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“Introduction

Health Information and communication Technology (HICT) is a collective term describing the application of modern communication technologies to improve delivery of healthcare services. Such services include nursing, which is a fundamental part of the greater healthcare realm. Such technologies include real time information systems such as monitoring technologies and recording and statistical tools that help in decision making as well as error prevention. New HICT tools help in tasks such as drug administration, patient monitoring and collection of data. For example Bar Coded medication Administration is a new information communication technology that addresses the problem of error in drug administration. Erroneous drug administration has been responsible for a significant number of patient death in the modern health care setting. While errors also occur at the time of ordering and dispensing, the greater risk of error is in drug administration. This is why BCMA is emerging as an essential tool in healthcare and specifically in nursing. Technologies such as telehealth help nursing practitioners to take care of their patients without being physically present. This is especially important for chronic conditions that need constant monitoring or for volatile situations such as prisons, mental healthcare setting, and patients at a risk of congestive heart failure. This paper explores one important health information and communication technology, establishes its role in nursing care, and explains how it is changing and improving nursing practice. Home telemonitoring for congestive heart failure is one of the most common applications of information and communication technologies. It provides an appropriate subject for further exploration.

Managing patients with a high risk of congestive heart failure is a labor intensive and time consuming tasks that requires a nurse to be always on call for some patients. The problem of heart failure is common and according to Gensini et al. (2017) about 1.1% to 2.2% of the general population suffer congestive heart failure. The authors say that the prevalence of heart failure in the United States is 5.8 million. Heart failure can occur suddenly, giving little time for the patient to get proper medical attention. Heart failure often leads to immediate death or serious incapacitation of the patient. As information and telecommunication technology has developed, software applications for healthcare purposes have also been used to help nursing practitioners deliver care and make better decisions, these applications are dependent on availability of reliable and up-to-date data for them to be effective. According to Gensini et al. (2017), these applications have previously relied on medical records in a healthcare facility in order to be effective. However, with the advent of telemonitoring, it is easier to monitor patients with critical illnesses more closely and real time. In the case of patients at risk of congestive heart failure, Gensini et al. (2017) says that telemonitoring eliminates physical barriers, bureaucracy, geographic barriers and economic barriers from nursing practice in case of monitoring patients at risk of congestive heart failure.

Home telemonitoring for congestive heart failure is a telehealth application that can use a range of instruments of varying technology to relay information from a remote home to a nursing practitioner who in turn offers nursing services and guidance remotely. Such technologies may include mobile wireless devices for simple set ups and sophisticated sensor systems for more sophisticated and precise systems. Sensors collect and relay information about the condition of the patient and indicators of the level of risk of occurrence of a heart failure. Such information may be collected over a period, say, several days or weeks. Chaudhry eta al. (2008) says that heart failure is usually preceded by days or weeks of health deterioration and weight gain. According to the authors, such symptoms could help nursing practitioners to respond to preclude heart failure. As such, events such as the actual heart failure and hospitalization or death could be avoided. In general home tele-monitoring of heart failure reduces the effort needed from both the patient and the nurse in order to provide sufficient nursing care.

Support Safety and Quality of Nursing

Home telemonitoring of heart failure patients is evaluated by its ability to reduce hospitalization of the patients by reducing those chances of occurrence or recurrence of heart failure. Evidence has demonstrated that telemonitoring increases support for the patient and also improves safety by reducing chances of re-hospitalization. Lobodzinski and Jadalla (2010) say that self care and compliance to the management regime is necessary in improving homecare, but telemonitoring actually allows caregivers at home to influence nursing care provided by professionals. According to Lobodzinski and Jadalla (2010), tele monitoring creates a network that connects caregivers, patients, professional nursing care providers, and healthcare facilities. In their secondary research, Chaudhry et al. (2008) summarizes the outcomes of a randomized controlled trial where patients received calls from nurses trained in management of heart failure. The telephone calls were aimed to promote self management skills and to educate the patients more about the condition. In the trails, the nurses also monitored the vital physiological indicators of an impending heart failure and accordingly advised the patients to take appropriate medicine. This particular study monitored for the outcome of events of hospitalization and emergency room visits. 47 percent improvement in outcomes was noted for patients in home telemonitoring program. This implies that even though the rate of hospitalization and emergency room visits might not be reduced by telemonitoring, the outcome can be significantly improved by the proactive action facilitated by remote monitoring.

According to Lobodzinski & Jadalla (2010) telemonitoring improves the quality of nursing by providing a realtime datastream of physiological indicators such as blood pressure, weight, oxygen saturation, lung sounds, echocardiography data and electrocardiography data. These indicators, when used in real time by a nursing practitioner, can provide an accurate insight into the progress of the patient or the level of need of hospitalization. As observed in research, telemonitoring is able to ensure continuous support of the patient by nursing practitioners as opposed to periodic support when the patient is hospitalized. Nursing care can be delivered remotely when the patient is at home. One of the most challenging problems when managing Heart Failure prone patients is the uncertainty of an impending event, which is usually eliminated by remote monitoring. Such monitoring guarantees safety for the patient when the danger of heart failure can be detected early.  However, the biggest benefit of home telemonitoring of heart failure is the improvement of outcome of hospitalization and emergency room admissions. This success it attributable to quick and timely response that is critical in changing the prognosis of heart failure event.  Some studies indeed have provided some evidence, even though limited, that telemonitoring implemented in certain methods may not reduce the rate of hospitalization and emergency room admission. On the other hand, studies consistently show that outcomes are improved when telemonitoring is employed in heart failure management. Another question is whether the overall quality of nursing care is improved by telemonitoring. Indeed, the continuous monitoring of heartfailure patients, involvement of a multifaceted team created by telemonitoring, and the reduced cost of management amount to improvement of quality.

Facilitate Continuity of Care and Care Coordination

Continuity of care and coordination of heart failure management is possible with telemonitoring not only in terms of absence of physical barriers, but also because telehealth eliminates the cost of the physical presence of nursing practitioners. Continuity includes continuity of the team that manages a particular case. This team may include doctors, nurses, and other care givers especially the family of the patient at home. Lindi eta al (2016) opines that nursing practitioners find it necessary to continue to be in charge of management of a case of convalescence even after the patient has been discharged. Telehealth is practical solution to such nursing approaches. The authors note that continued support and nursing care of the patient will often preclude further complications or recurrence of severe heart failure in the short period after hospitalization. Not only is such continued care and monitoring helpful in encouraging the patient to engage in the  best practices, but it also ensured that the condition is managed in the manner the nursing experts expected.

The level of involvement of patients and their families in managing heart failure is limited in the inpatient setting. However with the use of home telemonitoring, patients and their families are integrated into the management program. In some instances, the family of the patient will be involved in relaying data to nursing care providers through information telecommunication tools. This is an important part of the process because the patient may not be in a position to send reliable data to the nursing practitioner. Secondly, families, as caregivers, have a duty to educate themselves on how to manage heart failure cases. Nurses can provide information about heart failure management through the network created by the telemonitoring system. According to Shea & Chamoff (2012), family members create a relationship with the nursing care providers as a step toward successful self-management of heart failure. According to Shea & Chamoff (2012) communication barriers may exist between nursing practitioners and the patient in question. In such a case, the family becomes a critical channel through which the nursing practitioners can communicate with the patient. This is important because in a case of home telemonitoring, only family members at home are closest to the patient and in position of taking immediate action. Patients and family members are an integral part of implementation of a telemonitoring system while healthcare institutions and nursing practitioners are just the other part of it.

Unexpected outcomes

Telemonitoring has been established as a reliable tool for reducing the cost of managing heart failure as well as improving the outcome of hospitalization and emergency room admission due to heart failure. However, telemonitoring is prone to unexpected outcomes especially when patients recuperating from heart failure and those with chronic heart failure are involved. In a case where the patient has acute heart failure, telemonitoring may appear not to be able to avert hospitalization and recurrence of the ailment. Telemonitorinng can also give patients a false sense of security, where they fail to understand the role of the monitoring system in heart failure management”

Online term paper help with nursing papers

For nursing students, term papers are a usual thing that they have to deliver to the instructor. Every session in training at the nursing school may call for a term paper to be written. Other times, a report is required for the trainees to be evaluated for their ability to document their observations and how well they can adapt to patients changing needs. For example, a nurse trainee working in the general ward will be asked to deliver a report about the experiences in that particular department.