Nurses are educationally and professionally prepared to provide a wide array of skills and services across the healthcare continuum. The nursing workforce is now the largest contingency in the United States workforce with 3.6 million RNs, including 208,000 APNs who are board-certified to deliver primary care and specialty services with a similar scope of practice as primary care physicians.
There is an unending need for nurses and other healthcare professionals to ensure the timely and appropriate use of telehealth services and to guarantee Americans receive the care they need. Collaborative practice is key to building strong healthcare teams; improving telehealth services and patient experience; and creating efficiencies of healthcare delivery.
Nurses are often the only consistent frontline provider in communities, critically positioning them to support all telehealth services, with the greatest impact on patient care. As clinicians, educators, patient advocates, researchers, and transformational leaders, nurses need to practice to the full extent of their license and scope of practice to derive their full professional potential. In many states, continued reform is needed in order for nurses to have the opportunity to practice at the top of their license while developing and delivering telehealth services. This reform includes consideration of reimbursement for nursing services. It is important for nurses to advocate for critical legislation such as the Nurse Compact Licensure, which allows nurses to have a multi-state license.
Healthcare is being confronted with responding to how to address the growing need for providing health care in rural and underserved areas. APNs are being challenged to meet this demand using telehealth technologies. A study conducted in 2010 by Schlachta-Fairchild indicated that APNs have taken a leadership role in providing healthcare to rural communities. They are uniquely qualified clinicians who are already providing cost-effective, accessible, patient-centered care to underserved populations.
APNs are being used to fill physician shortages at the originating site within acute and critical care settings as well as provide services from remote locations. APNs can utilize store-and-forward tools (a transmission method used to store messages, videos, and images to store and send later) to obtain expert advice in wound management, dermatology, and teleophthalmology. A broad range of mental health services can be provided through video visits and store-and-forward of images and video, allowing APNs to interact with experts to ensure patients receive timely treatment. Other services, such as telestroke and other acute telehealth neurology services have been used for more than a decade.
Tele-ICU is another avenue for APNS where they can be at the originating or distant site to assist in the management of critically ill patients. At the UMass Memorial Health Care, APNs and PAs work collaboratively with nursing and physician providers to ensure critically injured patients receive evidence-based care. At Emory Healthcare, they realized a reduction in average spending per episode costs after implementing the Tele-ICU program, which involved using APNs at originating sites.
Authored by Cindy Ebner, MSN, RN, CPHRM, FASHRM and Colleen Harris Marzilli, PhD, DNP, MBA, RN-BC, CCM, PHNA-BC, NEA-BC, FNAP
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