Identifying the Educational Needs of Telenurses: What is the Role of Technologyenabled Education Sol

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Identifying the Educational Needs of Telenurses
What is the Role of Technology-enabled Education
Solutions?

• Lorraine CarterShirlene Hudyma
• Judith Horrigan
• Florence Luhanga
• Laurentian University

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Acknowledgments

• Canadian Society of Telehealth
• http//www.cst-sct.org/
• Canadian Association of University Continuing
  Education
• http//cauce-aepuc.ca/
• Telehealth organizations across Canada
• Nurses from coast to coast

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Plan

• Context and literature
• Overview of study
• Findings
• Discussion Technology-enabled education
  solutions
• Final thoughts

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Context

• What is telehealth/telemedicine?
• Two principal domains
• telephone-based
• hospital- and clinic-based (mainly
  videoconferencing)
• http//www.otn.ca/en/physicians-hcps/gp-fps/
• are other possibilities and practices emerging
• Role of nurses in telehealth in Canada
• triaging (T)
• assisting in the consult, clinical event (H/C)
• are other roles educational, administrative

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Literature

• Literature focuses principally on health
  applications and specialty projects
• Not a great deal on the role of nurses
• Even less on knowledge, skills, and attitudes
  required for competent nursing practice

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Our Study

• Demographic and descriptive data
• in the participants own words
• web-based tool with 14 topics/items
• English and French
• Recruitment through CST and other nursing
  organizations and contacts
• Winter 2009
• Four team members

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Participants

• n 138
• Ontario (36)
• Saskatchewan (22)
• Alberta (15)
• New Brunswick (15)
• Representation from all areas except the Yukon
  and NWT

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Type of facility? Primary area of responsibility?

• 8 choices
• 40.6 call centres
• 35.2 across 7 other choices
• 24.2 other
• 8 choices
• 43.7 telephone triage
• 12.6 across 7 other choices
• 43.7 other
• DIVERSITY and LANGUAGE

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Position/title?

• 12 choices
• 40.3 staff nurse
• 29.1 across 11 other choices
• 30.6 other
• DIVERSITY and LANGUAGE

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Years of experience?

• 69.8 with 20 plus years in nursing (none with
  less than 3 years)
• lt1 yr 12.9 in the tele field
• 1 2 yrs 24.1
• 3 4 yrs 23.3
• 5 9 yrs 33.6
• 10 19 yrs 6.9

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Education?

• Diploma 41.7, baccalaureate
• degree 35.4
• 38.3 reported never attending a presentation
  and/or PD session relevant to the field

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Before we move to the important stuff

• the practice of nursing through the use of
  technology over distance, with either the patient
  or the patient's consultant being at a distance
  from the nurse. Examples of technologiesare
  telephone, videoconferencing, information and
  communication devices such as blackberries, and
  various telehomecare monitoring devices.

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In their own words.

• What do you do? (think McGyver)
• clinical activity
• educational activity (patient teaching, sessions)
• administrative and operational work
• strategic planning and program development
• Are new nursing graduates adequately prepared to
  practice competently in this field?
• no and no again!!

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Nursing is a career that builds on itself. While
baccalaureate education is an important first
step, nothing but experience can build a
competent well rounded nurse.
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KSAs

• Pulled from responses to five questions
• 1. effective nurse in this field?
• 2. ineffective nurse?
• 3. what knowledgecompetent practice?
• 4. what skill?
• 5. what attitudes?

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KSAs

• Knowledge
• nursing
• technological
• Skills
• nursing
• technological
• Attitudes
• nursing
• technological

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Knowledge

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Skills
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Attitudes
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Continuing education?

• Knowledge
• specialty nursing knowledge (peds, mental health,
  suicide) (T)
• policies and protocols
• quality assurance practices
• cultural safety
• linkages within the HC system
• health informatics
• enhanced understanding of role, scope of practice
  
• Skills
• therapeutic counseling skills (T)
• teaching/explaining skills
• team skills
• time management skills
• coping with change

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Continuing education?

• Attitudes
• being non-judgmental
• being self-directed
• empowerment self and others
• sense of vision

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Stressors and limitations?

• Technology challenges
• Time restraints
• Ergonomic concerns (T)
• Lack of knowledge re outcomes (T)
• Lack of support/buy-in
• Virtual nature of exchange
• Systemic issues with tracking/connections
• No Canadian standards

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Benefits?

• Access to care for pts.
• Bridging of distances (northern, remote, rural)
• One pt. at a time
• Less physically demanding
• Constant learning
• Being part of the future of health care in Canada

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The future?

• The sky is the limit
• Telehomecare keeping people at home
• Integration of services
• Equipment more user friendly
• Increase in programs offered more specialized
  programs
• Continuity of care
• Retention of more experienced nurses

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Technology-enabled CE through universities?

• A natural choice
• number of involved nurses limited
• a chance to create provincial and national
  networks
• a way to develop technical knowledge, skill, and
  attitude
• brings attention to the field by institutions
  that are preparing nurses at the baccalaureate
  level a mutual win
• connections possible with other health
  disciplines
• research and partnership opportunities

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Technology-enabled CE through universities?

• Educationabout the available technologies to
  support patient care at a distance is the way to
  go.
• It would be nice to have some sort of
  certificate program available by distance that is
  recognized nationally specific to nurses to give
  them the basic background in health related
  technologies

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Final Thoughts

• We would love to hear from you!!
• lcarter_at_laurentian.ca
• shudyma_at_laurentian.ca
• jhorrigan_at_laurentian.ca
• fluhanga_at_laurentian.ca