Telehealth in Rural Nursing: Embracing Change for Better Patient Outcomes

rural road Photo by Bradyn Shock on Unsplash

When I first heard of telehealth services coming to our rural hospital, no one was a bigger skeptic than I was.

Perhaps the main reason was the way I was educated as a nurse and how I learned to practice as an APRN. Honestly, I am “old school” in every way possible. My first thought was, “This is not good practice; how could it be? Won’t there be shortcuts? How about the lack of a physical exam? How can you properly physically evaluate someone over telehealth? How can you take safe care of patients and avoid missing something that’s potentially life-threatening if you can’t touch them? How could someone a thousand miles away help me way up in the mountains of the Eastern Panhandle? What could they know about the community here and their needs?”

These were just a few of the questions and concerns I had regarding telehealth coming to our rural community access hospital. When we assess our patients, we not only to listen to their heart and lungs, look into their eyes, hear their voice, feel the temperature of their skin, but we connect. We are building trust and ensuring support with looking, listening, and […]

2023-10-03T10:04:41-04:00August 25th, 2023|digital health, Nursing, nursing roles, patient experience, Patients|5 Comments
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QR Codes for Rapid Responses: Improved Clinical Operations and DEI Insight

Improving data collection of RRTs for quality improvement

The method we use to track rapid response team (RRT) data has evolved on our health campus at Mount Sinai Queens. Just a few years ago we were using paper logs; now we use electronic logs accessed by a QR code. The goal initially has been to become paperless and collect data to analyze our rapid responses for clinical insight. The greater data collection with the QR code process has in turn allowed for analysis, including a closer examination of diversity, equity, and inclusion (DEI) variables. 

About our rapid response team

Our RRT consists of the ICU charge nurse, ICU attending, respiratory therapist, and the nurse manager or the evening/night nursing administrator. They are called upon when there is a significant change in a patient’s condition that requires critical care expertise at the bedside. After hearing the overhead call for a rapid response, the responding ICU RN scans the RRT QR code using a smart phone. The QR code is displayed within the ICU nurses station for easy access. Depending on the type of rapid response, the responding RN can enter data into the RRT electronic log as care progresses and/or at the conclusion of the response.

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2023-06-14T17:12:55-04:00June 14th, 2023|equity, Nursing, Quality improvement, Technology|0 Comments
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Black Boxes in the Operating Room: Improving Quality of Care and Patient Safety

What’s covered in this post?

  • Black boxes record video, audio, and data from multiple sources in the operating room (OR), such as cameras, microphones, patient monitoring equipment, and medical devices.
  • By offering transparency on the multiple simultaneous processes in the OR, black box data can be used to improve safety and efficiency, train staff, and onboard new nurses.
  • The data can be used for retrospective analysis of specific events or aggregate analysis to detect patterns and variations in practice over time.
  • Black box data has been used to improve and standardize OR processes such as handling tissue samples, handoff communication during shift changes, and pre-surgical patient positioning.
  • The data is de-identified and is normally deleted within 30 days.
  • Finding what went right and learning from it is the goal, not pointing fingers.

Figures in the OR as recorded and de-identified by an OR Black Box. Image courtesy Surgical Safety Technologies.

Rebecca McKenzie, DNP, MBA, MSN, RN, assistant vice president of perioperative services at Duke University Hospital, recently spoke with AJN about her hospital’s use of black boxes in operating rooms (ORs) to standardize key processes to improve safety and efficiency, train […]

2023-05-26T15:01:50-04:00May 5th, 2023|Nursing, patient safety, Quality improvement, Technology|1 Comment
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40-years of Forensic Nursing and Current Opportunities in Remote Sexual Assault Care

Remembering an influential article.

Patricia Speck

Timing is everything. Forensic nursing service through telehealth is possible today, as reported in a recent Kaiser Health News story, but it wasn’t always that way. Fifty years ago, Ann W. Burgess, a psychiatric–mental health nurse working in the emergency room, wrote a paper with a sociologist colleague about what she was seeing in patients who complained of being raped. “The Rape Victim in the Emergency Ward” (pdf), published in AJN, was reported nationally and informed 1970s kitchen table conversations about what rape is, is not, and when “no means no.”

Naming the trauma and its effects.

The ideas in this article were new at the time. Burgess wrote that sexual assault causes acute emotional trauma, requiring time for recovery, and she named phases of what she eventually called “rape trauma syndrome.” Prior to the article, victims of sexual assault often did not report the assault, and when they did they waited hours for a newly minted physician intern who had been punished with “rape-duty.” These physicians had no knowledge about what to do.

In accordance with societal views at the time, victims were often blamed for their rape—the way you dress, how you act, […]

2023-02-17T10:40:20-05:00February 17th, 2023|digital health, nursing roles, patient experience, Public health|2 Comments
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Over-the-Counter Hearing Aids: A Panacea?

The U.S. Food & Drug Administration (FDA) recently approved the sale of over-the-counter (OTC) hearing aids for people with mild to moderate hearing loss (not severe hearing loss), beginning Oct. 17, 2022. What should nurses know about these devices?

Margaret Wallhagen

Hearing loss is one of the most common chronic conditions, becomes increasingly prevalent across the life span, and is far from benign. This latter fact is often not appreciated, but hearing loss is associated with a range of negative psychosocial concerns such as isolation and depression, as well as many health-related conditions, including falls, delirium, and cognitive decline.

For a long time, I’ve been passionate about raising awareness about hearing loss and its impact on people, their families, society, and the health care they receive, as well as promoting hearing health care access. One intervention that can mitigate some of the impact of hearing loss is the use of hearing aids. The focus of this brief blog post is on a new opportunity for people to access this technology that those of us in health care should be aware of.

Cost as a barrier to use of hearing aids.

Prescription hearing aids, while far from perfect, can help, and usually do make hearing less […]

2022-12-05T17:33:55-05:00December 5th, 2022|health care policy, Nursing, Patients, Public health, Technology|2 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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