Date of Award

Spring 5-22-2021

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Joseph Burkard, DNSc, CRNA

Abstract

Abstract

Optimizing best clinical telehealth practices among APRNs

Abstract Title: Optimizing best clinical telehealth practices among APRNs through a survey that gauges their preparedness in core competencies and their recommendations.

Background: In April 2020, about half of all Medicare primary care visits were done through telehealth due to the COVID-19 pandemic. Telehealth evoked a strong positive response among patients, which created a new niche in healthcare. To effectively leverage its value, one of its key goals is the promotion of best clinical practices (Agrawal, 2020). However, very little information was found about programs that address NP training in telehealth. There are no standard competencies to date, and telehealth among APRNs has been mostly through experiential learning (Sharma, 2019). Therefore, a study geared toward the promotion of best telehealth practices is necessary to optimize its value.

Problem Statement: There is a need to develop and expand telehealth training among APRN students to improve telehealth clinical practice. If not addressed, this will deter the optimization of the value of telehealth. Research has shown that the lack of standardized core competencies and the limited research on APRNs’ telehealth training led to the necessity of advancing telehealth competencies. Perhaps, a study that investigates the level of preparedness among the APRNs, the core competencies used, and their recommendations will upgrade telehealth training and promote best clinical practices in the field.

EBP Model/Frameworks: This project initiative will utilize the data-driven policy framework by Weinke and Shin (2004). The data derived from this study will intensify the need to develop, restructure and find best practices in telemedicine training among APRNs. It will provide further fuel to telemedicine’s evolution in the academic sectors in developing core competencies and assessing and monitoring readiness responses among APRN students. Data can support crafting policies in order to strengthen and sustain telemedicine training as a health care safety net.

Methodology: This will be a retrospective review of non-identified survey data. The survey data will be conducted among APRN students, new graduates, and licensed professionals to evaluate telehealth best practices. The context of the questionnaire is derived from the core competencies used in training virtual practitioners, proposed by Sharma et al. (2019). It gauged the level of preparedness among APRNs for each competency and solicited recommendations for cultivating best practices in each field. The data set includes twenty-seven domains and six non-identified demographic fields.

Results: Based on the survey, 64.7% of the participants received telehealth training either in school or at their workplace. The domain which is often not addressed or discussed in school is on billing, licensing, and insurance, and likewise this domain is also where APRN students also feel the most pain in addition to topics on screen share and troubleshooting technological problems. Recommendations for best practices in telehealth include: more training and practice, and incorporating telehealth curriculum

Clinical Importance/Conclusion: This study will charge openness among institutions who have implemented telemedicine training to share experiences, stimulate research on best practices, and develop standard core competencies to be implemented in the curricula. The evidence will support in lobbying integration of telemedicine in APRN education and launching medical virtualism accreditation and certification.

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