Free Essay. Topic and Its Importance to Nursing/Healthcare Practice

Since the beginning of the year 2020, the world has been battling the novel COVID-19 pandemic. Despite massive attention, investment, and dedication from multi-sectoral and international entities towards combating the pandemic, the crisis has recorded considerable infections and mortalities (Ohannessian et al., 2020). Some of the main practices that have been advocated for in reducing the transmission of the coronavirus is self-isolation, quarantine, and keeping social distance. However, the conventional health care delivery model relies on patient and health care provider meeting face-to-face, a scenario complicated by quarantine or social distancing (Lin et al., 2020). Amid the crisis, telehealth also referred to as telemedicine or telenursing has emerged as a potential model to maintain continuity of care while preventing coronavirus transmission. However, the model is not well established, known, adopted, or accepted by patients and health professionals, among them nurse (Chauhan et al., 2020). There are issues of infrastructure, how to charge for services, how to conduct a valid and informative patient assessment, and reimbursement from insurance companies (Gong et al., 2020). Despite the challenges, there are notable cases where patients have received care through telehealth models.

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In this respect, it is essential to assess nurses the effectiveness of telehealth model in delivering quality patient care during the COVID-19 pandemic (Anthony 2020). In search, it would be essential to understand patients’ perspectives, professionals’ opinions, and evidence from reputable published data from past research. In a time when movement and social gatherings are limited, patients would like to have a platform to continue accessing healthcare services. Professionals would also prefer a model that reduces the risk for comorbidity or further infections to their patients of the staffs while evidence from the literature is not conclusive (Gong et al., 2020; Vidal-Alaball et al., 2020). A systematic review by Asiri and Househ (2016) acknowledged the role of telenursing as an emerging trend in the health industry.

Searchable Clinical Question

One of the best formats of organizing a topic into searchable clinical question is using the PICOT structure, which stands for population/patient/problem, intervention implemented, comparison intervention, and outcomes. The population, which is the sample targeted for observation or the problem being investigated, for the targeted study will be the nurses, who are critical stakeholders in ensuring telehealth is a success in health care delivery. The intervention, which is the tested treatment implemented will involve the use of telehealth platforms used in delivering care to patients during COVID-19 pandemic period. The comparison is the conventional health care delivery approach often characterized by face-to-face inpatient or outpatient healthcare service delivery. The outcome or the targeted results involves the effectiveness in terms of delivering quality care, reducing virus transmission, and meeting patients’ needs. The time frame is the duration of interest for the study. Therefore, the complete searchable clinical question reads;

“For nurses treating patients during COVID-19 pandemic, how effective is telehealth in optimizing delivery of quality health care services compared to conventional healthcare delivery model during the past nine months of the pandemic.”

P – Nurses

I – Telehealth healthcare delivery

C – Conventional health care delivery

O – Quality of care (patient satisfaction, reducing COVID-19 transmission, patient recovery, and manageable cost of care)

T – The last nine months that the world has been experiencing COVID-19 pandemic

Search Criteria

In searching the evidence, two databases – PubMed and ScienceDirect, were selected based on their wide volume of health-related articles. The keywords/terms such as Covid-19, telehealth, telemedicine, telenursing, effectiveness/improved care/quality and reducing transmission combined with Booleans operators (OR and AND) were fed to the databases. The most used combination of the terms was “telehealth OR telemedicine OR telenursing AND COVID-19 AND improved OR effectiveness AND patients Care OR patients outcome. For purposes of narrowing down the search and increasing precision to relevant articles, filters such as an article published 2020, published in English, randomized clinical trials, systematic reviews, meta-analysis, and full articles were applied. The filter ensured that book reviews, editorial posts, and website pages were exempted from the results. A snip of the search history is as shown in Appendices I and II for both databases. After the filtering, the resulting articles were then perused to identify those that are more relevant to the proposed research topic.

Search Results and Response to the Topic

A systematic review involving 45 articles (12 of which were randomized control trials) conducted by Novara et al. (2020) focused on assessing the usefulness of telehealth during and after COVID-19 pandemic. The evidence analyzed supported managing urological conditions including uncomplicated urinary tract infections, pelvic muscle training, urinary incontinence, hematuria, and urinary stones among others. Telehealth was pivotal in reaching out to patients with urological conditions ensuring continuity of care and reducing the risk of COVID-19 transmission. Also, beyond COVID-19 pandemic, telehealth has considerable potential for being scaled up. However, there was no clear link between success and the nurses’ contribution.

In their study, Kim et al. (2020) conducted a retrospective review of the medical record for 1742 patients who received health care through Korean Medicine telemedicine centre. All the patients included in the study were COVID-19 patients. The indicators outcomes targeted in the study included understanding the demographic characteristics of patients, the frequency of treatment, and patients’ response to the quality of care they received. The study results indicated that on average, 15 doctors managed to attend to 192 patients in 24 hours. The rate was a remarkable improvement in reducing the backlog and ensuring the rapid increase in patients’ number was addressed effectively and efficiently. Patients’ remarks indicated satisfaction, especially with continuity of care even following residence transitions.

Using data from 188 individuals enrolled in a telemedicine system, Xu et al. (2020) demonstrated that telehealth can offer an essential platform for managing patients with or without COVID-19, and reduce the need for hospitalization. The 74 patients from the 188 individuals were COVID-19 positive and went on to record full recovery while receiving care through telehealth system. Telehealth was crucial in reducing the cost of hospitalization, reduced risks of delayed hospitalization, alleviate staff shortage, and prevent cross-infections. The nurses were essential players in the multidisciplinary team utilizing the telehealth model in managing these patients.

Huang et al. (2020) used data from two cases with COVID-19 to assess the effectiveness of telehealth (online management). The two cases comprise one mild case and one severe case of COVID-19. Using a multidisciplinary team, the two cases received necessary health care services online, emerging as essential in making frequent and timely follow-ups, improving regime compliance, increasing confidence in the recovery, and empowering patient participation. The cases findings assert the place of telehealth in healthcare delivery, especially amid the heightened measure of practising social distancing and quarantine.

Conclusion

In summary, the role of nurses in patient care cannot be undermined or underrated. Amid the COVID-19 pandemic that is sending shrills and fears of infection to patients and health professionals alike, telehealth can play a significant role in reducing cross-infection, cutting on the cost of care, addressing the issue of staff shortage, and improving positive patient participation on matter health. However, this is not without challenges such as infrastructure to reach all patients, reimbursement policies, and charging terms for care delivered. Be that as it may, and considering COVID-19 has been a challenge to world health systems, telehealth has fundamental roles in revitalizing the modern healthcare systems.

References

Ackley, B. J., Swan, B. A., Ladwig, G., & Tucker, S. (2008). Evidence-based Nursing Care Guidelines: Medical-surgical Interventions. (p. 7). St. Louis, MO: Mosby Elsevier.

Anthony, B. (2020). “Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic.” Journal of Medical Systems, vol. 44, no. 132, pp. 1 - 9 HYPERLINK "https://doi.org/10.1007/s10916-020-01596-5" https://doi.org/10.1007/s10916-020-01596-5

Asiri, H., & Househ, M. (2016). “The Impact of Telenursing on Nursing Practice and Education: A Systematic Literature Review. “ Studies in Health Technology and Informatics, vol. 226, pp. 105–108. https://pubmed.ncbi.nlm.nih.gov/27350478/

Chauhan, V., Galwankar, S., Arquilla, B., Garg, M., Somma, S. D., El-Menyar, A., Krishnan, V., Gerber, J., Holland, R., & Stawicki, S. P. (2020). “Novel Coronavirus (COVID-19): Leveraging Telemedicine to Optimize Care While Minimizing Exposures and Viral Transmission.” Journal of Emergencies, Trauma, and Shock, vol. 13, no. 1, pp. 20–24. https://doi.org/10.4103/JETS.JETS_32_20

Gong, K., Xu, Z., Cai, Z., Chen, Y., and Wang, Z. (2020). “Internet Hospitals Help Prevent and Control the Epidemic of COVID-19 in China: Multicenter User Profiling Study.” Journal of Medical Internet Research., vol. 22, no. 4, pp.:e18908. https://doi.org/10.2196/18908

Hong, Y. R., Lawrence, J., Williams Jr, D., & Mainous, A. (2020). “Population-level Interest and Telehealth Capacity of US Hospitals in Response to COVID-19: Cross-Sectional Analysis of Google Search and National Hospital Survey Data.” JMIR Public Health and Surveillance, vol. 6, no. 2, pp. e18961. https://doi.org/10.2196/18961

Huang, S. et al. (2020). “Implications for Online Management: Two Cases with COVID-19.” Telemedicine and e-Health, vol. 26, no. 4, pp. 487 – 494. https://doi.org/10.1089/tmj.2020.0066

Kim, D.S. et al. (2020). “Telemedicine Center of Korean Medicine for Treating Patients with COVID-19: A Retrospective Analysis.” Integrative Medicine Research, vol. 9, no.3, pp. 1 – 5. https://doi.org/10.1016/j.imr.2020.100492