TELEHEALTH NURSING FACT SHEET

ATA Telehealth Nursing SIG

What is Telehealth Nursing?

Thefirstpublished
Telenursingarticlewasby
MaryQuinn,RNin1974.
Shedescribedworkingina
BostonHospital
telemedicineCenterand
seeingpatientsremotely
whowereatLoganAirport.

Anynursewhohasspokenwithapatientoverthephonehaspracticedtelehealthnursing;it
isnotanewrole,althoughadvancesintechnologyallownursestosee,monitor,and/or
interactremotelywithpatients/patientdevices.Telehealthnursingisdefinedastheuseof
telehealth/telemedicinetechnologytodelivernursingcareandconductnursingpractice.
Telenursing,telehealthnursing,nursingtelepracticeareinterchangeable.Telehealthnursing
isnotaspecialtyareainnursing.Nursesinallsettingswhoemploytelecommunicationsand
healthtechnologies,suchas,audio,video,ordataintegratedintotheirexistingpracticeare
providingtelehealthnursing.Combinedwithabodyofknowledgeandcompetenciesusedto
delivernursingcareoverdistancetelehealthnursesaresuccessfullycaringforpatients
remotely.

Who are Telehealth Nurses?

In2005,719telehealthnursesrespondedtoanInternationalTelenursingSurvey.*Thesurvey
reportedRegisteredNurses&AdvancedPracticeNurses,whowerefulltimeorparttime,
workastelehealthnursesinthefollowingregions:

49of50statesintheU.S.(Delawarenotrepresented)
36countriesaroundtheworld[USA(68%);Canada(10%);Australia(5%);UK(4%);
Norway(3.5%);NewZealand(1.1%);Sweden(1%);Iran(.6%);Finland(.6%);3countries
with3telehealthnurses;7countrieswith2telehealthnurses;17countrieswith1
telehealthnurse]

Theexactnumberofglobaltelenursesisunknown,however,ATAhasover500telehealth
nursemembers.OtherorganizationsthatsupporttelenursesaretheInternationalCouncilof
NursingTelenursingNetwork;InternationalSocietyforTelemedicineandeHealthTelenursing
WorkingGroup,andCanadianTelehealthForum/COACH.

WhyTelehealthNursing?
Decreasehospital
admissions&
emergency
departmentvisits
Managechronic
illness
Impactnursing
shortageby
improvingnurse
utilization
Reduce
healthcarecosts
Provideaccess
tocare

Grady,J.L,SchlachtaFairchild,L.,&Elfrink,V.(2005).Resultsofthe20042005InternationalTelenursingSurvey.Telemedicine
andeHealth,11(2),197.

Where is Telehealth Nursing Practiced?

Telehealthnursingispracticedinthehome,healthcareclinic,doctorsoffice,prisons,
hospitals,telehealthnursingcallcentersandmobileunits.Telephonetriage,remote
monitoringandhomecarearethefastestgrowingapplications.Hometelehealthnursesuse
systemsthatallowmonitoringofpatientdataandphysiologicparameters,suchas,blood
pressure,heartsounds,bloodglucose,oxygenlevels,respiratorypeakflow,andweight
measurementsviaaphoneorInternetconnection.Throughinteractivevideosystems,
patientscontactoncallnursesandarrangealivevideoconsultationtoaddressproblems;for
example,howtochangeadressing,giveaninsulininjectionortodiscussincreasingshortness
ofbreath.Telehealthnursingisalsousedbycallcentersoperatedbymanagedcare
organizations,andstaffedbyRNcasemanagerswhoconductpatienttriage,education,
counselingtoregulatepatientaccess/flowanddecreaseERuse.Telehealthnursingcanalso
involvepatienteducation,teleconsultations,conductingandcommunicatingmedical
tests/resultsconductingphysicalsexams/assessmentandcollaborationwithhealthcare
providersinimplementingmedicaltreatmentprotocolsandprovidingfollowupcare.

TelehealthNursingpractice
areasinclude:
TeleICU
Teletriage
Teletrauma
Telestroke
Telepediatrics
TelementalHealth
Telecardiology
Telehomecare
Telerehabilitation
Forensic
Telenursing,etc.

When is Telehealth Nursing used?

Telehealthnursingisemployedwhenthereisaneedtodelivernursingcareremotelyand
improveefficiencyandaccesstohealthcare.Anursecantelepresentapatienttoaremote
physician,nursepractitioner,orphysicianassistantforassessment,evaluationandtreatment
foremergentandnonemergentconsultations,routinepreandpostcareaswellasforensic
abusecases.Telehealthnursesdelivernursingcareremotely,andarealsocreators,
educators,designers,developers,implementers,andresearchersoftelehealthandehealth
services.

How does Telehealth Nursing work?

TelehealthnursingisasetofcompetenciesforanynursetoutilizeandaredefinedbytheICN.
Certificationisnotrequiredorrecommendedatthistime.Generalinformationfor
implementing,planningorconductinganytypeoftelehealthprogramcanbefoundonthe
ATAwebsite.

Licensure
Telehealthnursingmayrequireanadditionallicensuretopracticeacrossstatelines.
Innonfederalsettingtelehealthnursesmusthavearegisternurselicensethatcomplieswith
bothstateandfederalregulations.IntheUS,thenurselicensurecompact(NLC)allowsRNs
topracticeacrosscompactmembersstatelines.

Competencies
Nursesmustmeetstandardsofcareforsafe,quality,andcompetentpracticefortelehealth
nursingbypracticingwithintheANAscopeandstandardsofnursingpractice.Specific
telehealthstandardscanbefoundwiththeAmericanAcademyofAmbulatoryCareNurses
(AAACN)andAmericanNursesAssociation(ANA.)Internationaltelenursingcompetenciesare
availablefromtheInternationalCouncilofNursing(ICN),whichhasrigorouslyreviewedand
approveda39pagecompetenciesdocument.ICNcompetenciesapplytonursesintheUSA,
Canada,andover130countriesglobally.

Legal
PatientconfidentialityandHIPAArequirementsapplytotelehealthnursing.Privacypolicies
andinformedpatientconsentremainthesamefortelehealthencountersasforinperson
care.

Future
AstheUShealthcareenvironmentcontinuestoevolveduetochangesinreimbursement,
legalissues,andshrinkinghealthcareresources,theexpandingroleoftelehealthnurseswill
continuetoevolve.Leadershipandcollaborationamonginternationalnursesisneededto
outlinetheusesofehealth/telehealthtechnologiestoprovidenursingcareinan
interdisciplinarymannertopatients,regardlessofstaffing,time,orgeographicboundaries.

Contact:
AmericanTelemedicine
Association
1100ConnecticutAve,NW
Suite540
Washington,DC20036
Phone:2022233333
www.americantelemed.org

Complete References
ForcompletereferencesgototheATAwebsiteatamericantelemed.org/telehealthnursing,
scrolldowntoProductsandResources.

MoreinfoWebLinks
www.ncsbn.org/nlc.htm
www.icn.ch/telenursing_network.htm
www.isft.net/cms/index.php?telenursing
April2011