The Healing Power of Technology: Nursing Students Spread the Word about UA College of Nursing Telehealth Research

Tuesday, December 12, 2017

In early October, four students from the Doctor of Nursing Practice (DNP) program at the University of Arizona College of Nursing presented their research posters at the third annual Telemedicine & Telehealth Service Providers Showcase in Phoenix. Hosted by the UA’s Arizona Telemedicine Program, the conference is focused on building partnerships to bring high-quality telehealth services directly into hospitals, clinics, private practices and patients’ homes.

Nearly 400 attendees browsed an array of telehealth specialty services and supporting technologies and discussed the latest trends in applications of clinical telehealth. Associate Clinical Professor, Dr. Kimberly Shea, PhD, RN, CHPN, who accompanied the students to the showcase and serves as their doctoral committee chair, said, “It’s a national convention, and people come from all over the country. It’s a great way to give students terrific experience and shine a spotlight on the impressive work that students are doing in our doctoral programs, in the field of nursing and health informatics in general and more specifically telehealth.” 

Melissa Koon, MSN, APRN, FNP-BC, NP-C, third-year Dual-Degree DNP/PhD student
Project: A Best Practice Assessment Protocol for Mobile Technology Home

Tell us about your telehealth project.

We realized that technology could enable us to see more people in the home – especially those living in rural areas – than we could in person, so we’re working on bringing telehealth to palliative and hospice patients. The goal is to use telehealth to help people avoid having to go to hospitals or clinics. Typically, if you are a patient in hospice and need access to care, generally for distressing symptoms, you contact on-call staff and it may take a nurse an hour or two to arrive at your door. Using a telehealth strategy (an iPad for example) for the initial call, a nurse can immediately see what’s going on and coach toward a start on treatment or completely treat the distress. We asked our panel of experts, the hospice staff at Casa De La Luz, to help us develop a protocol by rating the most important activities occurring during home visits. We used the information to make the iPad visit protocol closely resemble the home visit, making sure the visits are appropriately structured and make good use of a limited amount of time.

How will your project impact patient care and education?

Compared to the usual approach, we expect that this telehealth enhancement will lead to relieving symptoms in a more timely fashion. It will also avert nurse burnout by allowing nurse case managers more flexibility in time management. In the realm of education, we hope to guide future nurses in how to do assessments and physical examinations by tablet visualization versus in-person, but still convey that personal human touch that comes with a visit. We’re already using telehealth strategies for many aspects of healthcare delivery, but not yet hospice and palliative care. We need to make this a formal part of our education programs because this is the way of the future.

John Lee Conway, RN, MSN, Ed., third-year online Dual Degree Doctor of Nursing Practice student.
Project: Telemonitoring: Utilizing Persuasive Technology to Improve Client Engagement

Tell us about your telehealth project.

I have a very personal interest in this field because it was the process of telemonitoring that identified anomalies in my mom’s heartbeat and led to early cardiac surgery. She was in and out of the hospital in record time and sent home with monitoring equipment.  However, she didn’t use it all appropriately. That led me to the question: What enablers would most motivate patients to monitor themselves and regularly report accurate healthcare data to their healthcare providers? The answer, I believe, lies in persuasive technology. My intention is to study the use of computers to test what would persuade patients to provide information to their healthcare providers on a regular basis. Improved, consistent and accurate health-related communication between the patient and provider would improve health and well-being outcomes and could be implemented at a distance. 

How are you helping to build better futures with your research?

My project is meant to expand healthcare capacity for managing chronic health care issues in the home, so the growing patient population of people with chronic conditions can be managed without repeat visits to hospitals or urgent care.  By managing health care using online strategies, we’re changing the face of how patient care occurs.

(L-R) Brooke Finley and Dr. Kimberly SheaBrooke Finley, BSN, RN-BC, third-year Dual Degree Doctor of Nursing Practice/ PhD student.
Project: Opting In
: Exploring Veterans’ Satisfaction and Perceptions of Telecardiology

Tell us about your telehealth project

It started with my interest in using information technology like teleconferencing to transmit video or auditory signals between people. I was working for the VA as a cardiology research assistant while I was in nursing school and one of our cardiologists was really curious as to how patients were doing in their telemedicine clinics. So I designed this study when I was entering my PhD program to examine the satisfaction ratings of veterans using telecardiology versus those who came into the VA in person. The first part of my survey asked, ‘Would you recommend telecardiology to a friend or family member?’ and overall the veterans thought it was great: they would recommend it, they got really good care, and they could see the same provider team every time. Most of the time, they saved hundreds of miles driving.

What makes your project unique and innovative?

Telehealth has been around for a while, but there really hasn’t been a lot of superb research on it as a healthcare delivery modality. A lot of the studies do not include advanced methodology or well-controlled quantitative investigation. My intent is to design better quality studies in telehealth to provide evidence that telehealth use should be expanded. It can save a lot of money and it helps the providers have a better quality of life too, because they’re not commuting all the time. I believe that’s really a win-win for lots of people and is cost effective.

John Paulo Batucan Bautista, BSN, RN, AGACNP, third-year online Doctor of Nursing Practice student
Project: TeleICU Nurse-Directed Low Tidal Volume Ventilator Rounds

Tell us about your telehealth project.

I work for Banner’s TeleICU, whereby a central command station is linked to a number of intensive care units (ICUs) across Banner hospitals and we provide extra oversight and expertise to support the on-site staff. As part of quality assurance for patients using a mechanical ventilator to assist with breathing, we regularly examine reports of best practices for low tidal volume ventilation, which in seriously ill patients protects against the developing or worsening lung tissue injury.  When I looked at a series of quarterly reports of data across ICUs, I noticed that we were not consistently hitting the ideal benchmarks.  The use of this protective ventilation technique requires advanced knowledge of ventilator management.  My intent was to create a way using TeleICU technology to make sure every patient in every ICU gets the exact same quality of care. 

What makes this project particularly unique and innovative?

I’m using telehealth technology to remotely monitor patients in ways to help free up bedside nurses so they don’t have to worry about making sure that patients are on proper low tidal volume ventilation.