Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this article focuses on topics including 1) defining telehealth, 2) telehealth etiquette, 3) interprofessional collaboration, 4) regulations, 5) reimbursement, 6) security/Health Insurance Portability and Accountability Act (HIPAA), 7) ethical practice in telehealth, and 8) satisfaction of patients and providers. A multimodal approach based on a review of the literature is presented for providing the training: 1) didactics, 2) simulations including standardized patient encounters, 3) practice immersions, and 4) telehealth projects. Studies found that training using the multimodal approach allowed the students to develop comfort, knowledge, and skills needed to embrace the utilization of telehealth in health care.
An Interprofessional Virtual Healthcare Neighborhood (VHN) was designed to deliver information, peer support, and professional guidance to caregivers of individuals with dementia. The VHN was also enhanced with an actigraphy band to monitor caregivers' sleep. The study sample comprised two groups (N = 28): caregivers participating in the VHN and those receiving usual care. Measures of sleep quality and quantity, using an actigraphy band; general self-efficacy, using the General Self-Efficacy Scale; and insomnia, using the Insomnia Severity Index, were measured pre- and postintervention for the intervention and comparison groups. Neither group reported significant changes in sleep quality or quantity over time. Insomnia severity decreased for both groups. Self-efficacy became worse for the comparison group, yet remained virtually unchanged for the intervention group. Overall, the current study also showed an effective use of technology to reach homebound caregivers of older adults with dementia. [Journal of Gerontological Nursing, 42(11), 39-47.].
It is estimated there are between 43.5 and 65.7 million caregivers in the United States who provide unpaid care for older adults. Although the number of informal caregivers is expected to continue to increase, few programs have been established in home healthcare agencies to support these caregivers. This article describes a project that used a unique Web site to connect caregivers of people with dementia in a geographic region with an interprofessional group of healthcare providers and caregiver peers. Virtual Healthcare Neighborhood (VHN) was developed and maintained by an interprofessional group of healthcare providers from nursing, physical therapy, clinical counseling, and dental hygiene. The VHN provided weekly information on topics relevant to caring for a loved one with dementia at home as well as Question and Answer and Social Support Blogging sections for use by participants. This project was viewed as a positive and helpful method to provide support for caregivers of homebound older adults that could be easily replicated by home healthcare agencies.
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