hours and go up to a maximum of four hours and are administered five to seven times a week. Most patients have shown great interest in this program because it is conducted from home. A substantial number of patients have demonstrated significant benefits in the nocturnal dialysis (Eren & Webster, 2016). This form of therapy typically takes eight to ten hours per night and is administered for a span of three to six night each week. In the case of our patient, we opted for intensive hemodialysis that was to be conducted at home (El-Miedany, 2017). It is notable that healthcare technological advancements possess great potential in improving the healthcare delivery quality. One of the most efficient progress is remote patient management and monitoring where the information regarding the patient such as significant signs and symptoms are observed from home monitoring tools and devices and transmitted to health centers. This has led to early and easier identification of disease worsening for patients who have diabetes or heart failure hence reduced re-hospitalization (Charness, Demiris & Krupinski, 2012).
Nurses can evaluate the access the suitability, effectiveness, and quality of a system through accessing the feedbacks given by the patients using the tool as well as their families. They can also obtain the health status of a community and determine whether there is an improvement recorded (De, 2017). The quality of the tool can be evaluated through the accuracy of the results obtained using it. The device can be rendered useful in cases where it relies on accurate information regarding the patients’ disease as well as the duration used to record the results (Serwe, Hersch & Pancheri, 2017).
One of the advanced tools used in telehealth includes Home Haemodialysis (HHD) recommended for patients suffering from final-stage renal failure. The device has been embraced due to improved patient results and outcomes as well as lower expenses incurred. Ongoing support and proper practices are ensured when patients receive dialysis at home (Suzuki, 2013). However, the tool is resource intensive, and the limited nursing resources restrict patients’ visitation over a wide geographical area. There is also a newly developed tool known as the Home Haemodialysis Remote Monitoring System (HHD-RMS). It is made up of mobile device application as well as a web portal for remotely monitoring the dialysis equipment of patients with the aim of supporting patients (Charness, Demiris & Krupinski, 2012). The preliminary results are recorded in an audit, monitoring and assessing the tool’s ability to offer sufficient data to facilitate a shift in dialysis prescriptions as well as its impacts on efficient delivery of care (Charness, Demiris & Krupinski, 2012).
Haemodialysis is an essential aspect in the medical field. This diagnosis method has been enhanced through the adoption and use of telehealthcare services. One of the telehealth tools is ‘My Home Hemo’ app which is connected to a mobile phone. It is used to monitor patients on hemodialysis remotely. Both nurses and patients need to be equipped with knowledge and know-how on using the app (Telehealth nursing practice administration and practice standards, n.d.). Nurses should learn effective communication where they can explain details to a patient. They should also be charismatic in the sense that they communicate is appealing to their patients. They should develop interpersonal skills that will help them handle patients confidently and efficiently. Nurses should learn the use of the app and the mobile devices. IT should be core, and they should be able to read and comprehend the data readings, and information relied on the app and made comprehensive and accurate conclusions and prescriptions or recommendations (Charness, Demiris & Krupinski, 2012).
Patients, on the other hand, should be trained on how to use the tools, how to set them and how to read the information or data shown by the app. They should be taught on effective communication to facilitate the proper connection between them and the providers. The tool is typically used by nurses to conduct hemodialysis on patients at home. They use mobile phones to monitor the app and observe any changes (Fitzpatrick and Ea, 2012). The device is used to read and record data such as blood pressure, body weight before and after dialysis, rates of blood flow, volumes of ultra-filtration, arterial and venous pressures as well as session times and durations. It can indicate abnormal parameters on the above data. Upon monitoring, a nurse can see any abnormal parameters thus making necessary prescriptions and recommendations to the patients. They usually reach the patients and their families through phone calls since the app is mobile connected in emergency scenarios (CLINICAL VIDEOCONFERENCING IN TELEHEALTH, 2016).
With the ever advancing technologies, our health facility has implemented the use of telehealth programs, websites, tools, and systems. This has led to improved health status in a community since diagnosis and treatment can be done at early stages of detection. It has also helped in reducing certain expenses such as travel costs to seek appropriate healthcare or costs incurred in treating already developed diseases. Doctors, clinicians, and nurses have also been impacted in the sense that they can attend to more patients at a go and within a short period. Some of them are required to study and get necessary skills in using telehealth tools and equipment.
Charness, N., Demiris, G., & Krupinski, E. (2012). Designing telehealth for an aging population. Boca Raton, Fla.: CRC Press.
CLINICAL VIDEOCONFERENCING IN TELEHEALTH. (2016). [Place of publication not identified].
De, S. (2017). Hemodialysis membranes. [Place of publication not identified]: CRC Press.
El-Miedany, Y. (2017). Telehealth and telemedicine: how the digital era is changing standard health care. Smart Homecare Technology And Telehealth, Volume 4, 43-51. http://dx.doi.org/10.2147/shtt.s116009
Eren, H., & Webster, J. (2016). The e-medicine, e-health, m-health, telemedicine, and telehealth handbook. Boca Raton, FL: CRC Press.
Fitzpatrick, J. and Ea, E. (2012). 201 careers in nursing. New York, N.Y.: Springer.
Fong, A., Li, C., & Fong, B. (2013). Telemedicine technologies. Hoboken, N.J.: Wiley.
Serwe, K., Hersch, G., & Pancheri, K. (2017). Feasibility of Using Telehealth to Deliver the “Powerful Tools for Caregivers” Program. International Journal Of Telerehabilitation, 9(1), 15-22. http://dx.doi.org/10.5195/ijt.2017.6214
Suzuki, H. (2013). Hemodialysis. Crotia: InTech.
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