This paper examines telenursing as a specialized area of telehealth, assessing its advantages and disadvantages for patients while exploring the legal and ethical principles that govern nursing practice in a remote-care setting. Topics covered include patient privacy and HIPAA compliance, the role of nurse-patient dialogue in care quality, the impact of telenursing on patient satisfaction and hospitalization rates, and ethical obligations such as transparency and accountability. Drawing on peer-reviewed research, the paper argues that telenursing's benefits — including reduced hospitalizations, improved comfort, and enhanced care coordination — outweigh its challenges when supported by appropriate organizational frameworks and nurse training.
Fifty years ago, the kind of technology depicted in science-fiction films may have seemed like an unattainable fantasy. Today, it is a reality. Advancements in technology across every sector of life have given human beings more communicative power than ever before: information can be conveyed digitally and electronically faster than the blink of an eye. This technology is now being instituted in the healthcare industry in the form of telehealth. Telehealth is a form of medicine that utilizes telecommunications technologies and electronic storage to make long-distance clinical care a real and effective practice in today's world (Hebda, 2013). This paper provides an assessment of one area of telehealth — telenursing — and includes a discussion of the advantages and disadvantages for the patient, as well as the legal and ethical principles that govern the nurse practicing in this setting.
One of the biggest concerns surrounding telenursing is privacy: with a monitor that shows the activities of a patient in a private setting, questions arise about what information is conveyed and to whom. Fortunately, HIPAA laws are in place to protect client privacy. Personnel using telenursing technology are required to sign in and access information using access codes, just as they would with any other form of clinical information. The privacy of the patient is to be respected exactly as it would be were the patient in a hospital receiving care. The advantage of telenursing is that it provides the same level of monitoring and care while allowing the patient to remain in his or her own private residence (Hebda, 2013). Still, the newness of the technology and concerns about privacy that accompany electronic information conveyance — especially in today's environment where cyberattacks are increasingly common — could be perceived as a disadvantage to the utilization of telenursing.
Another disadvantage is that malpractice claims could be initiated if telenursing operatives are not supported by a strong organizational environment (Roing & Holmstrom, 2015). Additionally, as Roing, Rosenqvist, and Holmstrom (2013) indicate, because the "main sources of information" in telenursing are the nurses' "dialogues with the callers, the provision of safe care can depend on the quality of this dialogue" (p. 969). If operatives are not skilled in maintaining a successful dialogue with patients, optimal care could be compromised — and this represents another significant disadvantage.
However, with the right training and organizational support in place, telenursing's advantages could far outweigh these perceived disadvantages. A higher degree of patient satisfaction has been shown to be one of the impacts of telenursing, because patients can be more comfortable in surroundings that are less intrusive (Odeh, 2014). Patients are also more likely to communicate openly with telenursing operatives, as they view this as a direct link to care and recognize their own proactive role in the provision of that care. In terms of interoperability, telenursing also benefits the healthcare industry by promoting greater teamwork and a positive organizational culture that integrates communication with care in a manner consistent with 21st-century technological standards.
Telenursing can also be valuable as a follow-up application, as Ramelet et al. (2014) indicate. Their study on how children with rheumatic diseases were supported via telenursing follow-up calls showed that patient satisfaction was high, thanks to the efforts of specialist nurses who connected with patients after discharge and provided adequate information and support regarding consultations, treatment options, and advice.
Perhaps one of the greatest advantages of telenursing is its ability to reduce the number of hospitalizations that patients would otherwise undergo. The study by Kamei et al. (2013) showed that "the effects of telehome monitoring-based telenursing on health outcomes and use of healthcare services" were "decreased hospitalization rates, emergency department visits, exacerbations, mean number of hospitalizations, and mean duration of bed days of care" among patients with chronic obstructive pulmonary disease (p. 180). If telenursing can reduce the number of patients occupying beds in hospitals, it can free up space for those who need more immediate care and reduce waiting times. Telenursing, in other words, could streamline healthcare services and make treatment more effective on a one-on-one basis. Furthermore, as this study demonstrates, telenursing clearly provides the requisite level of monitoring and assessment that in-house treatment offers.
"Outlines transparency, accountability, and reporting standards"
"Author connects telenursing benefits to personal practice"
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