Telehealth Nursing: Tools and Strategies for Optimal Patient Care

411 Pages·2016·4.254 MB·English

by  Dawna Martich MSN RN

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TELEHEALTH NURSING
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Tools and Strategies for Optimal Patient Care
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DAWNA MARTICH, MSN, RN TELEHEALTH
A step-by-step guide to delivering safe, effective care via telehealth nursing T
Including all the information necessary for safe, competent practice, this hands-on E
NURSING
resource walks nurses through telehealth guidelines and procedures to optimize L
patient communication, perform assessments, and provide effective care of chronic
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conditions. Replete with case studies and sample dialogue to mimic real-life
telehealth situations, introductory chapters cover patient and nurse perspectives on H
both sides of the telephone. Other sections cover individual body systems, breaking
them down into individual common diseases and disorders that might intersect E
with telehealth nursing.
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Tools and Strategies for Optimal Patient Care
The text instructs nurses on how to actively listen to the patient “between the lines” L
in the absence of an in-person examination and discern the right questions to ask
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and tone to adopt. Chapters provide enhanced communication techniques for
performing comprehensive health assessments using only the sense of hearing and H
resources available through the telephone. Clinical Pearls are scattered throughout
the text from those who have been “in the trenches” and cared for a wide variety of
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patients using the telehealth nursing techniques illustrated in this book.
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Key Features:
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• Helps nurses understand the keys to successful telehealth nursing
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• Teaches enhanced, specialized communication techniques including
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“active listening”
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• Guides nurses in assessing patients using only the sense of
hearing/active listening G
• Includes case studies, algorithms, patient teaching resources, and more
• Reviews body systems and disease processes with application exercises
ISBN 978-0-8261-3232-1
DAWNA MARTICH
11 W. 42nd Street
New York, NY 10036-8002 9 780826 132321
www.springerpub.com
Telehealth Nursing
Dawna Martich, MSN, RN, received her bachelor’s and master’s degrees
in nursing from the University of Pittsburgh and has been practicing as a
nursing education specialist for adult learners for three decades. After
working in neurology, postanesthesia recovery, home care, and physician
practice management, she served as a direct telephonic nursing care provider
for an organization with a satellite office in Pittsburgh, Pennsylvania.
Shortly thereafter, Ms. Martich became one of several training managers
for a telephonic organization. Although the organization had a specific
computerized clinical documentation system, it lacked approaches to help
nurses transition from direct care to the telephonic care environment. After
orienting hundreds of telephonic nurses in Pittsburgh, Arizona, Hawaii,
Seattle, and Baltimore, it became clear that telephonic nursing care would
stay as a viable avenue in the health care industry. She structured approaches
to help nurses fine-tune their communication skills and develop an ease with
computerized documentation.
Ms. Martich’s other experience includes preparing student learning
materials and ancillary materials for nursing publications and creating
NCLEX-style practice questions for students preparing to sit for the state
board of nursing examination. She has actively participated in creating
content for online learning courses for RN–BSN, RN–MSN, and RN–DNP
programs. She also served as the director of continuing nursing education
for an online continuing education company, ensuring that learning material
adhered to the American Nurses Credential Center criteria. Her most
recent accomplishments include consulting to aid a start-up personal care
agency with policies, procedures, quality improvement, human resources,
and financial management functions. She can be reached via e-mail: dawna
[email protected].
Telehealth Nursing
Tools and Strategies for Optimal
Patient Care
Dawna Martich, MSN, RN
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Composition: diacriTech
ISBN: 978-0-8261-3232-1
e-book ISBN: 978-0-8261-3233-8
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The author and the publisher of this Work have made every effort to use sources believed to be reliable
to provide information that is accurate and compatible with the standards generally accepted at the
time of publication. Because medical science is continually advancing, our knowledge base continues
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Library of Congress Cataloging-in-Publication Data
Names: Martich, Dawna, author.
Title: Telehealth nursing : tools and strategies for optimal patient care /
Dawna Martich.
Description: New York, NY : Springer Publishing Company, LLC, [2017] |
Includes bibliographical references and index.
Identifiers: LCCN 2016047388 | ISBN 9780826132321 | ISBN 9780826132338 (e-book)
Subjects: | MESH: Telemedicine | Nursing Care
Classification: LCC R855.3 | NLM WY 100.1 | DDC 610.285—dc23 LC record available at
https://lccn.loc.gov/2016047388
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I dedicate this text to the following individuals:
● My late parents, Daniel “Dragan” and Julia Martich—my first teachers,
who taught me the value of hard work and patience, and gifted me with an
understanding of the importance of lifelong learning. You are missed every
day. I hope this text makes you proud.
● All patients and clients who are accepting of receiving telephonic nursing
care.
● All organizations embracing telephonic nursing care.
● All current and future telephonic nursing care providers.
● All health care providers who question the validity of t elephonic care.
May this text change your mind. And if it doesn’t, I tried my best to
convince you.
And last, but not least, I dedicate this text to my husband, Michael L. Egan.
Without your patience, help, quiet strength, and love, none of this would
have been written. Thank you for being my rock in the storm and voice of
reality and reason. My heart is yours.

Contents
Preface ix
Acknowledgments xiii
Share Telehealth Nursing: Tools and Strategies for Optimal Patient Care
Section I: Introduction 1
1. Evolution/History of Telenursing 3
2. Assessment Techniques: Communication and
Active Listening 13
3. Professional Preparation for Telehealth Nursing 39
4. Patient/Client Perspective on Telehealth Nursing 47
Section II: Introduction to Body Systems 67
5. Integumentary System 69
6. Respiratory System 89
7. Cardiovascular System 101
8. Gastrointestinal System 119
9. Musculoskeletal System 137
10. Neurologic and Sensory Systems 153
11. Genitourinary System 169
Section III: Introduction to Body System Disorders 183
12. Disorders of the Integumentary System 185
13. Disorders of the Respiratory System 193
14. Disorders of the Cardiovascular System 207
15. Disorders of the Gastrointestinal System 225
16. Disorders of the Musculoskeletal System 243
17. Disorders of the Neurologic and Sensory Systems 259
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viii Contents
18. Disorders of the Genitourinary System 275
19. The Patient/Client With Diabetes Mellitus 289
20. The Patient/Client With HIV/AIDS 303
Section IV: Additional Aspects of Telephonic
Patient/Client Care 311
21. Patient/Client Care 313
22. Review of Laboratory Values and Diagnostic Tests 331
23. Documentation 343
24. Tools for Telephonic Care 355
25. Work Environments 363
26. Issues and Solutions 371
27. The Nurse as Client 379
Conclusion: The Rest of the Story 389
Index 391
Preface
Once upon a time, it was a dark and stormy night, the day before
I was starting as a new telephonic nurse. I was scared to death and
had no idea what I was supposed to do or how to do it. Over time, it
became clear to me that telephonic patient/client care was and is an
outstanding avenue to help many people.
Telephonic nursing care is not for everyone. For those nurses
who want to stay in nursing but no longer want to provide direct care,
this is not the text for you. Although you might not provide “hands
on” care through this avenue, you will be providing direct care via
ongoing assessment, follow-up, teaching, and support.
This text is divided into four sections. Section I sets the stage
for providing telephonic care. First, you will read about the history
of telemedicine and how telenursing was introduced into the field.
Chapter 2 presents critical information on the techniques used to
assess clients receiving telephonic care and includes an extensive
review of communication and active listening techniques and the role
of each in providing telephonic care. Section I ends with a chapter on
what is needed to professionally prepare to become a telephonic care
provider, followed by a chapter on the client’s perspective on receiv-
ing care via this route.
Section II focuses on the individual body systems and how they
can be assessed telephonically. After a brief anatomy and physiol-
ogy review, questions used to assess the body system are provided.
Approaches to use for special client situations are listed along with
tips and techniques to enhance the assessment process. This section
is divided into the major body systems: integumentary, respiratory,
cardiovascular, gastrointestinal, musculoskeletal, neurological and
sensory, and genitourinary. Although it is unlikely that you will need
to assess every body system when assessing a telephonic client, these
chapters will serve as a resource should the situation arise.
Section III focuses on illnesses, diseases, and disorders. The
chapters in this section are also categorized according to the major
body systems and can be used in sync with the chapters in Section II.
Both Sections II and III feature algorithms to assess specific manifes-
tations, along with practice exercises and case studies. You may note
ix