Assessing the Impact of Telemedicine on ICU Nursing Care

Kleinpell, Ruth M.

Thursday, 25 July 2013: 1:15 PM

Ruth M. Kleinpell, RN, PhD, FAAN, FAANP
Rush University Medical Center and Rush University College of Nursing, Chicago, IL

Learning Objective 1: 1. The leaner will be able to discuss the results of a national survey of nurses perceptions of the use of telehealth

Learning Objective 2: 2. The learner will be able to identify nursing implications of the study results and the clinical application of telehealth technologies to nursing care

Purpose: Telemedicine in the intensive care unit (ICU) has expanded to include over 200 hospitals with up to 1000 RN’s currently practicing in tele-ICU’s and over 16,000 bedside nurses interfacing with these units. Yet limited information exists on the impact of telehealth on nursing care. Therefore, the purpose of this study was to assess nurses’ perceptions of the impact of ICU telemedicine on nursing care and to identify priority areas of tele-ICU nursing.

Methods: A descriptive survey methodology was used for this national benchmarking survey with use of an electronic survey tool (SurveyMonkey). A random sample of nurses working in the tele-ICU remote monitoring sites and in ICUs that interface with them (nurses working in ICU settings with e-ICU systems) were surveyed on their perceptions of the impact of tele-ICU on nursing care. The eICU Acceptance Survey (Kowitlawakul, 2008) was adapted to include questions assessing barriers and benefits of telemedicine implementation on nursing care and priority areas of care for nursing care.

Results: A total of 1,213 nurses responded to the survey. Majority (75% or more) indicated that tele-ICU systems offer nurses an opportunity to improve patient care and enhance the nurses’ effectiveness, improve communication and promote collaboration. A number of benefits were identified including arrhythmia detection, physiologic instability detection, vital sign trending, and enhanced patient safety. Barriers included technical difficulties including audio and visual issues, interruptions of care, and attitudes of clinical staff toward the use of telehealth.

Conclusion: The results from this national survey indicate that nurses perceive that tele-ICU systems improve patient care and benefit nursing care practices. The data can be used to develop strategies to facilitate optimal use of telehealth technology and to develop tele-ICU nursing competencies and standards of care to enhance nursing care delivery.

Acknowledgement: Funding from the American Association of Critical Care Nurses 2011 Impact Grant

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