Telehealth is a major strategy to address the shrinking healthcare professional population. However, most nurses are not trained or are inadequately trained to use these technologies effectively. When nurses were surveyed, they identified the main barriers to gaining knowledge and skill in telehealth to be the lack of training and education, lack of time, lack of guidance, and insufficient access to appropriate technology.
Many graduate nursing programs in the U.S. offer basic education on telehealth during their clinical orientation or nurse residency program. Some medical schools are also including nurse practitioners in training for telehealth. However, it is just starting to permeate into baccalaureate-level nursing programs with the ambulatory scope and standards of care.
A study conducted in the Netherlands in 2015 by Houwelingen et al., convened a panel of experts to better understand nursing telehealth entrustable professional activities (NT-EPAs) and the required competencies which could contribute to the development of nursing telehealth education. They identified 14 NT-EPAs that required additional subject-specific competencies, such as the ability to put patients at ease when they feel insecure about using technology.
|Nursing telehealth entrustable professional activities (NT-EPAs)|
|1||Supporting patients in the use of technology|
|2||Training patients in the use of technology as a way to strengthen their social network|
|3||Providing health promotion remotely|
|4||Triaging incoming calls and alarms|
|5||Analyzing and interpreting incoming data derived from (automatic) devices for self-measurement|
|6||Monitoring body functions and lifestyle|
|7||Providing psychosocial support|
|8||Encouraging patients to undertake health promotion activities|
|9||Instructing patients and family caregivers in self-care|
|10||Assessing patient capacity to use telehealth|
|11||Evaluating and adjusting the patient care plan|
|12||Coordination of care with the use of telehealth technology|
|13||Independent double-check of high-risk medication|
|14||Guidance and peer consultation|
EPAs are different then competencies.
Authored by Cindy Ebner, MSN, RN, CPHRM, FASHRM and Colleen Harris Marzilli, PhD, DNP, MBA, RN-BC, CCM, PHNA-BC, NEA-BC, FNAP