Assessing the Impact of Telemedicine on Nursing Care in Intensive Care Units
Ruth Kleinpell1, Connie Barden2, Teresa Rincon2
1Ruth Kleinpell is director of the Center for Clinical Research, Rush University Medical Center, Chicago, Illinois, and a professor at Rush University College of Nursing, Chicago, Illinois. Connie Barden is currently the chief clinical officer of the American Association of Critical-Care Nurses, Aliso Viejo, California. During the study period, she was the clinical nurse specialist of the tele-intensive care unit at Baptist Health South Florida, Miami, Florida. Teresa Rincon is currently the operations director of the tele-intensive care unit, UMass Memorial Medical Center, Worcester, Massachusetts. During the study period she was director of nursing at Sutter Health, Sacramento, California. Mary McCarthy is director, Clinical Quality Value Analysis, Eastern Maine Healthcare Systems, Bangor, Maine. Rebecca J. Zapatochny Rufo is the, operations director of the tele-intensive care unit program at Resurrection Health Care, Chicago, Illinois. ruth_m_kleinpell@rush.edu.
Background:
Information on the impact of tele-intensive care on nursing and priority areas of nursing care is limited.
Objectives:
To conduct a national benchmarking survey of nurses working in intensive care telemedicine facilities in the United States.
Methods:
In a 2-phased study, an online survey was used to assess nurses' perceptions of intensive care telemedicine, and a modified 2-round Delphi study was used to identify priority areas of nursing.
Results:
In phase 1, most of the 1213 respondents agreed to strongly agreed that using tele-intensive care enables them to accomplish tasks more quickly (63%), improves collaboration (65.9%), improves job performance (63.6%) and communication (60.4%), is useful in nursing assessments (60%), and improves care by providing more time for patient care (45.6%). Benefits of tele-intensive care included ability to detect trends in vital signs, detect unstable physiological status, provide medical management, and enhance patient safety. Barriers included technical problems (audio and video), interruptions in care, perceptions of telemedicine as an interference, and attitudes of staff. In phase 2, 60 nurses ranked 15 priority areas of care, including critical thinking skills, intensive care experience, skillful communication, mutual respect, and management of emergency patient care.
Conclusions:
The findings can be used to further inform the development of competencies for tele-intensive care nursing, match the tele-intensive care nursing practice guidelines of the American Association of Critical-Care Nurses, and highlight concepts related to the association's standards for establishing and sustaining healthy work environments.
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