CASE You are a staff nurse working in a rural critical access hospital in Winner

Question

CASE You are a staff nurse working in a rural critical access hospital in Winner South Dakota. Over the past few months you have noticed that a number of your patients have been readmitted for exacerbation of congestive heart failure (CHF). When speaking with these patients, many have voiced difficulty maintaining follow-up appointments becouse of their rural location. In this month's Rural Nurse Journal, you read about a hospital that has experienced a decrease in CHF readmissions following implementation of telehealth monitoring during the first 90 days post-discharge. Your facility does not currently use telehealth, so you bring this information to a stoff meeting that was called to address the increased rate of readmission and exacerbation. Your department creates a task force and appoints you the lead in searching the literature and making a formal recommendation regarding on whether or not make this practice change that could be costly. uestions: 1. What type of PICOT format would be most appropriate (i.e. intervention, diagnosis, etiology, etc.)? Explain your answer. (1 point) Using the format you selected, write a complete PICO(T) question you would use to begin your search. (1 point) 2.

Explanation / Answer

1.Telehealthcare involves the use of information and communication technologies to deliver healthcare at a distance and to support patient self-management through remote monitoring and personalised feedback(Mclean et. al 2013)

According to the federal Health Resources and Services Administration (HRSA) telehealth is defined as "The use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.”

So implementing TELEHEALTH will be essential.   Prognosis/Prediction PICOT question format is used as you are in a place to provide a recommendation to overcome the situation.

2. Does telehealth monitoring(I) of patients with CHF(P)in rural health facility decreases the readmission and exacerbation rate(O) during the first 90 days of post-discharge(T).

3.PubMed, NCBI, Elsevier

4.Search for telehealth monitoring , rural health facility,readmission and post discharge.

Applying remote medical diagnosis and monitoring system based on mobile health systems can help significantly to reduce health care costs, correct performance management particularly in chronic disease management. Also some challenges are in patient monitoring in general and specific aspects like threats to confidentiality and privacy, technology acceptance in general and lack of system interoperability with electronic health records and other IT tools, decrease in face to face communication between doctor and patient, sudden interruptions of telecommunication networks, and device and sensor type in specific aspect.(Safdari et al ,2014).

Scholarly articles for telehealth monitoring pubmed

Use of home telehealth monitoring with active … - McFarland - Cited by 33

Applying research evidence to optimize telehomecare - Bowles - Cited by 132

… utilization of a care coordination/home-telehealth … - Chumbler - Cited by 90

Rural health facility pubmed

The Challenges and innovative solutions to rural health dilemma- Ashok panagariya NCBI

Rural Hospital Networks: Implications for Rural Health Reform -Ira Moscovice, Ph.D., Jon Christianson, Ph.D., Judy Johnson, M.H.S.A., John Kralewski, Ph.D., and Willard Manning, Ph.D. NCBI

Telehealth monitoring and rural health facilities:

Telehealth Use in Rural Healthcare- Rural health information Hub.2017

Telehealth Use in Rural Healthcare Models and Innovations-Rural health information Hub.2018

Ref:

1.Susannah McLean, * Aziz Sheikh, Kathrin Cresswell, Ulugbek Nurmatov, Mome Mukherjee, Akiko Hemmi, andClaudia Pagliari, 2013,The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview.NCBI journal

2.Niloofar Mohammadzadeh and Reza Safdari,2014,Patient Monitoring in Mobile Health: Opportunities and Challenges,NCBI

Scholarly articles for telehealth monitoring pubmed

Use of home telehealth monitoring with active … - McFarland - Cited by 33

Applying research evidence to optimize telehomecare - Bowles - Cited by 132

… utilization of a care coordination/home-telehealth … - Chumbler - Cited by 90

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