As advanced registered nursing implement practice change, it is crucial that research with qualitative and quantitative data is used. Anytime there is a practice change or new technology APRN’s should be benchmarking and identifying best practices through validated information. APRNs can determine the strength of information by following Evidenced Based practice procedures and evaluating the evidence. The AACN has published a tool to evaluate the quality and strength of information (DeNisco, 2021, p 575). When comparing the level of evidence of quantitative research versus opinions, it shows that using quality and quantitative research provides more validity to the information and practice than expert opinion. Thus, when searching for information to support best practices, APRN’s should seek the highest level of evidence that can be identified when looking for information on best practices and implementation strategies.
Virtual and telehealth technologies in healthcare have truly come a long way over the last decade, however I believe that it has rapidly evolved over the last couple years due to the covid pandemic. “The evolving roles of the Internet, electronic and personal health records, mobile health, health information exchanges, and telehealth all will support a more integrated healthcare model (McGonigle & Mastrian, 2022).” I have witnessed pros and cons with the technologies. For example, during the pandemic our ED deployed the use of telemedicine for some specialty consults and for some hospitalists. This allowed the provider to not have to come to the ED and potentially be exposed and to prevent spread to other patients. Another pro I have experienced was when my grandmother had a stroke and there was not a comprehensive stroke center nearby to get her to in time to start a thrombolytic if needed, but they had a neurologist on virtual/telehealth call 24/7 for stroke consults. After this telehealth bedside consult, the decision was made by the neurologist to administer thrombolytics. This decision saved her life, she made a full recovery after having a severe CVA. One con with telehealth is the fact that you cannot have a hands-on experience. Sometimes this is necessary to get a full picture as to what is going on with the patient, such as skins, etc. One negative experience I have seen with telehealth was a patient with complaints of chest pain, who was scared to come into the ED due to the covid pandemic. The patient instead had a telehealth visit with their primary physician where the patient’s wife had shared with us that the physician felt the patient did not need to come to the ED. The patient coded at home shortly thereafter and was brought in via EMS in full arrest. Unfortunately, the patient was unable to be revived. This was a point early in the covid pandemic that really broke me down as a nurse, as this patient might have been someone who if had come to the ED, we might have been able to quickly identify a STEMI, medicate and go to cath lab and save him. The point is, if the patient had been in person, you would’ve likely performed an EKG, rapid troponin or chem 8, checked skins, peripheral pulses and other vitals and this would have led you down a different diagnosis path.
McGonigle, D., & Mastrian, K. G. (2022). Nursing Informatics and the foundation of knowledge. Jones & Bartlett Learning.
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