Expanded Registered Nursing and Healthcare Outcomes

PICOT Statement/Clinical Question

Does the implementation of an expanded RN during telehealth visits improve healthcare outcomes?

• P: clinical team members in telehealth visits
• I: Expanded RN and MD/NP (APP) role share during the telehealth visit
• C: APP only visits
• O: improved efficiency and effectiveness of healthcare provided: improved patient outcomes, less provider burnout, more money made for the clinic.

Problem, Objectives, and Significance Statements

Problem Statement

A registered nurse (RN) plays a vital role in the clinical environment, particularly, within a team, as the member responsible for its support alongside Advanced Practice Providers (APPs) (Delaney & Vanderhoef, 2019). Thus, pressure can be removed from APPs as a result of a change in the workload amount. Due to the increased amount of information to process and the necessity for remote support of patients, the role of Telehealth in nursing has increased (Honey & Wright, 2018). However, because of an increase in the focus on patient education, RNs are drastically underutilized in the clinical setting, which limits the opportunities for APPs to tend to patients’ needs properly (Blouin & Podjasek, 2019).

Similarly, the number of APPs as the staff members that evaluate patients, diagnose health issues, and administer treatments, has been insufficient lately (Qureshi et al., 2019). Nevertheless, APPs are in high demand, which means that the redistribution of responsibilities, roles, and workload is needed. It is believed that nurses can be used in telehealth to communicate with patients, define health issues, outline possible solution strategies, and relay the data to APPs succinctly, thus, improving the efficacy of services delivered by APPs.

Objective Statement

The objective of this study is to evaluate the effect of utilizing an expanded RN role during telehealth visits and the effect it has on clinical outcomes (for patients/clinical efficiency).

Significance Statement

Over the past couple of years, the demand for clinical services has risen to a significant extent. Therefore, it has become particularly important to restructure the system in a way that would allow catering to as broad an audience as possible. The described opportunity is vital both for patients, who would benefit from a greater extent of attention from APPs, and administrators, who could improve the performance of the unit (Blouin & Podjasek, 2019).

Moreover, the opportunity for a successful follow-up would increase in this case with the development of time management and delegation skills (Honey & Wright, 2018). Finally, the cost to society as far as health rates and the productivity of clinical services would improve due to the increased range of services that APPs would provide and a greater audience that they would embrace.

References

Blouin, A. S., & Podjasek, K. (2019). The continuing saga of nurse staffing: Historical and emerging challenges. JONA: The Journal of Nursing Administration, 49(4), 221-227. Web.

Delaney, K. R., & Vanderhoef, D. (2019). The psychiatric mental health advanced practice registered nurse workforce: Charting the future. Journal of the American Psychiatric Nurses Association, 25(1), 11-18. Web.

Honey, M., & Wright, J. (2018). Nurses developing confidence and competence in telehealth: results of a descriptive qualitative study. Contemporary Nurse, 54(4-5), 472-482. Web.

Qureshi, S. M., Purdy, N., Mohani, A., & Neumann, W. P. (2019). Predicting the effect of nurse–patient ratio on nurse workload and care quality using discrete event simulation. Journal of Nursing Management, 27(5), 971-980. Web.